[The use of ciprofloxacin in patients with osteomyelitis associated with vascular insufficiency].
Osteomyelitis in patients with peripheral vascular insufficiency (PVI) has several characteristics which make its management a very difficult and controversial one. Generally it requires a prolonged course with broad spectrum intravenous antibiotics, which in turn requires hospitalization, increased risk of side effects and elevated cost. During the last years, the investigators developed the fluoroquinolones, which may help to simplify this treatment. These agents inhibit the synthesis of bacterial deoxyribonucleic acid. Ciprofloxacin is one of the most active of them. It has the following characteristics: broad spectrum of action, rapid absorption when administered by oral route, tolerated well by the patient, may be administered only twice a day, reach therapeutic concentrations in bone and it was more effective when compared with other antibiotics under the same conditions. Although the development of resistance against it has been clinically significant, it has been reported. We, the physicians, have the responsibility to use the quinolones correctly to avoid the development of resistance. Actually, ciprofloxacin is indicated for the treatment of osteomyelitis in patients with PVI, if it is bacteriologically documented. It is not indicated for empirical use. We use 750mg every 12 hours during 3 to 6 months. We have not been presenting ciprofloxacin as a panacea, but as an effective alternative, with clear indications that can decreases the cost of the treatment of osteomyelitis associated with PVI.
García-Rosario
L N
LN
Programa de Enfermedades Infecciosas, Escuela de Medicina, Universidad de Puerto Rico, San Juan 00927-5800.
Ramírez-Ronda
C H
CH
D000890:Anti-Infective Agents / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D004352:Drug Resistance, Microbial; D006801:Humans; D007866:Leg / Q000098:blood supply*; D010019:Osteomyelitis / Q000150:complications / Q000188:drug therapy*; D014652:Vascular Diseases / Q000150:complications*
D000890:Anti-Infective Agents; D002939:Ciprofloxacin
El uso de ciprofloxacin en pacientes con osteomielitis asociada a insuficiencia vascular.