title: Sequential intravenous-oral ciprofloxacin plus amoxycillin/clavulanic acid shortens hospital stay in infected non severe neutropenic patients.
abstract: The objective of this study was to determine the efficacy and safety of the combination ciprofloxacin plus amoxicillin/clavulanic acid as an empirical treatment of infection in hematologic patients without severe neutropenia. These drugs allowed us to carry out a sequential therapy, first intravenously and later orally, so that the patient could be discharged as soon as there was a response. Serum concentrations of ciprofloxacin were monitored in this study. Forty seven of the sixty-six patients included (71%) responded to the treatment with no differences between the dosages of ciprofloxacin employed (600-900 mg daily in two or three divided doses). In the patients who responded, the signs and symptoms of infection lasted only three days, which could allow a short hospital stay (median of six days). In the first pre and post-dose serum samples, ciprofloxacin concentrations were significantly higher when the drug was administered every 8 h. Nevertheless, 72 h after the beginning of treatment, they had leveled out in either 8 and 12 h schemes. The toxicity of the treatment was very light, with only four cases with adverse effects, grades I and II. This data suggests that the employed combination is effective and safe and can considerably decrease costs incurred through the admission of hematologic patients with serious infections but without severe neutropenia.
authors.affiliation: Hematology Department, University Hospital of Salamanca, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Vallejo
authors.forename: M D
authors.initials: MD
authors.lastname: Caballero
authors.forename: R
authors.initials: R
authors.lastname: García-Sanz
authors.forename: J M
authors.initials: JM
authors.lastname: Hernández
authors.forename: L
authors.initials: L
authors.lastname: Vázquez
authors.forename: M C
authors.initials: MC
authors.lastname: Cañizo
authors.forename: J
authors.initials: J
authors.lastname: Galende
authors.forename: C I
authors.initials: CI
authors.lastname: Colino
authors.forename: A
authors.initials: A
authors.lastname: Gil-Hurlé
authors.forename: J F
authors.initials: JF
authors.lastname: San Miguel
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000658:Amoxicillin / Q000008:administration & dosage / Q000627:therapeutic use; D000704:Analysis of Variance; D001424:Bacterial Infections / Q000150:complications / Q000188:drug therapy*; D002939:Ciprofloxacin / Q000009:adverse effects / Q000627:therapeutic use; D019818:Clavulanic Acid / Q000008:administration & dosage / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications*; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D019818:Clavulanic Acid; D002939:Ciprofloxacin; D000658:Amoxicillin