Enteric absorption of ciprofloxacin during the immediate postoperative period

We studied the enteric absorption of ciprofloxacin immediately following major abdominal surgery to determine if this drug could replace parenteral agents. Nine critically ill subjects received ciprofloxacin, 750 mg, every 12 h for 48 h via nasogastric tube. Drug concentrations were measured after the first and fourth doses. There was insignificant absorption after the initial dose, C_max = 0.6 ± 0.6 (mg/L) and AUCo-12 = 3.5 ± 3.2 (mg.h/L). Unfortunately, serum ciprofloxacin concentrations were also minimally detectable in three of nine subjects after the fourth dose. Enteric absorption of ciprofloxacin, therefore, was erratic and unpredictable in critically ill patients following major abdominal surgery.