Sequential intravenous/oral ciprofloxacin compared with parenteral ceftriaxone in the treatment of hospitalized patients with community-acquired pneumonia

Royce H. Johnson, Stephanie Levine, Scott L. Traub, Roger M. Echols, Daniel Haverstock, Erika Arnold, Steven F. Kowalsky

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

The efficacy and safety of sequential (intravenous/oral) ciprofloxacin were compared with the efficacy and safety of ceftriaxone for the treatment of hospitalized patients with acute bacterial pneumonia. In this prospective, controlled, double-blind, randomized multicenter trial, 227 patients were enrolled and received either intravenous ciprofloxacin (400 mg every 12 hours) followed by oral ciprofloxacin (500 mg every 12 hours) or intravenous ceftriaxone followed by intramuscular ceftriaxone (1 g every 24 hours). Ninety-six patients (50, ciprofloxacin; 46, ceftriaxone) were valid for efficacy; 91% had community-acquired pneumonia. Clinical cure, observed in 44 (90%) of 49 ciprofloxacin patients and in 38 (84%) of 45 ceftriaxone patients, was statistically equivalent for the two treatment groups, using a 95% confidence interval (CI) = -0.092, 0.198. Bacteriologic eradication was effective for 45 (94%) of 48 ciprofloxacin patients and for 42 (100%) of 42 ceftriaxone patients (95% CI = -0.189, 0.074). Both ciprofloxacin and ceftriaxone were effective in eradicating Streptococcus pneumoniae organisms in 21 (91%) of 23 patients and 17 (100%) of 17 patients, respectively; Haemophilus influenzae organisms in 18 of 18 patients and 8 of 8 patients, respectively; and Moraxella catarrhalis organisms in 4 of 4 patients and 2 of 2 patients, respectively. Both treatments were well tolerated, although ciprofloxacin had a higher rate of injection site reactions than ceftriaxone (10% and 3%, respectively) (P = .024). This study is the first demonstrating sequential ciprofloxacin therapy to be as safe and effective as parenteral ceftriaxone in the treatment of hospitalized patients with pneumonia.

Original languageEnglish (US)
Pages (from-to)265-272
Number of pages8
JournalInfectious Diseases in Clinical Practice
Volume5
Issue number4
StatePublished - 1996

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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