Scholten P C, Droppert R M, Zwinkels M G, Moesker H L, Nauta J J, Hoepelman I M
Department of Gynaecology and Obstetrics, University Hospital of Utrecht, 3584 CX Utrecht, The Netherlands.
Antimicrob Agents Chemother. 1998 Dec;42(12):3266-8. doi: 10.1128/AAC.42.12.3266.
Several antibiotics have been reported to lessen the ovarian suppression produced by oral contraceptive agents, as a result of drug interactions. The present investigation was designed to study the likelihood of the occurrence of any such interaction between the fluoroquinolone antibiotic ciprofloxacin (Ciproxin) at a dosage of 500 mg twice a day and the "low-dose" oral contraceptive Marvelon (30 microgram of ethinyl estradiol [EE] plus 150 microgram of desogestrel). Twenty-four healthy female volunteers were studied in a double-blind, placebo-controlled, randomized crossover trial. There were no significant differences between measurements of the area under the concentration-time curve of EE up to 24 h after oral contraceptive intake during placebo and ciprofloxacin administration on days 11 and 16 of the cycles, indicating the absence of pharmacokinetic interaction. Similarly, no clinically significant differences in the levels of sex hormone binding globulin were found between the placebo and ciprofloxacin cycles, indicating no major variation in EE levels during ciprofloxacin and placebo treatment. Ten subjects in each of the placebo and ciprofloxacin groups had early-follicular-phase levels of 17-beta estradiol (<184 ng/liter) at one or more points during their cycles, but none had values above the early-follicular-phase range, indicating no significant ovarian activity. In addition, all subjects had progesterone levels of <2 ng/ml, indicating the absence of ovulation. Only two subjects, who received the placebo, had evidence of sustained follicular growth to a potentially ovulatory follicle ( approximately 18 mm). We conclude that ciprofloxacin does not interfere with the ovarian suppression produced by the low-dose oral contraceptive Marvelon.
据报道，由于药物相互作用，几种抗生素可减轻口服避孕药引起的卵巢抑制作用。本研究旨在探讨每日两次服用500mg氟喹诺酮类抗生素环丙沙星（环丙氟哌酸）与“低剂量”口服避孕药妈富隆（30μg炔雌醇[EE]加150μg去氧孕烯）之间发生此类相互作用的可能性。在一项双盲、安慰剂对照、随机交叉试验中对24名健康女性志愿者进行了研究。在周期的第11天和第16天，服用安慰剂和环丙沙星期间，口服避孕药后24小时内EE浓度-时间曲线下面积的测量值之间无显著差异，表明不存在药代动力学相互作用。同样，在安慰剂组和环丙沙星组之间，未发现性激素结合球蛋白水平有临床显著差异，表明在环丙沙星和安慰剂治疗期间EE水平无重大变化。安慰剂组和环丙沙星组各有10名受试者在其周期中的一个或多个时间点卵泡早期的17-β雌二醇水平（<184ng/L），但均无高于卵泡早期范围的值，表明无明显卵巢活动。此外，所有受试者的孕酮水平均<2ng/ml，表明未排卵。只有两名服用安慰剂的受试者有证据表明卵泡持续生长至潜在排卵卵泡（约18mm）。我们得出结论，环丙沙星不会干扰低剂量口服避孕药妈富隆产生的卵巢抑制作用。
