[Ciprofloxacin in the treatment of hospital-acquired pneumonia: a surveillance study in 676 patients].
BACKGROUND
Controlled clinical trials have shown efficacy of high-dose ciprofloxacin for hospital-acquired (HAP) or nosocomial pneumonia. But it has yet to be demonstrated whether this good efficacy also holds true for routine intensive-care patients outside of controlled trials.


METHODS
In a post-marketing surveillance study at 87 intensive-care units in Germany we analyzed 676 cases of nosocomial pneumonia treated with intravenous ciprofloxacin in a daily dosage of at least 400 mg.


RESULTS
538 (80 %) patients were evaluable for efficacy. Cure or improvement was reported in 76 % of the cases. Clinical success rate was higher in previously untreated patients receiving ciprofloxacin as monotherapy (85.3 %) or in combination with other antibiotics (78.4 %) than in those who received ciprofloxacin as monotherapy (73.1 %) or as combination therapy (69.2 %) after an antibiotic pretreatment. In the 66 patients with Pseudomonas aeruginosa as causal pathogen, clinical success rate was 86.4 %. 32 adverse events classified as possibly or probably related to ciprofloxacin occurred in 3.1 % of patients; all of those were reversible.


CONCLUSIONS
Due to the high success rate, even in cases with failed antimicrobial pretreatment, and the favourable risk-benefit ratio of high-dose ciprofloxacin, ciprofloxacin appears to be an attractive choice in the empiric treatment of hospital-acquired pneumonia.
Kljucar
S
S
DRK-Kliniken Westend, Zentrale Abteilung für Anästhesiologie und Intensivmedizin, Berlin, Germany.
Rost
K L
KL
Landen
H
H
D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002939:Ciprofloxacin / Q000008:administration & dosage / Q000627:therapeutic use*; D003428:Cross Infection / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005858:Germany; D006801:Humans; D007262:Infusions, Intravenous; D011014:Pneumonia / Q000188:drug therapy*; D011552:Pseudomonas Infections / Q000188:drug therapy; D011550:Pseudomonas aeruginosa
D000890:Anti-Infective Agents; D002939:Ciprofloxacin