Assessment of the interaction between ciprofloxacin and teicoplanin in vitro and in neutropenic patients.

The interactions of ciprofloxacin and teicoplanin were investigated against methicillin-sensitive and methicillin-resistant Staphylococcus aureus and Staph. epidermidis isolated during a clinical trial of the efficacy of this combination. In-vitro studies of the combination of ciprofloxacin and teicoplanin found no evidence of any antagonism between these two drugs in terms of inhibition of bacterial multiplication, as determined by Fractional Inhibitory Concentration Indices, and lethality. Clinical use of teicoplanin plus ciprofloxacin as empirical therapy in 29 febrile neutropenic patients revealed an overall response rate of 75%. Response rate for staphylococcal infections, which accounted for 53% of isolated pathogens, was 80%. No serious adverse drug reactions were seen. Our results show that both in vitro, and in the treatment of febrile neutropenic patients, teicoplanin plus ciprofloxacin is an effective anti-staphylococcal combination.