Modai J
Department of Infectious Diseases, Saint Louis Hospital, Paris, France.
Am J Med. 1989 Nov 30;87(5A):243S-247S. doi: 10.1016/0002-9343(89)90070-3.
Ninety-four patients, 61 men and 33 women with a mean age of 54 years, were treated with intravenous ciprofloxacin. Eighty-one patients (86 percent) were in serious or fair condition. Pathogens included Enterobacteriaceae (74 patients), Pseudomonas sp. (23 patients), other gram-negative bacilli (five patients), staphylococci (19 patients), other gram-positive cocci (seven patients), and Rickettsia conorii (five patients). Thirty-eight patients were given parenteral therapy (ciprofloxacin at a mean daily dose of 200 mg every 12 hours, mean duration of therapy, nine days). Fifty-six patients were also given ciprofloxacin orally after initial intravenous therapy at a dose of either 500 or 750 mg every 12 hours (mean duration of therapy, 36 days). Another antibiotic was given concomitantly in 25 cases (27 percent). The overall clinical response was 93 percent and the bacteriologic response rate was 84 percent. There was no difference between patients treated by intravenous ciprofloxacin and those treated by intravenous ciprofloxacin followed by oral ciprofloxacin. Favorable responses (resolution of improvement) were observed in 39 of 42 patients (93 percent) with bacteremia, 28 of 30 (93 percent) with urinary tract infection, 10 of 13 (77 percent) with respiratory tract infection, 11 of 12 (92 percent) with bone and joint infection, three of three (100 percent) with skin and soft-tissue infection, nine of nine (100 percent) with intra-abdominal infection, three of three (100 percent) with typhoid fever, and two of two (100 percent) with meningitis. All five patients with R. conorii infections had a response to therapy. The adverse effects were minor and transient. Seven patients experienced clinical adverse effects: pain at the injection site (three patients), rash (two patients), and headache (2 patients). Serum transaminase levels were increased in 11 patients. Intravenously administered ciprofloxacin or intravenous ciprofloxacin followed by oral ciprofloxacin is a safe and effective therapy for serious infections.
94例患者接受了静脉注射环丙沙星治疗，其中男性61例，女性33例，平均年龄54岁。81例患者（86%）病情严重或一般。病原体包括肠杆菌科（74例）、假单胞菌属（23例）、其他革兰氏阴性杆菌（5例）、葡萄球菌（19例）、其他革兰氏阳性球菌（7例）和康氏立克次体（5例）。38例患者接受了胃肠外治疗（环丙沙星平均每日剂量200mg，每12小时一次，平均治疗时长9天）。56例患者在初始静脉治疗后还口服了环丙沙星，剂量为每12小时500或750mg（平均治疗时长36天）。25例患者（27%）同时使用了另一种抗生素。总体临床有效率为93%，细菌学有效率为84%。接受静脉注射环丙沙星治疗的患者与先静脉注射环丙沙星后口服环丙沙星治疗的患者之间无差异。42例菌血症患者中有39例（93%）出现良好反应（症状缓解或改善），30例尿路感染患者中有28例（93%），13例呼吸道感染患者中有10例（77%），12例骨和关节感染患者中有11例（92%），3例皮肤和软组织感染患者中有3例（100%），9例腹腔内感染患者中有9例（100%），3例伤寒患者中有3例（100%），2例脑膜炎患者中有2例（100%）。所有5例康氏立克次体感染患者对治疗均有反应。不良反应轻微且短暂。7例患者出现临床不良反应：注射部位疼痛（3例）、皮疹（2例）和头痛（2例）。11例患者血清转氨酶水平升高。静脉注射环丙沙星或先静脉注射环丙沙星后口服环丙沙星是治疗严重感染的一种安全有效的疗法。
