复方环丙沙星耳用滴丸临床疗效观察

目的观察、评价复方环丙沙星耳用滴丸的临床疗效。方法将140例慢性中耳炎患者随即分为治疗组和对照组,治疗组给予复方环丙沙星耳用滴丸治疗,对照组给予复方环丙沙星滴耳液治疗,观察治疗前后患者的临床症状和体征,以及病原菌转阴情况,并对上述指标进行量化分级。结果治疗组的有效率和病原菌转阴率明显大于对照组(P<0.01)。结论复方环丙沙星耳用滴丸治疗慢性化脓性中耳炎的临床效果显著优于滴耳液。     

乳酸环丙沙星淀粉微球的体外释药研究

目的：制备乳酸环丙沙星淀粉微球并对其体外释放行为进行考察。方法：采用反相乳液聚合法结合包埋载药法制备乳酸环丙沙星淀粉微球，应用体外恒温透析法考察其释药行为及影响因素，以紫外可见分光光度法测定并计算累积释药百分数。使用origin软件，将微球释药数据与载药微粒的主要释药方程进行拟合，以找出最佳拟合释药方程。结果：制备的乳酸环丙沙星淀粉微球置于生理盐水中约5小时后达到释放平衡，其释放行为受处方中球-药比和交联剂用量及释放介质的影响。该载药淀粉微球的释药行为最符合双指数双相动力学方程，即呈双相释放，前期为快速释放相，后期（5小时后）为缓慢释放相。结论：本制剂工艺切实可行，所得乳酸环丙沙星淀粉微球具有明显的缓释制剂特征。     

大肠埃希菌对氟喹诺酮类和阿米卡星的耐药性分析

目的 了解大肠埃希菌对氟喹诺酮类和阿米卡星的耐药性.方法 CLSI表型确证试验(纸片增强法)检测产超广谱β-内酰胺酶(ESBLs)菌株,脂稀释法进行药敏试验.结果 361株大肠埃希菌中,产ESBLs菌株的检出率为33.8%(122/361).产ESBLs菌株对环丙沙星、左氧氟沙星、阿米卡星的耐药率分别为93.4%、90.9%、13.1%;非产ESBLs菌株对环丙沙星、左氧氟沙星、阿米卡星的耐药率分别为69.5%、68.6%、19.7%.结论 大肠埃希菌对阿米卡星较为敏感;对氟喹诺酮类耐药显著,且产ESBLs菌株的耐药率高于非产ESBL5菌株.     

Ciprofloxacin in typhoid fever

The study covers 78 children with typhoid fever who were hospitalized in April & May 1990. Serious complications were present in 32% (toxemia 22%, ileus 25% and myocarditis 8%). Blood cultures were positive in 30 of 49 tested. Others were diagnosed by positive Widal test.In vitro cultures ofS. typhi were resistant to chloramphenicol (90%), ampicillin (93%) and co-trimoxazole (97%). However all were highly sensitive to ciprofloxacin and moderately sensitive to cephalexin and gentamycin. Ciprofloxacin alone or in combination was given in 73 of the 78 children and found to be remarkably effective in controlling the disease and preventing relapse. No serious side effects were noted. The cohort is being followed up for possible long term adverse effects.     

复方环丙沙星滴眼液的制备及质量控制

目的:制备复方环丙沙星滴眼液并建立其质量控制方法。方法:采用紫外分光光度法测定环丙沙星含量,高效液相色谱法测定利巴韦林含量。结果:环丙沙星和利巴韦林检测浓度分别在19~56μg/ml(r=0·9995,n=5)和30~70μg/ml(r=0·9998,n=5)范围内线性关系良好,平均回收率分别为100·9%(RSD=0·83%,n=5)和99·66%(RSD=0·54%,n=5)。结论:本滴眼液配制工艺简单,性质稳定,质量可控。     

Single-dose oral ciprofloxacin compared with single-dose intravenous cefazolin for prophylaxis in inguinal hernia repair: a controlled randomized clinical study

The aim of this study was to compare the efficacy of single-dose intravenous cefazolin prophylaxis with single-dose oral ciprofloxacin prophylaxis in patients undergoing tension-free inguinal hernia repair with polypropylene mesh. In a prospective and randomized setting, 395 patients received either a single dose of 500 mg of ciprofloxacin orally, 1--2h before the operation, or a single dose of 1g cefazolin intravenously on induction of anaesthesia. The primary outcome was to determine the wound infection rate within one year. The overall infection among the entire study population was 2% (eight of 395) including 2% (four of 199) of those receiving intravenous cefazolin and 2% (four of 196) of those treated with oral ciprofloxacin. There was no statistically significant difference between groups (P=0.59). All the infections were superficial incisional surgical site infections, and none progressed to a deep infection. Escherichia coli was the most commonly isolated bacterium. None of the infected patients developed recurrence of hernia. The rate of recurrence was 1.3% (five of 395) at one year including 2% (four of 199) of those receiving cefazolin and 0.5% (one of 196) of those receiving ciprofloxacin. Oral ciprofloxacin prophylaxis was found to be an attractive option with its wide antibacterial spectrum, low cost and ease of administration in patients undergoing tension-free inguinal hernia repair with polypropylene mesh.     

Topical ciprofloxacin/dexamethasone is superior to ciprofloxacin alone in pediatric patients with acute otitis media and otorrhea through tympanostomy tubes

OBJECTIVE: To determine whether topical administration of a corticosteroid improves resolution of acute tympanostomy tube otorrhea when combined with topical antibiotic drops. STUDY DESIGN: Randomized, patient-masked, parallel-group, multicenter trial of topical otic ciprofloxacin/dexamethasone versus topical ciprofloxacin alone in 201 children aged 6 months to 12 years with acute otitis media with tympanostomy tubes (AOMT) of less than or equal to 3 weeks' duration and visible otorrhea. METHODS: Eligible patients were randomized to receive three drops of either ciprofloxacin 0.3%/dexamethasone 0.1% or ciprofloxacin 0.3% into the affected ear or ears twice daily for 7 days. Clinical signs and symptoms of AOMT were evaluated on days 1 (baseline), 3, 8 (end-of-therapy), and 14 (test-of-cure), and twice-daily assessments of otorrhea were recorded in patient diaries. RESULTS: The mean time to cessation of otorrhea in the microbiologically culture-positive patient population (n = 167) was significantly shorter with topical ciprofloxacin/dexamethasone than with ciprofloxacin alone (4.22 vs. 5.31 days; P =.004). This resulted in significantly better clinical responses on days 3 and 8 (P <.0001 and P =.0499, respectively). However, there were no significant differences between the two treatment groups in either the clinical response or the microbial eradication rate by day 14. CONCLUSIONS: Topical otic treatment with ciprofloxacin/dexamethasone is superior to treatment with ciprofloxacin alone and results in a faster clinical resolution in children with AOMT. The contribution of the corticosteroid in achieving a 20% reduction (1.1 day) in time to cessation of otorrhea is clinically meaningful and represents an important advance over single-agent antibiotic therapy.     

An HPTLC method for the determination and the purity control of ciprofloxacin HCl in coated tablets

A high-performance thin-layer chromatographic method (HPTLC) has been developed for the determination and the purity control of a synthetic fluoroquinolone antibiotic ciprofloxacin hydrochloride in coated tablets when desfluoro compound, ethylene diamine compound, by-compound A and fluoroquinolonic acid are considered as impurities. Silica gel F₂₅₄ was used as a stationary phase and a mixture of acetonitrile, ammonia 25%, methanol and methylene chloride (1:2:4:4, v/v/v/v) as a mobile phase. The method was validated in terms of linearity (range), selectivity (placebo and related compounds), precision, accuracy (Recovery), system suitability (repeatability, peak symmetry, resolution) and impurities limit of detection (LOD). The analysis of variance (ANOVA) and t-test were applied to correlate the results of ciprofloxacin hydrochloride determination in coated tablets by means of the HPTLC method and the official British Pharmacopoeia (BP 1999) high-performance liquid chromatographic (HPLC) method.     

Prevalence of Ciprofloxacin-Resistant Escherichia coli in Hematologic-Oncologic Patients

Summary Background: The objective of this study was to characterize the prevalence and clinical significance of ciprofloxacin-resistant Escherichia coli in perianal swabs of patients with hematologic malignancies in a German university hospital. Patients and Methods: Weekly surveillance cultures were performed for 26 weeks. 294 perianal swabs were obtained from 104 consecutive patients. Species discrimination, susceptibility testing and genotyping using pulsed-field gelelectrophoresis (PFGE) was performed for all E. coli isolates. Preceding antibiotic prophylaxis and treatment as well as the frequency and duration of the hospital stay in the 6 months prior to the study were analyzed. Results: A total of 31 patients (29.8%) were colonized with E. coli strains. Although 81.8% of the patients colonized with ciprofloxacin-resistant E. coli had received former treatment with ciprofloxacin, this finding did not reach statistical significance, probably due to the small study population. During the surveillance period one of the colonized patients developed septicemia with a ciprofloxacin-resistant E. coli. Genotypic identity was demonstrated for the E. coli isolates from perianal swab and blood culture. Conclusion: We propose that selective gut decontamination with ciprofloxacin should be discontinued as a routine measure for all neutropenic patients in the department under investigation. We propose waiving oral decontamination in low-risk patients with neutropenia of only a few days duration. For all other patients, a regimen with alternating prophylactic treatments of cotrimoxazol and fluoroquinolone should be considered. Received: August 24, 1999 · Revision accepted: July 1, 2000