Investigation of the clinical efficacy and dosage of intravenous ciprofloxacin in patients with respiratory infection.
OBJECTIVE
Infection control is particularly vital in hospitals, and proper use of antimicrobial drugs is one of the most important roles of hospital pharmacists. In this study, we surveyed patients who had been prescribed single-use ciprofloxacin (CPFX), and evaluated the blood concentration of CPFX from the predictive AUC (area under the concentration curve).


METHODS
This study was performed retrospectively to 112 adult patients diagnosed as having respiratory infections who had been treated as inpatients with intravenous CPFX for more than 3 days at Toho University Omori Hospital in Tokyo. The predictive AUC of each patient was obtained from the modified formulae reported by Forrest et al. (1993) [1]. The relation between the antimicrobial activity of CPFX and pharmacokinetic/pharmacodynamic (Cmax, AUC and AUC/MIC (minimum inhibitory concentration)) was studied.


RESULTS
Although CPFX is excreted from the kidney, standard treatment with this drug does not take renal function into consideration. Our results indicated that CPFX was effective in less than 50% of the patients who received it. Moreover, the AUC/MIC ratio in both the effective group and the failure group was less than 125 when the clinical target was gram-negative bacteria.


CONCLUSIONS
These results suggest that the clinical use of CPFX for the treatment of infectious diseases does not reach the target AUC/MIC ratio, and that the concentration of CPFX is not within the range to which many pathogens are susceptible in a large proportion of patients. To ensure the effective treatment of patients with infectious diseases and to prevent the development of resistance in bacteria, we recommend therapeutic drug monitoring (TDM) of CPFX in hospitals.
Matsuo
Kazuhiro
K
Department of Pharmacy, Toho University Omori Medical Center, 6-11-1 Omorinishi, Ota-ku, Tokyo 143-8540,Japan.
Azuma
Minako
M
Kasai
Maki
M
Hanji
Itsuka
I
Kimura
Itsuki
I
Kosugi
Takayoshi
T
Suga
Noriko
N
Satoh
Mitsutoshi
M
D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002939:Ciprofloxacin / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D015201:Meta-Analysis as Topic; D055656:Prescriptions; D012141:Respiratory Tract Infections / Q000188:drug therapy*
D000890:Anti-Infective Agents; D002939:Ciprofloxacin