Ofloxacin versus vancomycin/polymyxin for prevention of infection in granulocytopenic patients

Article Abstract:

Granulocytopenia is an abnormal decrease in granulocytes, a type of white blood cell in the bone marrow. The disease is often associated with bacterial infections and can be controlled by antibiotics. Under normal conditions, the gastrointestinal tract has anaerobic bacteria, which prevent the growth of aerobic bacteria, that is, bacteria that require oxygen to thrive. Ofloxacin is an antibiotic that specifically attacks aerobic bacteria, such as gram-negative bacilli and gram-positive cocci, but preserves the natural anaerobic bacteria in the gastrointestinal tract. The effectiveness and safety of ofloxacin were compared with that of the antibiotic mixture vancomycin/polymyxin in treating bacterial infections in 62 patients with granulocytopenia. There were fewer numbers of gram-negative bacilli organism per patient, fewer patients with infection, and fewer cases of septicemia, or bacteria in the blood, in the group receiving ofloxacin than those receiving the antibiotic mixture. Ofloxacin was also better tolerated and caused fewer side effects. However, neither of the antibiotic preparations could eliminate infection by viridans group streptococci, coagulase-negative staphylococci, or other gram-positive organisms. Three types of bacteria that were resistant to inactivation by ofloxacin were isolated but did not cause infections. The results show that ofloxacin is a more effective and tolerable antibiotic than vancomycin/polymyxin for the prevention of infections by gram-negative bacteria in granulocytopenic patients, although more effective treatment is needed to prevent gram-positive infections.

Drug therapy, Antibacterial agents, Vancomycin, Bacterial infections, Immunologic diseases

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Introduction: ofloxacin (Symposium: Ofloxacin: a pharmacodynamic advance in quinolone antimicrobial therapy)

Article Abstract:

The quinolone antibiotics that were first introduced in 1962 were effective against only a few types of microorganisms, and were associated with the rapid development of resistance or insensitivity of microorganisms to these agents. Changes in the chemical structure of the original quinolones resulted in newer derivatives, which are effective against a greater variety of microorganisms, and have a lower incidence of resistance, fewer unfavorable side effects, and improved pharmacokinetics (the characteristics of the drug that describe its absorption, distribution, metabolism, and elimination from the body). The new quinolones can be taken orally or by mouth for the treatment of infections by gram-negative type bacteria, such as Pseudomonas aeruginosa and Acinetobacter, and urinary tract infections by multiply resistant microorganisms. The new quinolone antibiotic ofloxacin is effective in treatment of Enterobacteriaceae, Pseudomonas, and Streptococcus pneumoniae infections, cystitis (inflammation of the bladder), urinary tract infections, and prostatitis (inflammation of the prostate gland), sexually transmitted diseases, and skin infections. Ofloxacin has favorable pharmacokinetic properties, and no serious side effects; nausea, insomnia or inability to sleep, headache, and dizziness occur in five percent of patients. Recent studies show that the new quinolone antibiotic ofloxacin may be useful in the treatment of a variety of bacterial infections. (Consumer Summary produced by Reliance Medical Information, Inc.)

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In vitro antimicrobial activity and susceptibility testing of ofloxacin: current status

Article Abstract:

The fluoroquinolone antibiotic ofloxacin has a broad antibacterial spectrum, meaning that it is effective in preventing the growth of a wide variety of bacteria. The sensitivity of bacterial types is determined by measuring the minimal inhibitory concentration, or least amount of antibiotic required to prevent the growth of a bacteria. Ofloxacin inhibited 100 percent of Staphylococci (including strains resistant to another antibiotic, oxacillin), Haemophilus influenzae, Neisseria, Branhamella catarrhalis, 95 percent of Enterobacteriaceae, 79 percent of Pseudomonas aeruginosa, and 63 percent of enterococci. Clostridium bacteria, including Clostridium difficile, were resistant or insensitive to ofloxacin, whereas other anaerobic bacteria such as Bacteroides were fully or partially sensitive. Ofloxacin is bactericidal, in that it can kill bacteria at amounts greater than those required to prevent bacterial growth. When a sensitive bacterial type is exposed to increasing amounts of nalidixic acid, the original quinolone antibiotic, the bacteria rapidly develops resistance or insensitivity to all other quinolones, including ofloxacin. Various aspects of measuring MIC for determining the sensitivity of various strains of bacteria to ofloxacin are described. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Drug resistance, Nalidixic acid, Urinary anti-infective agents

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