Urinary excretion and bactericidal activity of intravenous ciprofloxacin compared with oral ciprofloxacin
Abstract
Twelve healthy volunteers participated in a randomized crossover study to compare urinary concentrations, serum parameters, and urinary bactericidal activity of ciprofloxacin after single intravenous (i.v.) doses of 200 mg and 400 mg and an oral (p.o.) dose of 500 mg. The median serum concentrations at 1 h after administration were 1 microg/ml, 4.3 microg/ml, and 2.2 microg/ml, respectively. Between the first collection period (0-2 h) and the last collection period (38-48 h), the median urinary concentrations decreased from 394 microg/ml, 675 microg/ml, and 585 microg/ml, respectively, to 0.3 microg/ml, 0.6 microg/ml, and 1 microg/ml, respectively. The urinary concentrations after the 400 mg i.v. and the 500 mg p.o. doses were not statistically different but were significantly higher than those after the 200 mg i.v. dose. The urinary bactericidal titers (UBTs), defined as the highest urinary dilution bactericidal for the organism tested, were determined against Escherichia coli (ATCC 25922) and eight uropathogens up to 48 h after administration of ciprofloxacin. The UBTs after the 400 mg i.v. and the 500 mg p.o. doses were similar and were significantly higher (P or = 1:4 were present up to 48 h for all strains for which the MIC was or = 1 microg/ml showed median UBTs of > or = 1:4 for 8-16 h. Median UBTs of > or = 1:4 were present up to 8 and 12 h for both Pseudomonas strains tested. A once-daily dosage of 400 mg i.v. or 500 mg p.o. might be sufficient for treatment of…
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Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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