Skip to main content
Erschienen in: Journal of Gastroenterology 7/2009

01.07.2009 | Original Article—Liver, Pancreas, and Biliary Tract

Clinical efficacy of intravenous ciprofloxacin in patients with biliary tract infection: a randomized controlled trial with carbapenem as comparator

verfasst von: Susumu Tazuma, Yoshinori Igarashi, Toshio Tsuyuguchi, Hirotaka Ohara, Kazuo Inui, Toshihide Ohya, On behalf of the BTI Therapy Research Group

Erschienen in: Journal of Gastroenterology | Ausgabe 7/2009

Einloggen, um Zugang zu erhalten

Abstract

Background

We conducted a randomized controlled trial (RCT) to evaluate the clinical efficacy of an intravenous fluoroquinolone, ciprofloxacin (CIP), in patients with biliary tract infection requiring biliary drainage using imipenem/cilastatin (IPM/CS) as a control.

Methods

After the initial collection of bile, patients were randomly assigned to receive CIP at 300 mg twice daily by intravenous drip infusion or IPM/CS at 500 mg twice daily by intravenous drip infusion with the envelope method.

Results

The characteristics of the 104 patients evaluated for efficacy were well balanced. The clinical response rates were 100.0% (50/50 patients) in the CIP group and 94.4% (51/54) in the IPM/CS group. The difference in clinical response rate between groups (CIP, IPM/CS) was 5.56% (90% confidence interval: −0.26%, 13.95%), and the non-inferiority of CIP to IPM/CS was confirmed. Adverse events for which causal relationships with the study drugs could not be ruled out developed in 5.4% (3/56) of patients in the CIP group and 5.2% (3/58) of patients in the IPM/CS group, and none of them were serious.

Conclusions

The clinical efficacy of CIP in treating biliary tract infection requiring drainage was comparable to that of IPM/CS. These findings suggest that CIP is useful as a new therapeutic option for biliary tract infection.
Anhänge
Nur mit Berechtigung zugänglich
Fußnoten
1
Package insert of Tienam (imipenem/cilastatin).
 
Literatur
1.
Zurück zum Zitat Tazuma S, Iwamoto K, Hyogo H, Shimatani T, Ono H, Hiyama E, et al. Clinical experience of injectable ciprofloxacin (CIP) for biliary tract infection. J Biliary Tract Pancreas. 2003;24:781–5. Tazuma S, Iwamoto K, Hyogo H, Shimatani T, Ono H, Hiyama E, et al. Clinical experience of injectable ciprofloxacin (CIP) for biliary tract infection. J Biliary Tract Pancreas. 2003;24:781–5.
2.
Zurück zum Zitat Sung JJ, Lyon DJ, Suen R, Chung SC, Co AL, Cheng AF, et al. Intravenous ciprofloxacin as treatment for patients with acute suppurative cholangitis: randomized, controlled clinical trial. J Antimicrob Chemother. 1995;35:855–64.PubMedCrossRef Sung JJ, Lyon DJ, Suen R, Chung SC, Co AL, Cheng AF, et al. Intravenous ciprofloxacin as treatment for patients with acute suppurative cholangitis: randomized, controlled clinical trial. J Antimicrob Chemother. 1995;35:855–64.PubMedCrossRef
3.
Zurück zum Zitat Elkhajli H, Kamili N, Linger L, Levêque D, Pompei D, Monteil H, et al. In vitro time-kill curves of cefepime and cefpirome combined with amikacin, gentamicin or ciprofloxacin against Klebsiella pneumoniae producing extended-spectrum beta-lactamase. Chemotherapy. 1997;43:245–53.CrossRef Elkhajli H, Kamili N, Linger L, Levêque D, Pompei D, Monteil H, et al. In vitro time-kill curves of cefepime and cefpirome combined with amikacin, gentamicin or ciprofloxacin against Klebsiella pneumoniae producing extended-spectrum beta-lactamase. Chemotherapy. 1997;43:245–53.CrossRef
4.
Zurück zum Zitat Hirakata Y, Izumikawa K, Yamaguchi T, Takemura H, Tanaka H, Yoshida R, et al. Rapid detection and evaluation of clinical characteristics of emerging multiple-drug-resistant gram-negative rods carrying the metallo-β-lactamase gene blaIMP. Antimicrob Agents Chemother. 1998;42:2006–11.PubMed Hirakata Y, Izumikawa K, Yamaguchi T, Takemura H, Tanaka H, Yoshida R, et al. Rapid detection and evaluation of clinical characteristics of emerging multiple-drug-resistant gram-negative rods carrying the metallo-β-lactamase gene blaIMP. Antimicrob Agents Chemother. 1998;42:2006–11.PubMed
5.
Zurück zum Zitat Hara K, Kohno S, Kadota J, Tomono K, Hirakata Y, Maesaki S, et al. Clinical evaluation of injectable ciprofloxacin for bacterial pneumonia–Ceftazidime-controlled phase-III clinical study. Chemotherapy. 1997;45:901–22. (in Japanese with English abstract). Hara K, Kohno S, Kadota J, Tomono K, Hirakata Y, Maesaki S, et al. Clinical evaluation of injectable ciprofloxacin for bacterial pneumonia–Ceftazidime-controlled phase-III clinical study. Chemotherapy. 1997;45:901–22. (in Japanese with English abstract).
6.
Zurück zum Zitat Kobayashi H, Kawai H, Oshitani H, Koike T, Sakayori S, Ohnishi K, et al. Late phase-II clinical study of injectable ciprofloxacin. Chemotherapy. 1997;45:846–71. (in Japanese with English abstract). Kobayashi H, Kawai H, Oshitani H, Koike T, Sakayori S, Ohnishi K, et al. Late phase-II clinical study of injectable ciprofloxacin. Chemotherapy. 1997;45:846–71. (in Japanese with English abstract).
7.
Zurück zum Zitat Aikawa N, Sasaki J, Iwai S, Kunimatsu M, Furuhata H, Watanabe T, et al. Clinical evaluation of injectable ciprofloxacin for severe or refractory infection in surgical/gynecological areas. Chemotherapy. 1997;45:936–50. (in Japanese with English abstract). Aikawa N, Sasaki J, Iwai S, Kunimatsu M, Furuhata H, Watanabe T, et al. Clinical evaluation of injectable ciprofloxacin for severe or refractory infection in surgical/gynecological areas. Chemotherapy. 1997;45:936–50. (in Japanese with English abstract).
8.
Zurück zum Zitat Endo S, Inoue Y, Kikuchi M, Yamada Y, Nakae H. Clinical efficacy of ciprofloxacin for injection (ciprofloxacin injection) in emergency medical care area. Antibiot Chemother. 2001;17:980–6. (in Japanese with English abstract). Endo S, Inoue Y, Kikuchi M, Yamada Y, Nakae H. Clinical efficacy of ciprofloxacin for injection (ciprofloxacin injection) in emergency medical care area. Antibiot Chemother. 2001;17:980–6. (in Japanese with English abstract).
9.
Zurück zum Zitat Ichiyama S, Mori T, Yamaguchi K, Hayashi M, Yamanaka K, Kurokawa Y, et al. Surveillance of susceptibility of clinical isolates from severe infection to various antimicrobials. Jpn J Antibiot. 2001;54:401–47. (in Japanese with English abstract).PubMed Ichiyama S, Mori T, Yamaguchi K, Hayashi M, Yamanaka K, Kurokawa Y, et al. Surveillance of susceptibility of clinical isolates from severe infection to various antimicrobials. Jpn J Antibiot. 2001;54:401–47. (in Japanese with English abstract).PubMed
10.
Zurück zum Zitat Parry MF, Smego DA, Digiovanni MA. Hepatobiliary kinetics and excretion of ciprofloxacin. Antimicrob Agents Chemother. 1998;32:982–5. Parry MF, Smego DA, Digiovanni MA. Hepatobiliary kinetics and excretion of ciprofloxacin. Antimicrob Agents Chemother. 1998;32:982–5.
11.
Zurück zum Zitat Tanimura H, Ishihara H, Kobayashi N, Tsuchiya Y, Uchiyama K. National survey report for gallstones for fiscal 1997. J Jpn Biliary Assoc. 1998;12:276–93. (in Japanese with English abstract). Tanimura H, Ishihara H, Kobayashi N, Tsuchiya Y, Uchiyama K. National survey report for gallstones for fiscal 1997. J Jpn Biliary Assoc. 1998;12:276–93. (in Japanese with English abstract).
12.
Zurück zum Zitat Takesue Y, Nakajima K, Ichiki K, Wada Y, Kuramoto M, Yanagi H, et al. Usage of antimicrobials for biliary tract infection in Europe and the United States. J Jpn Soc Surg Infect. 2006;3:227–32. (in Japanese with English abstract). Takesue Y, Nakajima K, Ichiki K, Wada Y, Kuramoto M, Yanagi H, et al. Usage of antimicrobials for biliary tract infection in Europe and the United States. J Jpn Soc Surg Infect. 2006;3:227–32. (in Japanese with English abstract).
13.
Zurück zum Zitat Gerecht WB, Henry NK, Hoffman WW, Muller SM, LaRusso NF, Rosenblatt JE. Prospective randomized comparison of mezlocillin therapy alone with combined ampicillin and gentamicin therapy for patients with cholangitis. Arch Intern Med. 1989;149:1279–84.PubMedCrossRef Gerecht WB, Henry NK, Hoffman WW, Muller SM, LaRusso NF, Rosenblatt JE. Prospective randomized comparison of mezlocillin therapy alone with combined ampicillin and gentamicin therapy for patients with cholangitis. Arch Intern Med. 1989;149:1279–84.PubMedCrossRef
14.
Zurück zum Zitat Muller EL, Pitt HA, Thompson JE Jr, Doty JE, Mann LL, Manchester B. Antibiotics in infections of the biliary tract. Surg Gynecol Obstet. 1987;165:285–92.PubMed Muller EL, Pitt HA, Thompson JE Jr, Doty JE, Mann LL, Manchester B. Antibiotics in infections of the biliary tract. Surg Gynecol Obstet. 1987;165:285–92.PubMed
15.
Zurück zum Zitat Thompson JE Jr, Pitt HA, Doty JE, Coleman J, Irving C. Broad spectrum penicillin as an adequate therapy for acute cholangitis. Surg Gynecol Obstet. 1990;171:275–82.PubMed Thompson JE Jr, Pitt HA, Doty JE, Coleman J, Irving C. Broad spectrum penicillin as an adequate therapy for acute cholangitis. Surg Gynecol Obstet. 1990;171:275–82.PubMed
16.
Zurück zum Zitat Thompson JE Jr, Bennion RS, Roettger R, Lally KP, Hopkins JA, Wilson SE. Cefepime for infections of the biliary tract. Surg Gynecol Obstet. 1993;177(Suppl):30–4.PubMed Thompson JE Jr, Bennion RS, Roettger R, Lally KP, Hopkins JA, Wilson SE. Cefepime for infections of the biliary tract. Surg Gynecol Obstet. 1993;177(Suppl):30–4.PubMed
17.
Zurück zum Zitat Chacon JP, Criscuolo PD, Kobata CM, Ferraro JR, Saad SS, Reis C. Prospective randomized comparison of pefloxacin and ampicillin plus gentamicin in the treatment of bacteriologically proven biliary tract infections. J Antimicrob Chemother. 1990;26(Suppl B):167–72.PubMed Chacon JP, Criscuolo PD, Kobata CM, Ferraro JR, Saad SS, Reis C. Prospective randomized comparison of pefloxacin and ampicillin plus gentamicin in the treatment of bacteriologically proven biliary tract infections. J Antimicrob Chemother. 1990;26(Suppl B):167–72.PubMed
18.
Zurück zum Zitat Committee on Guidelines for the Management of Acute Cholangitis. Guidelines for the Management of Acute Cholangitis/Cholecystitis 1st ed. Tokyo: Igaku Tosho Shuppan, 2005. Committee on Guidelines for the Management of Acute Cholangitis. Guidelines for the Management of Acute Cholangitis/Cholecystitis 1st ed. Tokyo: Igaku Tosho Shuppan, 2005.
19.
Zurück zum Zitat Raymond DP, Pelletier SJ, Crabtree TD, Gleason TG, Hamm LL, Pruett TL, et al. Impact of a rotating empiric antibiotic schedule on infectious mortality in an intensive care unit. Crit Care Med. 2001;29:1101–8.PubMedCrossRef Raymond DP, Pelletier SJ, Crabtree TD, Gleason TG, Hamm LL, Pruett TL, et al. Impact of a rotating empiric antibiotic schedule on infectious mortality in an intensive care unit. Crit Care Med. 2001;29:1101–8.PubMedCrossRef
Metadaten
Titel
Clinical efficacy of intravenous ciprofloxacin in patients with biliary tract infection: a randomized controlled trial with carbapenem as comparator
verfasst von
Susumu Tazuma
Yoshinori Igarashi
Toshio Tsuyuguchi
Hirotaka Ohara
Kazuo Inui
Toshihide Ohya
On behalf of the BTI Therapy Research Group
Publikationsdatum
01.07.2009
Verlag
Springer Japan
Erschienen in
Journal of Gastroenterology / Ausgabe 7/2009
Print ISSN: 0944-1174
Elektronische ISSN: 1435-5922
DOI
https://doi.org/10.1007/s00535-009-0067-1

Weitere Artikel der Ausgabe 7/2009

Journal of Gastroenterology 7/2009 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Erhöhte Mortalität bei postpartalem Brustkrebs

07.05.2024 Mammakarzinom Nachrichten

Auch für Trägerinnen von BRCA-Varianten gilt: Erkranken sie fünf bis zehn Jahre nach der letzten Schwangerschaft an Brustkrebs, ist das Sterberisiko besonders hoch.

Hypertherme Chemotherapie bietet Chance auf Blasenerhalt

07.05.2024 Harnblasenkarzinom Nachrichten

Eine hypertherme intravesikale Chemotherapie mit Mitomycin kann für Patienten mit hochriskantem nicht muskelinvasivem Blasenkrebs eine Alternative zur radikalen Zystektomie darstellen. Kölner Urologen berichten über ihre Erfahrungen.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Medizinstudium Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Vorhofflimmern bei Jüngeren gefährlicher als gedacht

06.05.2024 Vorhofflimmern Nachrichten

Immer mehr jüngere Menschen leiden unter Vorhofflimmern. Betroffene unter 65 Jahren haben viele Risikofaktoren und ein signifikant erhöhtes Sterberisiko verglichen mit Gleichaltrigen ohne die Erkrankung.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.