Sequential intravenous-oral ciprofloxacin plus amoxycillin/clavulanic acid shortens hospital stay in infected non severe neutropenic patients

• Published in: Hematology and cell therapy Vol. 39; no. 5; pp. 223 - 227
• Main Authors: VALLEJO, C, CABALLERO, M. D, GARCIA-SANZ, R, HERNANDEZ, J. M, VAZQUEZ, L, CANIZO, M. C, GALENDE, J, COLINO, C. I, GIL-HURLE, A, SAN MIGUEL, J. F
• Format: Conference Proceeding Journal Article
• Language: English
• Published: Paris Springer 01.10.1997
• Subjects: Administration, Oral; Adolescent; Adult; Aged; Aged, 80 and over; Amoxicillin - administration & dosage; Amoxicillin - therapeutic use; Analysis of Variance; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Bacterial Infections - complications; Bacterial Infections - drug therapy; Biological and medical sciences; Ciprofloxacin - adverse effects; Ciprofloxacin - therapeutic use; Clavulanic Acid - administration & dosage; Clavulanic Acid - therapeutic use; Drug Administration Schedule; Drug Therapy, Combination - adverse effects; Drug Therapy, Combination - therapeutic use; Female; Humans; Length of Stay; Male; Medical sciences; Middle Aged; Neutropenia - complications; Pharmacology. Drug treatments; Risk Factors; Treatment Outcome; Human; Drug combination; Intravenous administration; Clavulanic acid; Aplastic anemia; Empirical method; Oral administration; Administration schedule; Hemopathy; Malignant hemopathy; Infection; Penicillin derivatives; Antibiotic; Chemotherapy; Fluoroquinolone derivatives; Treatment; Amoxicillin; Bacteriosis; Complication; Antibacterial agent; Ciprofloxacin; Quinolone derivatives
• ISSN: 1269-3286; 1279-8509
• DOI: 10.1007/s00282-997-0223-0

The objective of this study was to determine the efficacy and safety of the combination ciprofloxacin plus amoxicillin/clavulanic acid as an empirical treatment of infection in hematologic patients without severe neutropenia. These drugs allowed us to carry out a sequential therapy, first intravenously and later orally, so that the patient could be discharged as soon as there was a response. Serum concentrations of ciprofloxacin were monitored in this study. Forty seven of the sixty-six patients included (71%) responded to the treatment with no differences between the dosages of ciprofloxacin employed (600-900 mg daily in two or three divided doses). In the patients who responded, the signs and symptoms of infection lasted only three days, which could allow a short hospital stay (median of six days). In the first pre and post-dose serum samples, ciprofloxacin concentrations were significantly higher when the drug was administered every 8 h. Nevertheless, 72 h after the beginning of treatment, they had leveled out in either 8 and 12 h schemes. The toxicity of the treatment was very light, with only four cases with adverse effects, grades I and II. This data suggests that the employed combination is effective and safe and can considerably decrease costs incurred through the admission of hematologic patients with serious infections but without severe neutropenia.