Ciprofloxacin in Elderly Patients with Pneumonia

Tanveer P Mir, Alaa Soltan, Javed Mir, Riyad Basir, Faroque Ahmad Khan

Abstract


DOI: http://dx.doi.org/10.5915/24-1-15451

 

From January 1987 to July 1989, we prospectively evaluated the safety and efficacy of a fluoroquinolone, ciprofloxacin (Cipro), in the treatment of elderly patients hospitalized with pneumonia. Of the 39 patients, there were 25 females and 14 males, with an age range of 65-94 years (mean age 79.1 years). The four common pathogens were Pseudomonas aeruginosa (12), Streptococcus pneumoniae (5), Haemophilus parainfluenza (5) and Staphylococcus aureus (5). All isolates were sensitive in vitro. Ciprofloxacin was given intravenously (IV) 200 mg every 12 hours. When the patient was able to take oral medication, therapy was switched to oral ciprofloxacin 500 mg every 12 hours. Mean duration of IV/PO therapy was 5.8 days.

This study concluded: 1) In the elderly, ciprofloxacin is useful due to convenience of BID dosage, sequential IV/PO availability, good safety and efficacy. 2) Ciprofloxacin shows good in vitro activity. 3) Clinical results are comparable to the results obtained with conventional antimicrobial therapy for treatment of pneumonia in the elderly. 4) All 5/39 ciprofloxain-treated patients with S. pneumoniae as an isolate were cured. 5) Quinolones are cost effective. Early use of oral Cipro in the 39 patients resulted in estimated savings of approximately $6,000.

Presented at the IMA 24th Annual Convention Long Island, New York, July 1991

 


Keywords


Ciproflaxin; Pneumonia; Elderly

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References


Khan FA, Basir R. Sequential intravenous-oral administration of ciprofloxacin vs. ceftazidime in serious bacterial respiratory tract infecions. Chest. 1989 Sep;96(3):528-37.

Soltan A, Mir J, Khan FA. Sequential intravenous-oral administration of ofloxacin vs. ceftazidime in serious bacterial respiratory tract infections. Abstract 3-lnternational Symposium on Qufoolons: Vancouver, Canada. July 12-14, 1990.

Gleckman RA, Esposito AL. Fever of unknown origin in the elderly: diagnosis and treatment. Geriatrics. 1986;41:45-7, 50-2.

Verghese A, Berk SL. Bacterial pneumonia in the elderly. Medicine. 1983;62:271-85.

Yashikama TT. Aging and infectious disease: State of the art. Gerontology. 1984;30:275-78.

Greenblatt DJ, Sellers EM, Shader RI. Drug disposition in gold age. N Engl J Med. 1982;18:1081-88.

Schmucker DL. Aging and drug disposition: an update. Pharmacol Rev. 1985;36:133-48.

Clark RJ. Overview of fluoroquinolones in respiratory tract infection. J Repiratory Diseases. Suppl. May 1990;11(5):S6-Sl2.

Sanders WE Jr. Efficacy, safety and potential economic benefits of oral ciprofloxacin in the treatment of infections. Rev Infect Dis. 1988;10:528-43.

Finkelstein MS. Unusual features of infection in the aging. Geriatrics. 1982;32:65-78.

Valenti W, Trudell G, Bentley OW. Factors predisposing to oropharyngeal colonization with Gram-negative bacilli in the aged. N Engl J Med. 1978;298:1109-11.

Garibaldi RA, Nurse BA. Infections in the elderly. Am J Med. 1986;81:53-8.

Paterson PK, Stein 0, David RP, Guay D, Logan G, Obaid S, Grunninger R, Davies S, Breitenleucher R. Prospective study of lower respiratory tract infections in an extended case nursing home program: potential role of oral ciprofloxacin. Am J Med. 1988;85:164-171.

Marrie TJ, Durant M, Kwan C. Nursing home acquired pneumonia. A case control study. J Am Geriatric Society. 1986;146:2353-7.

Mufson MA. Pneumococcal infections. JAMA. 1981;246:1942-45.

Marrie TJ, Haldane EV, Faulkner RS, Durant M, Kwan C. Community-acquired pneumonia requiring hospitalization: Is it different in the elderly?. J Am Geriatric Soc. 1985;33:671-80.

Gleadhill K, Ferguson WP, Lowry RC. Efficacy and safety of ciprofloxacin in patients with respiratory tract infections in comparison with amoxacillin. J Antimicrobial Chemother. 1986;18(Suppl. D):133-38.

Raoof S, Wollschlager CM, Khan F. Treatment of respiratory tract infections with ciprofloxacin. J Antimicrob Chemother. 1986; 18(Suppl D):139-45.

Khan FA. Ciprofloxacin in the treatment of lower respiratory tract infection due to streptococcus pneumoniae. Int Med. 1989;10:33-8.

Bergogne-Berezin E., Berthelot G, Even P, Stern M, Reynaud P. Penetration of ciprofloxacin into bronchial secretions. Eur J Clin Microbial. 1986;5:197-200.

Fass RJ. Ciprofloxacin, best use of this new broad spectrum antibiotic. Postgrad Med. 1990 Jun;87(8):117-22, 124, 127-31.




DOI: https://doi.org/10.5915/24-1-15451





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