Active Ingredient: Ciprofloxacin
Geometric means of these replicates were used in the analysis.
MICs of the colonies growing on selective media were determined by the agar dilution method.
Endpoints Resistance to nalidixic acid and ciprofloxacin in E. Emergence of resistance was defined by the detection of resistant strains at day 7, 14 or 42 in subjects in whom only susceptible strains were detected and resistant strains were not detected before treatment.
Pharmacokinetic study Serum and saliva samples were taken from each volunteer before and 1, 6 and 12 hours after the first ciprofloxacin intake, at trough on day 8 and day 14, and again 1, 6 and 12 hours after the last intake.
Stool samples were collected on days 0, 14 and 42.
Ciprofloxacin concentrations were determined by liquid chromatography with fluorimetric detection after deproteinization or stool extraction in acidic medium, as described.
Statistical analysis A population pharmacokinetic analysis with, as previously described a one compartment model with first order absorption was used to analyze plasma and saliva concentrations and estimate the maximal concentration peak and AUC from 0 to 24 h at steady-state for each volunteer, taking into account the dosing schedule.
Confidence intervals for proportion of emergence of resistance were estimated using the binomial distribution.
For each target flora, the volunteers were divided into two groups regardless of the dosing schedule according to the emergence or not of resistance.
Variables integrating pharmacokinetic and pharmacodynamic parameters were compared between the two groups using the Wilcoxon-Mann and Whitney non parametric test. The number of subjects were determined expecting emergence of quinolone resistance in the fecal flora in one third of the volunteers.
Results Subjects Eighty subjects were screened and 48 subjects 28 males and 20 females who fulfilled the predefined criteria for healthy subjects were selected.
Median age was 28. One subject who developed tendinitis at day 8 while receiving the 750 mg bid regimen and stopped therapy was excluded from the microbiological and pharmacokinetic follow-up analysis.
In general, immunosuppressed patients who develop signs or symptoms of serious gram-negative infections should receive high doses of anti-Pseudomonal antibiotics.
This mucoid property predicts chronic infection that cannot be cleared. They also experience a more rapid decline in pulmonary function and more frequent hospitalizations 72.
Ne onatal Intensive Care Unit Sepsis is a frequent infection in premature infants. Therefore skin colonization can lead to bacteremia from catheter-related infection, or gastrointestinal colonization can lead to aspiration and pneumonia.
Large inocula of the bacteria can overwhelm normal defenses and lead to infection. Uri nary Tract Infections P. Eradication of the organism remains challenging and requires elimination of the predisposing factors in addition to antibiotic therapy.
Risk factors for adults developing VAP include: antibiotic exposure, use of H 2-receptor blockers, advanced age, reintubation, and transport from the ICU while intubated.
In children in the pediatric intensive care unit three independent risk factors for pediatric VAP include: immunodeficiency, immunosuppression, and neuromuscular blockade 232.