Saengsuwan Phanvasri, Jaruratanasirikul Sutep, Jullangkoon Monchana, Aeinlang Nanchanit
Department of Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
J Med Assoc Thai. 2010 Jul;93(7):784-8.
To compare the ratio of the area under the concentration-time curve at 24 hours to the minimum inhibitory concentration value (24-h AUC/MIC) of ciprofloxacin between 400 mg intravenously every 8 h and 400 mg intravenously every 12 h.
A prospective, randomized, two-way crossover study of 10 patients with gram-negative bacilli bacteremia was conducted. All patients were randomized to receive ciprofloxacin in both regimens consecutively: (i) 400 mg intravenously every 8 h for four doses; (ii) 400 mg intravenously every 12 h for four doses. Ciprofloxacin pharmacokinetic studies were carried out after the start of both regimens.
For the ciprofloxacin 400 mg intravenously every 8 h regimen, the 24-h AUC/MIC at MICs of 0.5 and 1 microg/ml were 218.63 +/- 78.75 and 109.31 +/- 39.37, respectively. For the ciprofloxacin 400 mg intravenously every 12 h regimen, the 24-h AUC/MIC at MICs of 0.5 and +/- microg/ml were 144.07 +/- 57.02 and 72.03 +/- 28.51, respectively. After 14 days of ciprofloxacin treatment, the gram-negative bacilli infections were eradicated in all patients. Moreover, during both regimens, no adverse events related to the use of ciprofloxacin were observed.
Both ciprofloxacin 400 mg every 8 h and 400 mg every 12 h regimens can provide good coverage for pathogens with the susceptibility breakpoint of ciprofloxacin with an MIC of 0.5 microg/ml. For pathogens with an MIC of 1.0 microg/ml, only ciprofloxacin 400 mg every 8 h regimen can provide a 24-h AUC/MIC ratio greater than 100.
比较每8小时静脉注射400mg环丙沙星与每12小时静脉注射400mg环丙沙星的24小时血药浓度-时间曲线下面积与最低抑菌浓度值之比（24小时AUC/MIC）。
对10例革兰氏阴性杆菌血症患者进行了一项前瞻性、随机、双向交叉研究。所有患者均随机连续接受两种方案的环丙沙星治疗：（i）每8小时静脉注射400mg，共四剂；（ii）每12小时静脉注射400mg，共四剂。两种方案开始后均进行环丙沙星药代动力学研究。
对于每8小时静脉注射400mg环丙沙星方案，在最低抑菌浓度为0.5和1μg/ml时，24小时AUC/MIC分别为218.63±78.75和109.31±39.37。对于每12小时静脉注射400mg环丙沙星方案，在最低抑菌浓度为0.5和±μg/ml时，24小时AUC/MIC分别为144.07±57.02和72.03±28.51。环丙沙星治疗14天后，所有患者的革兰氏阴性杆菌感染均得到根除。此外，在两种方案治疗期间，均未观察到与使用环丙沙星相关的不良事件。
每8小时400mg和每12小时400mg的环丙沙星方案均可为最低抑菌浓度为0.5μg/ml的环丙沙星敏感病原体提供良好的覆盖。对于最低抑菌浓度为1.0μg/ml的病原体，只有每8小时400mg环丙沙星方案可提供大于100的24小时AUC/MIC比值。
