Ciprofloxacin: an oral quinolone for the treatment of infections with gram-negative pathogens. Committee on Antimicrobial Agents. Canadian Infectious Disease Society.
OBJECTIVE
To optimize the use of ciprofloxacin, a synthetic fluoroquinolone, in community and hospital practice, and to minimize overprescribing by providing an overview of the literature and recommendations for appropriate use.


METHODS
First-line treatment for infections in which ciprofloxacin is shown to be effective, treatment with oral ciprofloxacin rather than parenteral therapy with another drug, and step-down therapy with oral ciprofloxacin after initial parenteral treatment.


RESULTS
In order of importance: efficacy, side effects and cost.


METHODS
A MEDLINE search of articles concerning ciprofloxacin, including in-vitro and pharmacokinetic studies using recognized standard methods with appropriate controls and published in recognized peer-reviewed journals, and randomized, controlled, double-blind clinical trials.


METHODS
The Committee on Antimicrobial Agents of the Canadian Infectious Disease Society (CIDS) and a recognized expert (T.J.L.) recommended use of ciprofloxacin to treat infections against which it has proved effective both in vitro and in randomized controlled trials. They took into account its value as an oral replacement for other drugs given parenterally and development of resistance.


RESULTS
With more appropriate use of ciprofloxacin there will be less development of resistant pathogens. For certain infections patients who would otherwise require admission to hospital could be treated at home and patients initially admitted for parenteral therapy could be discharged sooner on oral therapy with ciprofloxacin.


CONCLUSIONS
Ciprofloxacin may be considered as first-line treatment for a number of infections in which gram-negative pathogens are proven or strongly suspected, including complicated urinary tract infections, bacterial prostatitis, bacterial diarrhea, selected bone and joint infections, malignant otitis externa, bronchopulmonary infections in patients with cystic fibrosis and selected pneumonia cases.


RESULTS
The paper was prepared, reviewed and revised by the Committee on Antimicrobial Agents of the CIDS. It was then reviewed and revised further by the Council of the CIDS.


BACKGROUND
The CIDS is solely responsible for developing, funding and endorsing these guidelines.
Louie
T J
TJ
Division of Infectious Diseases, University of Calgary, Alta.
D000284:Administration, Oral; D002939:Ciprofloxacin / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D003967:Diarrhea / Q000188:drug therapy / Q000382:microbiology; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000382:microbiology; D012749:Sexually Transmitted Diseases / Q000188:drug therapy / Q000382:microbiology; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000382:microbiology; D014946:Wound Infection / Q000188:drug therapy / Q000382:microbiology
D002939:Ciprofloxacin