Ciprofloxacin: major advances in intravenous and oral quinolone therapy: an introduction

Article Abstract:

The fluoroquinolone-type antibiotics are currently of great interest in terms of their mechanism of action, therapeutic use, and pharmacology (which is the study of the origin, nature, properties and effects of drugs). Two types of fluoroquinolones, ciprofloxacin and norfloxacin, have been available for use in the United States for the past three years. These drugs suppress the replication or duplication of bacterial deoxyribonucleic acid (DNA, which carries the genetic information of the cell) by preventing the action of bacterial DNA gyrase, an enzyme that causes the coiling arrangement of the DNA molecule. The study of the interaction between fluoroquinolones and DNA gyrase will contribute to the understanding of how some bacteria develop resistance or insensitivity to these drugs. In the United States and other parts of the world, most bacteria, with the exception of Pseudomonas aeruginosa and Staphylococcus aureus, have not developed resistance to the fluoroquinolones. These agents are available in oral forms and ciprofloxacin has been used to treat respiratory, skin, bone, gastrointestinal and urinary tract infections. Their interactions with other medications have been studied. Ciprofloxacin is the first fluoroquinolone to be used intravenously, which involves injecting the drug directly into the circulation. The applications of intravenous ciprofloxacin and its comparison with other intravenous antibiotics have also been examined. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Drug resistance, Drug interactions

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Resistance to ciprofloxacin appearing during therapy

Article Abstract:

The development of resistance to the fluoroquinolone antibiotic ciprofloxacin, or the loss of sensitivity to this drug, was examined in nine clinical isolates of Pseudomonas aeruginosa bacteria from patients with infections. The isolates showed an increase in minimal inhibitory concentration (MIC), which is a measure of the minimum amount of drug required to prevent the growth of the bacteria, indicating the development of resistance. The isolates were resistant to other fluoroquinolones, ofloxacin and norfloxacin, but not to the antibiotics aminoglycosides, antipseudomonas penicillins, or cephalosporins. One isolate from a patient with endocarditis, or inflammation of the lining membrane of heart, showed a decrease in an outer membrane protein, increase in MIC, and impaired uptake of ciprofloxacin. Bacteria obtained from patients with cystic fibrosis, an inherited disease of the exocrine glands associated with long-term respiratory infections, did not show a loss of outer membrane proteins, although there was evidence of change in the membrane lipopolysaccharides, compounds of glucose and lipids. The resistant bacteria were affected by combinations of ciprofloxacin and tobramycin or ceftazidime, although the doses required for prevention of bacterial growth were extremely high. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Drug resistance in microorganisms, Microbial drug resistance, Microorganisms

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Introduction (effectiveness of the fluoroquinolone antibiotics)

Article Abstract:

Fluoroquinolones are a new group of antibiotics that have recently become available. One of these fluoroquinolones is called temafloxacin. It has been clinically tested and is extremely safe with minimum side effects. Fluoroquinolones act against a wide spectrum of bacteria, including those that are resistant to other types of antibiotics. Hence, fluoroquinolones can be used to treat a variety of illnesses. Fluoroquinolones inhibit one of the enzymes in bacteria that is involved in the synthesis of DNA, the component of the genes of the bacteria. The rate at which bacteria become resistant to these antibiotics is very low. Temafloxacin works well in the body; it is completely absorbed and high levels are distributed in many tissues. The drug is not metabolized by the body and therefore does not react with other drugs. The antibiotic remains active in the body for a long time period, at least eight hours. Therefore, the fluoroquinolones, in particular temafloxacin, are very effective antibiotics and can be used to treat a variety of bacterial infections. (Consumer Summary produced by Reliance Medical Information, Inc.)

Fluoroquinolones, Temafloxacin

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