Efficacy and safety of long-term ciprofloxacin in the management of severe bronchiectasis.
The efficacy and safety of long-term ciprofloxacin therapy in the management of severe bronchiectasis were retrospectively assessed in patients who had taken oral ciprofloxacin continuously for at least 90 days. The drug was well tolerated, with only one reported side effect. Treatment resulted in a symptomatic improvement in seven of the ten patients and significant improvements in peak expiratory flow rate and residual volume. There was a decrease in the number of infective exacerbations from 6.2 +/- 2.9 during 365 days to 0.5 +/- 0.53 during 412 days. Resistance to ciprofloxacin developed in 2 patients with Pseudomonas aeruginosa infection and this was associated with clinical deterioration, but in a further two patients with P. aeruginosa the pathogen was eradicated. Two patients had persistent Streptococcus pneumoniae cultured from sputum but this was not associated with clinical deterioration. The study suggests that ciprofloxacin is effective and safe in the long-term treatment of chronic bronchial sepsis due to bronchiectasis, but emergence of P. aeruginosa resistance is of some concern.
Department of Thoracic Medicine, Royal Brompton National Heart and Lung Institute, London, UK.
C F
CF
Rayner
G
G
Tillotson
P J
PJ
Cole
R
R
Wilson
D000328:Adult; D000368:Aged; D001987:Bronchiectasis / Q000188:drug therapy* / Q000382:microbiology* / Q000503:physiopathology; D002939:Ciprofloxacin / Q000009:adverse effects* / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008168:Lung / Q000187:drug effects / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000188:drug therapy; D011550:Pseudomonas aeruginosa; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D013183:Sputum / Q000382:microbiology
D002939:Ciprofloxacin