Literature DB >> 9829160

Ofloxacin. A reappraisal of its use in the management of genitourinary tract infections.

S V Onrust1, H M Lamb, J A Balfour.   

Abstract

UNLABELLED: Ofloxacin is an established fluoroquinolone agent which achieves good concentrations in genitourinary tract tissues and fluids. It has good in vitro activity against most Enterobacteriaceae, Staphylococcus saprophyticus, methicillin-susceptible S. aureus, Neisseria gonorrhoeae, Chlamydia trachomatis and Haemophilus ducreyi, intermediate activity against Ureaplasma urealyticum and most enterococci, but limited or no in vitro activity against enterococci, Serratia marcescens, Pseudomonas aeruginosa and many anaerobes. However, high concentrations achieved in the urine ensure its activity against most urinary tract pathogens. Ofloxacin demonstrates consistent efficacy in a broad range of urinary tract infections, achieving bacteriological response rates in excess of 80% in uncomplicated and 70% in complicated infections. The efficacy of ofloxacin was similar to that of all comparators tested including other fluoroquinolones, cephalosporins and cotrimoxazole (trimethoprim/sulfamethoxazole). Ofloxacin is also effective as a single-dose regimen in the treatment of uncomplicated gonorrhoea, as a 7-day regimen in uncomplicated C. trachomatis infections, and as monotherapy in uncomplicated pelvic inflammatory disease (PID). Again, ofloxacin demonstrated similar efficacy to alternative treatments in each type of infection. The availability of an intravenous formulation and near-complete oral bioavailability allow ofloxacin to be administered as a sequential regimen without loss of activity. The tolerability and drug interaction profile of ofloxacin is consistent with that of other fluoroquinolones. The most commonly reported adverse events with ofloxacin are gastrointestinal, neurological and dermatological. It was associated with a lower incidence of photosensitivity and tendinitis and higher incidence of some neurological events than some other fluoroquinolones. Ofloxacin seems to have a lower propensity to interact with xanthines than other fluoroquinolones.
CONCLUSION: ofloxacin has established efficacy in the treatment of a wide variety of urinary tract infections, although, like other fluoroquinolones, it should be used rationally to preserve its activity. Currently, ofloxacin also holds an important place among fluoroquinolones in the treatment of C. trachomatis infections and uncomplicated PID, although its acceptance as monotherapy in PID is likely to depend on clarification of the causative role of anaerobic pathogens in this infection.

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Year:  1998        PMID: 9829160     DOI: 10.2165/00003495-199856050-00015

Source DB:  PubMed          Journal:  Drugs        ISSN: 0012-6667            Impact factor:   9.546


  141 in total

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Journal:  Pharmacoeconomics       Date:  1996-04       Impact factor: 4.981

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Journal:  Diagn Microbiol Infect Dis       Date:  1998-04       Impact factor: 2.803

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Journal:  Infection       Date:  1986       Impact factor: 3.553

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Authors:  W E Stamm; T M Hooton
Journal:  N Engl J Med       Date:  1993-10-28       Impact factor: 91.245

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Journal:  Am J Med       Date:  1989-12-29       Impact factor: 4.965

6.  Treatment of nongonococcal urethritis: comparison of ofloxacin and erythromycin.

Authors:  H H Ibsen; B R Møller; L Halkier-Sørensen; E From
Journal:  Sex Transm Dis       Date:  1989 Jan-Mar       Impact factor: 2.830

7.  In vitro susceptibilities of isolates of Haemophilus ducreyi from Thailand and the United States to currently recommended and newer agents for treatment of chancroid.

Authors:  J S Knapp; A F Back; A F Babst; D Taylor; R J Rice
Journal:  Antimicrob Agents Chemother       Date:  1993-07       Impact factor: 5.191

8.  Ceftriaxone in the prevention of postoperative infection in patients undergoing transurethral resection of the prostate.

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Journal:  Am J Surg       Date:  1984-10-19       Impact factor: 2.565

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Authors:  I E Nygaard; J M Johnson
Journal:  Am Fam Physician       Date:  1996-01       Impact factor: 3.292

10.  Susceptibilities of Chlamydia trachomatis isolates causing uncomplicated female genital tract infections and pelvic inflammatory disease.

Authors:  R J Rice; V Bhullar; S H Mitchell; J Bullard; J S Knapp
Journal:  Antimicrob Agents Chemother       Date:  1995-03       Impact factor: 5.191

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Review 2.  Concurrent gonococcal and chlamydial infection: how best to treat.

Authors:  A J Robinson; G L Ridgway
Journal:  Drugs       Date:  2000-04       Impact factor: 9.546

Review 3.  Ofloxacin otic solution: a review of its use in the management of ear infections.

Authors:  K L Simpson; A Markham
Journal:  Drugs       Date:  1999-09       Impact factor: 9.546

Review 4.  Gatifloxacin: a review of its use in the management of bacterial infections.

Authors:  Caroline M Perry; Douglas Ormrod; Miriam Hurst; Susan V Onrust
Journal:  Drugs       Date:  2002       Impact factor: 9.546

5.  Ofloxacin-loaded liposomes: in vitro activity and drug accumulation in bacteria.

Authors:  P M Furneri; M Fresta; G Puglisi; G Tempera
Journal:  Antimicrob Agents Chemother       Date:  2000-09       Impact factor: 5.191

  5 in total

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