title: Inappropriate use of oral ciprofloxacin.
abstract: More than $2.4 billion is spent annually on oral antibiotics. Their inappropriate use is common, and newer ones offer expanded and expensive opportunities for abuse. Ciprofloxacin, an oral quinolone with systemic absorption and broad antimicrobial spectrum, illustrates this pattern. Since its release in the US in October 1987, ciprofloxacin has rapidly become one of the most frequently prescribed oral antibiotics. We have observed widespread inappropriate use of ciprofloxacin and describe several patterns of misuse. The activity of ciprofloxacin against streptococci, anaerobic organisms, and Mycoplasma ranges from intermediate to poor. Properly used, ciprofloxacin can extend the range of oral therapy. However, ciprofloxacin is inappropriate initial therapy for common outpatient infections, including otitis media, sinusitis, pharyngitis, and pneumonia.
authors.affiliation: Infectious Disease Section, Yale University School of Medicine, New Haven, Conn.
authors.forename: T R
authors.initials: TR
authors.lastname: Frieden
authors.forename: R J
authors.initials: RJ
authors.lastname: Mangi
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002481:Cellulitis / Q000188:drug therapy; D002939:Ciprofloxacin / Q000008:administration & dosage / Q000009:adverse effects*; D004363:Drug Utilization / Q000592:standards; D005260:Female; D006300:Health Services Misuse; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000188:drug therapy; D011019:Pneumonia, Mycoplasma / Q000188:drug therapy; D011018:Pneumonia, Pneumococcal / Q000188:drug therapy; D013296:Streptococcus pneumoniae
chemical_list: D002939:Ciprofloxacin