Treatment of serious infections with intravenous ciprofloxacin. French Multicenter Study Group.

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.