Clinical efficacy of ciprofloxacin compared with placebo in bacterial diarrhea.

In a double-blind, randomized trial, 85 adult patients with acute diarrhea (more than three watery stools per day) received either 500 mg of ciprofloxacin twice daily or placebo for five days. Seventy-six patients were evaluated, 38 patients in the ciprofloxacin group (16 with Salmonella species, 19 with Campylobacter jejuni, and three with Shigella species) and 38 patients in the placebo group (21 with Salmonella species, 11 with C. jejuni, and six with Shigella species). The duration of fever in patients treated with ciprofloxacin was 1.3 days versus 3.1 days in the placebo group (p less than 0.05). The mean duration of diarrhea in the ciprofloxacin group was 1.5 days versus 2.9 days in the placebo group (p less than 0.001). The corresponding numbers in patients with salmonellosis were 1.9 versus 3.4 days (p less than 0.01). In the ciprofloxacin group, all stool culture results became negative within 48 hours of treatment. Relapse occurred in four patients with salmonellosis within three weeks after the end of treatment. In the placebo group, only four of 38 patients had negative stool culture results during treatment and results were negative in only 13 at one week after the treatment period (p less than 0.001). Modest transient elevation of serum transaminase levels was detected in three patients in the ciprofloxacin group and in two patients in the placebo group. Epigastric pain occurred in one patient, and leukopenia occurred in one patient in the ciprofloxacin group. Gastrointestinal discomfort was recorded in two patients and rash was found in one patient in the placebo group.

Ciprofloxacin in the treatment of acute bacterial diarrhea: a double blind study.

In a double-blind, randomized, placebo-controlled trial 50 adult patients with acute diarrhea received either 500 mg ciprofloxacin b.i.d. or a placebo for five days. Results were evaluated in 21 patients in the ciprofloxacin group (10 with Salmonella spp., 11 with Campylobacter jejuni) and 25 patients in the placebo group (16 with Salmonella spp., 5 with Campylobacter jejuni, 4 with Shigella spp.). The duration of fever in patients treated with ciprofloxacin was 1.5 days versus 2.3 days in the placebo group; the difference was not statistically significant. The duration of diarrhea in the ciprofloxacin group was 1.4 days versus 2.6 days in the placebo group (p less than 0.01); the corresponding figures in patients with salmonellosis were 1.6 versus 3.2 (p = 0.01). In the ciprofloxacin group all stool cultures became negative 48 h after start of treatment and remained negative during the follow-up period of three weeks. In the placebo group only one of the 25 patients had negative stool cultures during therapy and only seven after the treatment period (p less than 0.001). Ciprofloxacin was very well tolerated and was found to be a safe compound without major adverse effects.

[Evaluation of exanthemas following high-dosage intravenous penicillin combinations in intensive care]. / Zur Wertung von Exanthemen nach hochdosierten intravenösen Penicillinkombinationen in der Intensivpflege

118 patients of a non specialized intensive care unit have been studied, all of them under high dose bactericidal cover (10 MIU of Na-Penicillin G and 2,0 Ciclacillin q 12 hrs.) for a period of days to 4 weeks. In 17 (14,4%) a skin rash was observed. 10 of these could be studied using special techniques (radial immunodiffusion, passive hemagglutination, RIST and RAST), however in none of these cases there was a hint of the existence of penicillin specific antibodies. In 6 patients also skin tests were performed. There was no immediate type reaction, only twice delayed type reactions occured to Na Pencillin G.6 patients had continuing treatment on spite of the rash and without further steps the effluorescences vanished within 3-6 days. Therefore continuation of the antibiotic therapy in spite of rash along with strict clinical and laboratory monitoring seems to be preferable to a hastened change of antibiotic regime