J Chromatogr A, 2004 Dec 24, 1061(2), 123 - 31 Determination and on-line clean-up of (fluoro)quinolones in bovine milk using column-switching liquid chromatography fluorescence detection; Ho C et al.; A simple, cost-effective, and high throughput method using on-line column-switching liquid chromatography fluorescence detection was developed and validated for analysing five (fluoro)quinolones (FQs)--enrofloxacin (ENRO), ciprofloxacin (CIPR), sarafloxacin (SARA), oxolinic acid (OXOL), and flumequine (FLUM) in bovine milk . Norfloxacin (NORF) and nalixidic acid (NALI) were used as internal standards . After simple deproteination of milk sample with 5% (w/v) metaphosphoric acid, the supernatant was subject to on-line column clean-up and direct analysis by LC-FLD . The extraction cartridge was prepared in-house by slurry packing with hydrophilic-lipophilic polymer sorbent . The accuracy of measurement for each (fluoro)quinolone at different maximum residue limits (MRL) was 101-103% (ENRO), 92.8-97.4% (CIPR), 89.8-92.8% (SARA), 116-121% (OXOL), and 81.3-85.5% (FLUM), whilst the precision was 2.9-6.1% (ENRO), 2.5-5.1% (CIPR), 2.3-5.0% (SARA), 3.1-5.9% (OXOL), and 5.6-6.5% (FLUM) . The decision limits, detection capabilities, specificity and analytes stability during storage were also investigated. Medicina (B Aires), 2004, 64(6), 529 - 32 {Mastitis due to Mycobacterium fortuitum in an HIV negative patient}; Palmero DJ et al.; A case of a 39 year old HIV negative female patient with a Mycobacterium fortuitum mastitis without previous pathogenic history is reported . She was treated on the bases of drug-susceptibility testing and bibliographic empirical evidence with kanamycin, doxicicline, ciprofloxacin and trimetoprim-sulfametoxazol . A complete remission of her lesions was obtained after 15 months of treatment . Lesions due to this rapidly growing mycobacterium, diagnosis and treatment are commented. J Ayub Med Coll Abbottabad, 2004 Jul-Sep, 16(3), 43 - 6 Effects of ciprofloxacin on secondary ossification centers in juvenile Wistar albino rats; Channa MA et al.; BACKGROUND: Administration of quinolone therapy is controversial during juvenile age as stated by earlier workers . The fluroquinolones are currently not indicated for young children, because of the arthropathy and adverse effect on growing cartilage shown by studies . However the effects of ciprofloxacin on secondary ossification centers has remained undocumented . This study is therefore aimed to determine the risk of Ciprofloxacin administration on neonatal skeletal differentiation by a prospective and comparative animal study model using Wistar albino rats . METHODS: Ciprofloxacin was administered to newly born Wistar albino rat pups at a dose of 20 mg/kg body weight intraperitoneally twice daily from day-1 to day-14 after birth . These animals were killed by deep ether anaesthesia and fixed in 80% alcohol . They were then bulk stained with Alizarin red and Alcian blue . Finally they were cleared in 4% KOH and stored in glycerin . The fore and hind limbs were disarticulated from the axial skeleton and observed under stereomicroscope for evidence of skeletal differentiation in the form of presence of secondary ossification centers in long hones (left humerus and left femur) . The time of appearance of these centers were noted and compared statistically with those in control animals . RESULTS: The study revealed that the skeletal differentiation in long bones was delayed by 2.4 +/- 0.2 days at both proximal and distal ends in humerus and 2.4 +/- 0.2 days at proximal end and 2.2 +/- 0.2 days at distal end of femur in experimental animals as compared with controls . CONCLUSION: The ciprofloxacin administration during post-natally presents a risk to skeletal differentiation and therefore to its growth up to the age of six weeks is albino rate pups. Farm Hosp, 2004 Nov-Dec, 28(6), 419 - 25 {A prospective comparative stydy to assess the impacto fo pharmaceutical intervention in the promotion of sequential therapy with flouroquinolones.}; Pinteno Blanco M et al.; Objective: To assess the impact of pharmaceutical intervention on the use of sequential therapy (ST) with fluoroquinolones . Methods: A prospective comparative study of pharmaceutical intervention in two stages: observational stage and intervention stage for ST promotion . Results: In all, 250 patients receiving intravenous therapy with fluoroquinolones (113 with levofloxacin and 137 with ciprofloxacin) were studied, with 76 and 70 patients, respectively, being eligible for a pharmaceutical intervention program to promote ST . Pharmaceutical intervention showed a decreased duration of intravenous therapy and increased duration of oral therapy for both drugs, as well as decreased medication-related costs, all in a statistically significant manner . Discussion: ST promotion provides an opportunity to expand the role of hospital pharmacists and to optimize fluoroquinolone-based therapy, which results in decreased intravenous treatments and provides a more cost-effective option. J Drugs Dermatol, 2004 Nov-Dec, 3(6), 685 - 6 Allergic contact dermatitis to propolis; Ting PT et al.; A 35-year-old Asian woman was referred to the dermatology clinic with a 2-week history of enlarging, fluid-filled, pruritic lesions on the right foot . The affected area had a recent history of minor trauma for which the patient applied an over-the-counter propolis ointment . At presentation, the patient was also noted to have been using the following, as prescribed by her primary care physician: valacyclovir, ciprofloxacin, terbinafine cream, mupirocin ointment, and 2% hydrocortisone cream . No clinical improvement was observed with these agents . Examination revealed grouped erythematous papules progressing into vesicles and bulla on the lateral side of the right foot . A KOH scraping was negative . We diagnosed the patient with allergic contact dermatitis to propolis. Antimicrob Agents Chemother, 2005 Jan, 49(1), 118 - 25 Interaction of the plasmid-encoded quinolone resistance protein Qnr with Escherichia coli DNA gyrase; Tran JH et al.; Quinolone resistance normally arises by mutations in the chromosomal genes for type II topoisomerases and by changes in the expression of proteins that control the accumulation of quinolones inside bacteria . A novel mechanism of plasmid-mediated quinolone resistance was recently reported that involves DNA gyrase protection by a pentapeptide repeat family member called Qnr . This family includes two other members, McbG and MfpA, that are also involved in resistance to gyrase inhibitors . Purified Qnr-His(6) was shown to protect Escherichia coli DNA gyrase directly from inhibition by ciprofloxacin . Here we have provided a biochemical basis for the mechanism of quinolone resistance . We have shown that Qnr can bind to the gyrase holoenzyme and its respective subunits, GyrA and GyrB . The binding of Qnr to gyrase does not require the presence of the complex of enzyme, DNA, and quinolone, since binding occurred in the absence of relaxed DNA, ciprofloxacin, or ATP . We hypothesize that the formation of Qnr-gyrase complex occurs before the formation of the cleavage complex . Furthermore, there was a decrease in DNA binding by gyrase when the enzyme interacted with Qnr . Therefore, it is possible that the reaction intermediate recognized by Qnr is one early in the gyrase catalytic cycle, in which gyrase has just begun to interact with DNA . Quinolones bind later in the catalytic cycle and stabilize a ternary complex consisting of the drug, gyrase, and DNA . By lowering gyrase binding to DNA, Qnr may reduce the amount of holoenzyme-DNA targets for quinolone inhibition. Tidsskr Nor Laegeforen, 2004 Dec 16, 124(24), 3197 - 8 {Tularemia from a cat bite}; Yaqub S et al.; We report the first case in Norway of a man who developed ulceroglandular tularaemia following a cat bite . If after feline contact, patients develop skin and soft-tissue infections that fail to respond to therapy with penicillin, physicians should consider the possibility of tularaemia . Our patient was successfully treated with ciprofloxacin, which is effective against Francisella tularensis and most pathogens associated with feline infections . A greater awareness of infections following a cat bite is important for recognising this uncommon condition. Aliment Pharmacol Ther, 2004 Dec, 20(11-12), 1329 - 36 Clinical and endosonographic effect of ciprofloxacin on the treatment of perianal fistulae in Crohn's disease with infliximab: a double-blind placebo-controlled study; West RL et al.; BACKGROUND: Ciprofloxacin is effective in perianal Crohn's disease but after treatment discontinuation symptoms reoccur . Infliximab is effective but requires maintenance therapy . AIM: To evaluate the effect of combined ciprofloxacin and infliximab in perianal Crohn's disease . METHODS: A double-blind placebo-controlled study was conducted . Patients were randomly assigned to receive 500-mg ciprofloxacin twice daily or a placebo for 12 weeks . All patients received 5-mg/kg infliximab in week 6, 8 and 12 and were followed for 18 weeks . Primary end-point was clinical response, defined as a 50% or greater reduction from baseline in the number of draining fistulae . Secondary end-points were the change in Perianal Disease Activity Index and hydrogen peroxide enhanced three-dimensional endoanal ultrasonography findings . Analysis was by intention-to-treat . RESULTS: Twenty-four patients were included but two discontinued treatment . At week 18, response was 73% (eight of 11) in the ciprofloxacin group and 39% (five of 13) in the placebo group (P = 0.12) . Using logistic regression analysis patients treated with ciprofloxacin tended to respond better (OR = 2.37, CI: 0.94-5.98, P = 0.07) . The Perianal Disease Activity Index score only improved (P = 0.008) in the ciprofloxacin group . Three-dimensional endoanal ultrasonography improved in three patients with a clinical response . CONCLUSIONS: A combination of ciprofloxacin and infliximab tended to be more effective than infliximab alone. Clin Pharmacol Ther, 2004 Dec, 76(6), 598 - 606 Ciprofloxacin greatly increases concentrations and hypotensive effect of tizanidine by inhibiting its cytochrome P450 1A2-mediated presystemic metabolism; Granfors MT et al.; BACKGROUND AND OBJECTIVE: Tizanidine, a centrally acting skeletal muscle relaxant, is metabolized mainly by cytochrome P450 (CYP) 1A2 and has a low oral bioavailability . The fluoroquinolone antibiotic ciprofloxacin is only a moderately potent inhibitor of CYP1A2 . Our objective was to study the extent and mechanism of a possible interaction of ciprofloxacin with tizanidine . METHODS: In a double-blind, randomized, 2-phase crossover study, 10 healthy volunteers ingested 500 mg ciprofloxacin or placebo twice daily for 3 days . On day 3, a single dose of 4 mg tizanidine was ingested 1 hour after the morning dose of ciprofloxacin . Plasma concentrations of tizanidine and ciprofloxacin and pharmacodynamic variables were measured . A caffeine test was used as a marker for CYP1A2 activity . RESULTS: Ciprofloxacin increased the area under the plasma concentration-time curve from time 0 to infinity {AUC(0-infinity)} of tizanidine by 10-fold (range, 6-fold to 24-fold; P < .001) and its peak concentration by 7-fold (range, 4-fold to 21-fold; P < .001), whereas its elimination half-life was only prolonged from 1.5 to 1.8 hours (P = .007) . The pharmacodynamic effects of tizanidine were much stronger during the ciprofloxacin phase than during the placebo phase with regard to changes in systolic blood pressure (-35 mm Hg versus -15 mm Hg, P = .001), diastolic blood pressure (-24 mm Hg versus -11 mm Hg, P < .001), Digit Symbol Substitution Test (P = .02), subjective drug effect (P = .002), and subjective drowsiness (P = .009) . The AUC(0-infinity) of tizanidine and its change correlated (P < .01) with the caffeine/paraxanthine ratio and its change . CONCLUSIONS: Ciprofloxacin greatly elevates plasma concentrations of tizanidine and dangerously potentiates its hypotensive and sedative effects, mainly by inhibiting its CYP1A2-mediated metabolism, at least when administered 1 hour before tizanidine . Tizanidine seems to be a useful probe drug for measuring presystemic metabolism by CYP1A2 . Care should be exercised when tizanidine is used concomitantly with ciprofloxacin. Indian Pediatr, 2004 Nov, 41(11), 1115 - 23 Multiple dose pharmacokinetics of ciprofloxacin in preterm babies; Godbole K; Hirschsprung's disease (HSCR) is the main genetic cause of functional intestinal obstruction with an incidence of 1/5000 live births . The etiology of HSCR is complex and is presumed to be a sex-influenced multifactorial disorder, with contributions from several genes . All the genes involved in HSCR are also involved with the early development of the enteric nervous system . HSCR is known to be associated with a chromosomal abnormality in 12 percnt of cases, and with other congenital anomalies in additional 18 percnt of cases . It is recommended that patients, including newborns, with HSCR undergo a careful assessment by a clinician trained in dysmorphology . Echocardiography, ultrasono-graphy for urogenital malformations and skeletal x-rays should be routinely performed in cases with HSCR to rule out associated anomalies . HSCR associated with dysmorphic features or any additional systemic anomaly should prompt chromosomal studies . Genetic counseling should be provided to families of HSCR patients as the recurrence risk varies from 4percnt to up to 50percnt depending on whether it is non-syndromic or part of a specific syndrome. Semin Ophthalmol, 2004, 19(3-4), 125 - 6 Late onset of serologic positive titers in a patient with Parinaud's oculoglandular syndrome; Kymionis G et al.; Purpose . To report a case of Parinaud's oculoglandular syndrome (POS) in which, despite the initially negative, a late onset of serologic positive titers was observed . Methods . Case report . Results . A 65-year-old man was examined for a foreign body in the left eye associated with granulomatous nodule on the palpebral conjuctiva, chemosis and a swollen preauricular lymph node . Despite the initially negative serologic titers to Bartonella henselae, a clinical diagnosis of POS was made and treatment was instituted initially with oral ciprofloxacin (500 mg twice a day) . Three weeks later, serologic positive titers were found which confirmed the diagnosis of POS . Conclusion . Even though the improvements in diagnostic testing such as indirect immunofluorescence antibody, negative titles could be initially observed, confusing the diagnostic process . Other techniques (such as polymerase chain reaction (PCR) testing) should be also taken into consideration in cases with increased clinical suspicious of B . henselae indections. Rev Soc Bras Med Trop, 2004, 37 Suppl 2, 90 - 2 {Complications in typhoid fever: description of an anusual case and its bearing on diagnosis and control}; de Ramos FL; A case of typhoid fever with colestatic hepatitis is described, with diagnosis made by stool culture . Examination for malaria, leptospirosis and viral hepatitis were all negatives . These results and the rapid response of the patient to treatment with ciprofloxacin confirmed the diagnosis of typhoid fever and indicate the importance of considering typhoid fever in cases of fever with jaundice. J Med Microbiol, 2004 Dec, 53(Pt 12), 1259 - 62 Percutaneous exposure resulting in laboratory-acquired leptospirosis -- a case report; Sugunan AP et al.; A screw-capped glass tube containing a Leptospira culture accidentally broke and the laboratory worker who was handling the tube sustained a cut on his hand . The wound was flooded with the culture . The culture was that of strain MG 347 belonging to serovar Australis recovered from a patient, and it had undergone 52 passages in Ellinghausen McCullough Johnson Harris medium . The laboratory worker developed a headache 21 days after the accident and became febrile the next day . He was hospitalized for 5 days and was treated initially with doxycycline and later with ciprofloxacin . A blood sample collected on the second day of illness, after starting doxycycline therapy, yielded leptospires and the isolate, HZ 651, was identified as serovar Australis . Monoclonal antibody patterns and randomly amplified polymorphic DNA fingerprinting patterns of the isolate and strain MG 347 were identical, thus indicating that HZ 651 and MG 347 were clonal. J Clin Microbiol, 2004 Dec, 42(12), 5917 - 20 Molecular epidemiological analysis of Escherichia coli isolates producing extended-spectrum beta-lactamases for identification of nosocomial outbreaks in Stockholm, Sweden; Fang H et al.; From June to October of 2002, a cluster of Escherichia coli isolates producing extended-spectrum beta-lactamases (ESBLs) was detected in Stockholm . The isolates were grouped into two clones, one of which had already circulated in the same area before the outbreak . CTX-M-type ESBLs and coresistance to ciprofloxacin were identified in the strains. Eur J Intern Med, 2004 Nov, 15(7), 463 - 464 SIADH consecutive to ciprofloxacin intake; Adler D et al.; The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is often drug-induced . We describe the first case, to our knowledge, of SIADH consecutive to ciprofloxacin administration . On two occasions, a 70-year-old patient, known for post-actinic bladder with repeated episodes of hematuria, was given ciprofloxacin and developed severe hyponatremia with seizures . On both occasions, the patient's condition improved rapidly after withdrawal of the drug . As all organic diseases likely to cause SIADH were excluded, and because the drug rechallenge was positive, we suggest that ciprofloxacin be added to the list of drugs prone to induce SIADH. Transplant Proc, 2004 Oct, 36(8), 2396 - 8 Various clinical presentations of tuberculosis in heart transplant recipients; Chou NK et al.; The purpose of this study was to clarify the various clinical presentations, incidence, and complications associated with tuberculosis (TB), as well as patient survival in heart transplantation (HTx) recipients . A retrospective review of 177 case records of HTx recipients from May 1989 to April 2003 were evaluated for their clinical course, diagnostic procedures, treatment, and survival . TB was diagnosed by culture . TB was proven in five (2.8%) patients . There were three pulmonary lesions and two extrapulmonary lesions . TB was diagnosed at 3.5 to 85 months after HTx . Pulmonary lesions were detected by cultures of sputum, bronchoalveolar lavage, or pleural effusion . For extrapulmonay lesions, one subject had neck lymphadenopathy shown by biopsy and culture to be TB; another suffered from swelling of the finger joints which upon culture of the aspirate proved to be TB . Treatment consisted of isoniazid (INH), rifampin (RIF), ethambutol, pyrazinamide, streptomycin (STR), ciprofloxacin (Ciproxin), and levofloxacin (Cravit) . During the use of RIF, the daily dosage of cyclosporine (CsA) or tacrolimus was increased to maintain appropriate levels . Because of severe hepatotoxicity and interference with CsA, RIF was withdrawn and STR given in the last three patients . In addition, ciprofloxacin was given in the patient with miliary TB . Levofloxacin was given to the other two patients . All patients survived the TB infection under treatment with at least three drugs . There were five clinical presentations of TB in our HTx recipients . Because of the high incidence of hepatitis and severe drug interaction with CsA or tacrolimus on RIF treatment, avoiding the use of RIF but treatment with at least three drugs is recommended. Spectrochim Acta A Mol Biomol Spectrosc, 2005 Jan 1, 61(1-2), 281 - 6 Spectrofluorimetric study of the charge-transfer complexation of certain fluoroquinolones with 7,7,8,8-tetracyanoquinodimethane; Du LM et al.; Simple, rapid and sensitive spectrofluorimetric methods are described, for the first time, for the determination of ciprofloxacin (CIP), norfloxacin (NOR), pefloxacin (PEF) and fleroxacin (FLE) . The methods are based on the charge-transfer (CT) reaction of these drugs as n-electron donors with 7,7,8,8-tetracyanoquinodimethane (TCNQ) as pi-electron acceptor . TCNQ was found to react with these drugs to produce intensely transfer reaction complexes and the fluorescence intensity of the complexes was enhanced in 21-35 fold higher than that of the studied fluoroquinolones itself . The formation of such complexes was also confirmed by both infrared and ultraviolet-visible measurements . The different experimental parameters that affect the fluorescence intensity were carefully studied . At the optimum reaction conditions, the drug-TCNQ complexes showed excitation maxima ranging from 277 to 284 nm and emission maxima ranging from 451 to 458 nm . Rectilinear calibration graphs were obtained in the concentration range of 0.03-0.9, 0.04-1.2, 0.04-1.3 and 0.08-2.4 microg ml(-1) for CIP, NOR, PEF and FLE, respectively . The developed methods were applied successfully for the determination of the studied drugs in their pharmaceutical dosage forms with a good precision and accuracy compared to official and reported methods as revealed by t- and F-tests. Br J Dermatol, 2004 Nov, 151(5), 1096 - 100 Successive development of cutaneous polyarteritis nodosa, leucocytoclastic vasculitis and Sweet's syndrome in a patient with cervical lymphadenitis caused by Mycobacterium fortuitum; Chen HH et al.; Mycobacterium fortuitum is a rapidly growing mycobacterium found in soil and water throughout the world . It can cause diseases in immunocompetent patients, usually resulting in localized skin and soft tissue infections . Cervical lymphadenitis caused by M . fortuitum is rare . We report a 46-year-old woman in whom skin lesions of cutaneous polyarteritis nodosa, leucocytoclastic vasculitis and Sweet's syndrome had successively developed before the diagnosis of cervical lymphadenitis caused by M . fortuitum was made . The skin lesions responded to colchicine and systemic corticosteroids but recurred intermittently . After establishment of the diagnosis, she received treatment with clarithromycin and ciprofloxacin . The cervical lymph nodes decreased in size 6 months later and no more new skin lesions were found. Arch Ophthalmol, 2004 Nov, 122(11), 1693 - 9 193-nm excimer laser-induced fluorescence detection of fluoroquinolones in rabbit corneas; Chuck RS et al.; OBJECTIVE: To measure the 193-nm excimer laser-induced fluorescence of fluoroquinolone-treated cadaver rabbit corneas . METHODS: Prior to ablation with a commercially available ophthalmic excimer laser (Nidek EC-5000; Nidek Technologies, Pasadena, Calif), 35 cadaver rabbit corneas were treated with topical sterile balanced salt solution, 0.3% tobramycin sulfate, or the fluoroquinolones-0.3% ofloxacin, 0.5% levofloxacin, 0.3% ciprofloxacin hydrochloride, or 0.3% gatifloxacin . The fluorescence generated from each ablated corneal layer was measured and used to identify the presence of antibiotic . This was achieved by training a partial least-squares model to discriminate between the fluorescence spectra of antibiotic-treated and antibiotic-free (healthy) cornea . Antibiotic concentrations down to 0.06 microg/mL were detected with high accuracy . Assuming a constant ablation rate of 0.3 microm per laser pulse, the number of corneal layers ablated to reach antibiotic-free cornea is used to calculate the penetration depth of the antibiotic . RESULTS: The mean +/- SD penetration to a detectable depth was as follows: 0.3% ofloxacin, 7.1 +/- 3.0 microm; 0.5% levofloxacin, 6.7 +/- 1.4 microm; 0.3% ciprofloxacin, 1.2 +/- 0.6 microm; and 0.3% gatifloxacin, 7.0 +/- 1.9 microm . The penetration depth of 0.3% tobramycin could not be determined because its fluorescence spectrum overlapped with that of the native cornea . CONCLUSIONS: Topical administration of fluoroquinolone-containing solutions results in measurable differences in laser-induced corneal fluorescence . Under these experimental conditions, 0.3% ofloxacin, 0.5% levofloxacin, and 0.3% gatifloxacin all appear to penetrate the epithelium significantly more than 0.3% ciprofloxacin (P<.02).Clinical Relevance Monitoring of laser-induced fluorescence may be helpful in determining the penetration depths and concentrations of topically applied fluoroquinolones within the cornea. J Chromatogr A, 2004 Oct 8, 1051(1-2), 283 - 90 Electrophoretic behavior and pKa determination of quinolones with a piperazinyl substituent by capillary zone electrophoresis; Lin CE et al.; Electrophoretic behavior and pKa determination of six quinolones with a piperazinyl substituent, together with two quinolones without a piperazinyl substituent and 1-phenylpiperazine, were investigated by capillary zone electrophoresis . The results indicate that quinolones with a piperazinyl substituent involve three protonation/deprotonation equilibria . The results also suggest that the contribution of the zwitterionic species of these quinolones to the effective mobility may not be neglected . This is probably due to a slightly incomplete protonation of the piperazinyl moiety in the pH range of 6.0-8.0, compared with the complete dissociation of the carboxylic group . Consequently, the zwitterionic species of ciprofloxacin, in particular, is slightly negatively charged . With the aid of computer simulation, three pKa values were determined for quinolones with a piperazinyl substituent, thus allowing us to rationalize precisely the influence of pH on the electrophoretic behavior of these compounds. J Chromatogr A, 2004 Oct 8, 1051(1-2), 267 - 72 Determination of ciprofloxacin and its impurities by capillary zone electrophoresis; Michalska K et al.; Capillary zone electrophoresis (CZE) has been elaborated for separation, identification and determination of ciprofloxacin and its impurities . The separation, phosphate buffer pH 6.0 was supplemented with 0.075 M pentane-1-sulfonic acid sodium salt . The elaborated method was validated . The selectivity, linearity, limits of detection (LOD) and quantification (LOQ), precision, and accuracy of capillary zone electrophoresis were evaluated . The results obtained by CZE were also compared with those obtained by liquid chromatography . Regarding the validation results the CE method fulfils the current European Pharmacopoeia (Eur . Ph.) requirements . The evaluated CE method could be applicable to the analysis of different medicinal products containing ciprofloxacin. Ear Nose Throat J, 2004 Sep, 83(9), 625 - 6, 628, 630 passim Ototopical ciprofloxacin in a glycerin vehicle for the treatment of acute external otitis; Olivera ME et al.; We conducted a prospective, randomized, controlled, double-blind study of 33 patients to compare the efficacy and tolerability of a new glycerin formulation of ototopical 0.3% ciprofloxacin with that of a conventional aqueous formulation of ciprofloxacin for the treatment of acute external otitis . Outcomes measures were resolution of discharge, swelling, pain, and redness and the incidence of adverse side effects . Patients were examined on three occasions: on the day of enrollment (visit 1), 48 to 72 hours later (visit 2), and 7 days after enrollment (visit 3) . At visit 2, the patients in the glycerin group showed a significantly greater resolution of discharge . We observed the same pattern with respect to swelling, pain, and redness, which resolved more quickly in the glycerin group, although not significantly so . All patients were cured by visit 3, and the two treatments were equally well tolerated . On the basis of our findings, we conclude that the glycerin formulation of ototopical 0.3% ciprofloxacin appears to be at least as effective as the aqueous form in the treatment of acute external otitis--and in the case of otorrhea, more so. Int J Antimicrob Agents, 2004 Nov, 24(5), 502 - 7 Treatment of brucella spondylitis: lessons from an impossible meta-analysis and initial report of efficacy of a fluoroquinolone-containing regimen; Pappas G et al.; Although spondylitis is the most common of the complications of brucellosis, and is often debilitating and difficult to treat, there is no consensus on the preferred combination of antibiotics used . We attempted to perform a meta-analysis based on series on brucellar spondylitis published in the last 22 years . Meta-analysis was aborted largely due to insufficient data recorded in most series . However, useful conclusions could be drawn, such as the importance of prolonged treatment, usually more than 12 weeks . No antibiotic combination was proven to be superior, but 14 different regimens were used in the series studied . The authors propose the use of a combination of doxycycline and ciprofloxacin for a period of 3 months, and report the successful use of such a combination in five patients with brucellosis and spondylitis. Chang Gung Med J, 2004 Jul, 27(7), 555 - 7 Idiopathic subconjunctival abscess; Yang KS et al.; Subconjunctival abscess is a relatively rare cause of ocular infection . It is usually associated with predisposing factors such as previous trauma or surgery . We report a case of subconjunctival abscess in a 61-year-old woman with no known risk factors . The subconjunctival abscess resolved completely after surgical excision and treatment with topical ciprofloxacin . The final vision preserved 20/20. Prescrire Int, 2004 Oct, 13(73), 184 - 6 Fluoroquinolones in children: poorly defined risk of joint damage; Corneal intrastromal gatifloxacin crystal deposits after penetrating keratoplasty; Department of Ophthalmology (S.T.A., D.P., D.C., H.D.C.), University of Texas, Southwestern Medical Center at Dallas, Dallas, TX 75390-9057, USABACKGROUND: An 85-year-old man developed faint crystallike white precipitates in the mid peripheral stroma of his left cornea 3 weeks after undergoing penetrating keratoplasty . The patient had been initially treated with 1% prednisolone acetate ophthalmic suspension and 0.3% gatifloxacin eyedrops to his left eye from the first day postoperatively . Three weeks later, the precipitates were more numerous, larger, and diffuse in distribution . Gatifloxacin was discontinued and substituted with a neomycin-polymixin B-dexamethasone ophthalmic ointment . METHODS: A detailed history, physical examination, laboratory workup, and tandem scanning confocal microscopy were performed . RESULTS: Tandem scanning corneal confocal microscopy confirmed the presence of crystals in the cornea . CONCLUSIONS: Gatifloxacin, a fourth-generation fluoroquinolone, can cause intrastromal macroscopic crystalline deposits through a compromised corneal epithelium, similar to what has been described for ciprofloxacin, a second-generation fluoroquinolone. J Pharm Biomed Anal, 2004 Oct 29, 36(2), 295 - 307 Microcalorimetric evaluation of the in vitro compatibility of amoxicillin/clavulanic acid and ampicillin/sulbactam with ciprofloxacin; Chadha R et al.; Solution calorimetric technique has been used to determine the compatibility of binary and ternary systems of ampicillin trihydrate (AMP), sulbactam sodium (SS), amoxicillin trihydrate (AM), potassium clavulanate (PC) and ciprofloxacin hydrochloride (CP) . The enthalpy of solution (DeltasolH) were obtained over a wide range of composition in the pH range 2-9 . For all the pure drugs the DeltasolH is endothermic in nature . The molar enthalpies of interaction of binary (DeltaHbi.E) and ternary (DeltaHter.E) mixtures of the drugs in aqueous buffers have been determined . The DeltaHbi.E for all binary systems is negative and pH dependent (maximum pH 6-8) indicating the interaction among charged species of the drugs . In case of binary systems with CP the magnitude of DeltaHbi.E indicate strong interactions . The variation and magnitude of DeltaHbi.E for the systems is discussed in terms of hydrogen bonding and van der Waal's interaction in the solution . The interaction parameter for ternary systems (A) is positive indicating repulsive interaction among the drugs . The coefficients hi's calculated from Redlich-Kister equation for binary systems (DeltaHbi.E) and ternary interaction parameter (A) were used to predict the compatibility of the marketed formulations in pH range studied. Drug Chem Toxicol, 2004 Aug, 27(3), 233 - 42 Ciprofloxacin-induced glutathione redox status alterations in rat tissues; Gurbay A et al.; The possible oxidative stress inducing effect of a fluoroquinolone (FQ) antibiotic, ciprofloxacin (CPFX), was investigated in rats measuring glutathione redox status . For this purpose, the drug was administered to rats as two different single doses (100 and 150 mg/kg, ip) or a repeated dose (500 mg/kg/d, ig, for 5d) . Then, total and oxidized glutathione levels were determined in hepatic and cerebral tissues of the rats by an enzymatic cycling assay, and the glutathione redox status was calculated . The possible protective effects of vitamin E or allopurinol against CPFX-induced alterations on glutathione system have also been examined . Following both routes of administration of CPFX, the total glutathione content of the liver, but not of brain decreased significantly . The oxidized glutathione (GSSG) in the brain increased after single or repeated dose treatments, but only with repeated doses of CPFX in the liver . CPFX induced dose-dependent alterations in the glutathione redox status in both tissues . With single doses the effect was more pronounced in cerebral tissue, and with repeated ig doses it was significant in both tissues . Pretreatment of rats with vitamin E or allopurinol before the administration of CPFX provided marked protection against glutathione redox status alterations in both tissues . Our results, thus, indicate that CPFX treatment introduces an oxidative stress in cerebral and hepatic tissues of rat. J Cyst Fibros, 2003 Sep, 2(3), 152 - 4 Ciprofloxacin-induced renal insufficiency in cystic fibrosis; Moffett BS et al.; Acute renal insufficiency is known to occur in patients who are taking ciprofloxacin, particularly the elderly . We report two young patients with cystic fibrosis who presented with acute renal insufficiency after 2-3 weeks of oral ciprofloxacin therapy . The incidence of this adverse effect in children and young adults who have cystic fibrosis is unknown . Multiple mechanisms for ciprofloxacin-induced nephrotoxicity have been proposed . Sex Transm Infect, 2004 Oct, 80(5), 386 - 8 Which cephalosporin for gonorrhoea? Ison CA, Mouton JW, Jones K, Fenton KA, Livermore DM; North Thames Audit Group. The recommended treatment for gonorrhoea in the United Kingdom has, until recently, included the fluoroquinolone, ciprofloxacin, which consequently was used by most genitourinary medicine clinics . In 2002 national surveillance data showed that resistance to ciprofloxacin had risen to a prevalence of 9.8% (9% in 2003), indicating that the target of >95% efficacy in first line therapy was no longer achievable . The third generation cephalosporins, ceftriaxone (intramuscular) or cefixime (oral), are the recommended alternatives, but recent audit data reveal other cephalosporins are currently being used to treat gonorrhoea, notably including cefuroxime (intramuscular or, often, oral) . A pharmacodynamic analysis was undertaken to determine whether all these regimens were equally potent . Ceftriaxone, 250 (or 500) mg intramuscularly, or cefixime, 400 mg orally, were calculated to give free drug concentrations above the MIC90 for 22-50 hours post dose whereas the cefuroxime regimens being used were pharmacodynamically borderline, achieving this target for only 6.8-11.2 hours and raising the spectre that continued use may select for stepwise increases in resistance, as occurred with penicillin . We therefore underscore that ceftriaxone or cefixime should be the agents of choice to replace ciprofloxacin, as recommended in the new treatment guidelines, and that cefuroxime is a poor substitute. Eur J Pharm Biopharm, 2004 Nov, 58(3), 539 - 49 The influence of the use of viscosifying agents as dispersion media on the drug release properties from PLGA nanoparticles; Dillen K et al.; Poly(lactide-co-glycolide) nanoparticles incorporating ciprofloxacin HCl were prepared by means of a W/O/W emulsification solvent evaporation method . The physicochemical properties of these particles were evaluated by measuring particle size, zeta potential and drug loading efficiency . Gamma-sterilised nanoparticles were dispersed in different isoviscous polymer solutions, commonly used as vehicles in eye drops . The influence of gamma-irradiation of the viscosifying agents on the drug release properties of the dispersed nanoparticles was evaluated with respect to release in mannitol solution . The viscosity of the polymer solutions prepared was measured by flow rheometry and thereby the influence of temperature and sterilisation by autoclaving on viscosity was examined . Before and after freeze-drying and subsequent sterilisation by gamma-irradiation, the polymer solutions were also characterised by dynamic stress sweep and dynamic frequency sweep oscillation measurements to deduce possible structural changes . A possible relationship between the differences in ciprofloxacin release from the nanoparticles suspended in the various media and the network structure or rheological behaviour of the polymers was investigated. Antimicrob Agents Chemother, 2004 Oct, 48(10), 3850 - 7 {18F}Ciprofloxacin, a new positron emission tomography tracer for noninvasive assessment of the tissue distribution and pharmacokinetics of ciprofloxacin in humans; Brunner M et al.; The biodistribution and pharmacokinetics of the fluorine-18-labeled fluoroquinolone antibiotic {(18)F}ciprofloxacin in tissue were studied noninvasively in humans by means of positron emission tomography (PET) . Special attention was paid to characterizing the distribution of {(18)F}ciprofloxacin to select target tissues . Healthy volunteers (n = 12) were orally pretreated for 5 days with therapeutic doses of unlabeled ciprofloxacin . On day 6, subjects received a tracer dose (mean injected amount, 700 +/- 55 MBq, which contained about 0.6 mg of unlabeled ciprofloxacin) of {(18)F}ciprofloxacin as an intravenous bolus . Thereafter, PET imaging and venous blood sampling were initiated . Time-radioactivity curves were measured for liver, kidney, lung, heart, spleen, skeletal muscle, and brain tissues for up to 6 h after radiotracer administration . The first application of {(18)F}ciprofloxacin in humans has demonstrated the safety and utility of the newly developed radiotracer for pharmacokinetic PET imaging of the tissue ciprofloxacin distribution . Two different tissue compartments of radiotracer distribution could be identified . The first compartment including the kidney, heart, and spleen, from which the radiotracer was washed out relatively quickly (half-lives {t(1/2)s}, 68, 57, and 106 min, respectively) . The second compartment comprised liver, muscle, and lung tissue, which displayed prolonged radiotracer retention (t(1/2), >130 min) . The highest concentrations of radioactivity were measured in the liver and kidney, the main organs of excretion (standardized uptake values {SUVs}, 4.9 +/- 1.0 and 9.9 +/- 4.4, respectively) . The brain radioactivity concentrations were very low (<1 kBq . g(-1)) and could therefore not be quantified . Transformation of SUVs into absolute concentrations (in micrograms per milliliter) allowed us to relate the concentrations at the target site to the susceptibilities of bacterial pathogens . In this way, the frequent use of ciprofloxacin for the treatment of a variety of infections could be corroborated. Magn Reson Chem, 2004 Oct, 42(10), 903 - 4 1H, (13)C and (15)N NMR spectra of ciprofloxacin; Zieba A et al.; 1H NMR assignment, including the values of delta(H) and J(H,H) for the cyclopropane moiety, and (13)C NMR and (15)N NMR spectral data for ciprofloxacin are presented . J Toxicol Clin Toxicol, 2004, 42(3), 295 - 7 Refractory hypoglycemia from ciprofloxacin and glyburide interaction; Lin G et al.; Patients taking multiple medications may suffer from unpredictable and complex drug-drug interactions resulting in significant morbidity and mortality . There are few reports in the literature of hypoglycemia with concurrent administration of an oral hyperglycemic agent and a fluoroquinolone antibiotic . We present a case of a diabetic patient taking glyburide who was prescribed ciprofloxacin and developed prolonged hypoglycemia, which persisted for over 24 hours . The mechanisms by which these agents interact to produce prolonged hypoglycemia are complex and probably multifactorial . Patients stabilized on glyburide who are started on a fluoroquinolone should have their glucose levels monitored closely. J Med Microbiol, 2004 Oct, 53(Pt 10), 1019 - 22 In vitro activity of fluoroquinolone and the gyrA gene mutation in Helicobacter pylori strains isolated from children; Fujimura S et al.; Resistance to antibiotics, especially clarithromycin, is the major cause of the failure to eradicate Helicobacter pylori . There are few studies in children concerning fluoroquinolone activity against H . pylori . Primary resistance to antibiotics including fluoroquinolones was studied in 55 H . pylori strains isolated from Japanese children . DNA sequences of the gyrA gene in fluoroquinolone-resistant strains were determined . Twelve strains (21.8%) were resistant to clarithromycin and three (5.5%) were resistant to both levofloxacin and ciprofloxacin . Out of 12 clarithromycin-resistant strains, 11 (91.7%) were susceptible to levofloxacin and ciprofloxacin . Sequence analysis in three fluoroquinolone-resistant strains showed point mutations of the gyrA gene at G271A, G271T and A272G, indicating mutations of the codon Asp91 in the fluoroquinolone-resistance-determining region of the DNA gyrase . The results suggest that fluoroquinolones should be considered as an option for second- or third-line H . pylori eradication therapy in children. Aliment Pharmacol Ther, 2004 Oct, 20 Suppl 4, 106 - 10 Review article: treatment of perianal fistulizing Crohn's disease; Rutgeerts P; Fistulizing Crohn's disease can involve the bowel, but is more commonly seen in the perianal region . In acute perianal Crohn's disease, perianal lesions are manifestations of disease activity and are frequently treated concomitantly with bowel lesions . Spontaneous resolution occurs in up to 50% of patients . Fistulae are secondary lesions that may progress to destruction of the sphincter apparatus necessitating proctectomy after years of suffering . The control of sepsis is the first objective . The drainage of abscesses and the placement of setons are essential steps in treatment . Disease severity can be readily assessed by examination under anaesthesia and by magnetic resonance imaging . Endoscopic ultrasonography is sensitive, but is hampered by the necessary introduction of a large instrument into an often narrowed anorectum . Antibiotics, especially metronidazole and ciprofloxacin, are useful short-term therapies to decrease or stop drainage, but relapse is immediate on discontinuation . Immunosuppression with azathioprine (2.5 mg/kg per day) or mercaptopurine (1.5 mg/kg per day) is effective, but slow and often incomplete . The management of perianal fistulizing disease resistant to standard treatment has greatly improved with the introduction of the anti-tumour necrosis factor-alpha antibody, infliximab . The complete arrest of the drainage of fistulae is obtained in 46% of patients 10 weeks after the administration of 5-10 mg/kg of infliximab at weeks 0, 2 and 6 and, on average, lasts for 12 weeks . A treatment algorithm for fistulizing Crohn's disease must therefore involve the early and optimal use of immunosuppression and of infliximab . Medical and surgical co-operation is also critical to achieve the best possible outcome. J Pharm Biomed Anal, 2004 Sep 21, 36(1), 81 - 9 Identification of 5-aminosalicylic acid, ciprofloxacin and azithromycin by abrasive stripping voltammetry; Komorsky-Lovric S et al.; Solid microparticles of 5-aminosalicylic acid, ciprofloxacin, and azithromycin were mechanically immobilized on the surface of the paraffin impregnated graphite electrode and investigated by square-wave and cyclic voltammetry in order to develop a method for their qualitative determination . 5-Aminosalicylic acid is oxidized at 0.540 V in the quasireversible electrode reaction, which is followed by the chemical transformation of the product, while ciprofloxacin and azithromycin are oxidized at 1.2 V and 0.94 V, respectively, in totally irreversible electrode reactions . The detection of these drugs in commercial dosage formulations is reported. J Mater Sci Mater Med, 2002 Dec, 13(12), 1259 - 64 In vitro mechanical and drug release properties of bioabsorbable ciprofloxacin containing and neat self-reinforced P(L/DL)LA 70/30 fixation screws; Veiranto M et al.; Osteomyelitis is inflammation of the bone caused by a pathogenic organism . Both its acute and chronic forms are difficult to heal . Antibiotics are still the basic treatment for osteomyelitis . Bioabsorbable ciprofloxacin containing bone fixation screws based on self-reinforced (SR) copolylactide P(L/DL)LA 70/30 have been developed for local treatment of bone infections . These screws gradually released ciprofloxacin during the in vitro bulk degradation of the matrix polymer and at the same time have sufficient mechanical strength . All the loaded ciprofloxacin was released from the gamma sterilized screws during 44 in vitro weeks and the concentration of the released drug per day remained between 0.06 and 8.7 microg/ml after the start-up burst peak. Antibiot Khimioter, 2004, 49(3), 22 - 5 {Therapy of bronchopulmonary infection in smokers}; Sokolova VI et al.; The efficacy and safety of Cifran OD, a new dosage form of ciprofloxacin with prolonged action were studied in the treatment of patients with bronchopulmonary infection (n=23) . The drug was used orally in a dose of 1 g once a day . The patients were divided into 2 groups: group 1 included patients with aggravation of chronic bronchitis and group 2 included patients with bacterial pneumonia . The recovery was stated in 77.7% of the patients in group 1, the other 26.3% of the patients showed clinical improvement . In the patients with pneumonia (group 2) the recovery was recorded in 100% of the cases . No significant side effects were observed. Clin Breast Cancer, 2004 Aug, 5(3), 208 - 15 Phase II trial of a doxorubicin/docetaxel doublet for locally advanced and metastatic breast cancer: results from national surgical adjuvant breast and bowel project trial BP-57; Smith RE et al.; A phase II trial at 12 institutions using AT (doxorubicin 60 mg/m2 plus docetaxel 60 mg/m2) given every 21 days was conducted . Eighty-nine patients were entered who ranged in age from 25 to 75 years, 41.6% of whom had stage IIIB disease and 58.4% of whom had stage IV disease . Among the patients with stage IV disease, 32.7% had received prior adjuvant chemotherapy . Premedication with dexamethasone (8 mg orally twice per day for 3 days) and prophylactic ciprofloxacin (500 mg orally twice per day on days 5-15) was used . Colony-stimulating growth factors were reserved for secondary prophylaxis after prolonged or febrile neutropenia (FN) or documented severe infection in an earlier cycle . After a cumulative dose of doxorubicin of 480 mg/m2, patients could continue to receive docetaxel (100 mg/m2) alone . Median time on study as of July 6, 2003, was 54 months . Febrile neutropenia occurred in 36 patients (41.9%): 23 developed FN in the absence of previous prophylactic growth factor support and 13 developed it despite previous growth factor support . One patient died from sepsis . Other grade 3/4 adverse events included nausea in 3.5%, vomiting in 4.7%, stomatitis in 8.1%, diarrhea in 5.8%, arthralgia/myalgia in 2.3%, fluid retention in 1.2%, pulmonary embolism in 1.2%, rest dyspnea in 1.2%, neuromotory toxicity in 1.2%, and neurosensory toxicity in 1.2% . Clinical congestive heart failure was seen in 2 patients (2.3%) . Sixty-seven patients were evaluable for best response with 6 cycles of therapy . Fourteen patients (20.9%) had a complete response and 30 (44.8%) had a partial response, for an overall response rate of 65.7% in evaluable patients . The median response duration was 25.9 months, and the median time from entry to progression or death was 27.5 months . The median survival time for the 86 patients with endpoint information was 31.1 months . The administration of AT with primary ciprofloxacin and secondary colony-stimulating factor prophylaxis is feasible, and the combination is active . Its value in the adjuvant setting is currently under investigation. Rev Inst Med Trop Sao Paulo, 2004 May-Jun, 46(3), 171 - 4 Epub 2004 Jul 20. Carrion's disease (Bartonellosis bacilliformis) confirmed by histopathology in the High Forest of Peru; Maco V et al.; Bartonellosis or Carrion's disease is endemic in some regions of Peru, classically found in the inter-Andean valleys located between 500 and 3200 meters above sea level . We report the case of a 43 year-old male patient, farmer, who was born in the Pichanaki district (Chanchamayo, Junin), located in the High Forest of Peru . He presented with disseminated, raised, erythematous cutaneous lesions, some of which bled . The distribution of these lesions included the nasal mucosa and penile region . Additionally subcutaneous nodules were distributed over the trunk and extremities . Hematologic exams showed a moderate anemia . Serologic studies for HIV and Treponema pallidum were negative . The histopathologic results of two biopsies were compatible with Peruvian wart . Oral treatment with ciprofloxacin (500 mg BID) was begun . Over 10 days, the patient showed clinical improvement . This is the first report of a confirmed case of bartonellosis in the eruptive phase originating from the Peruvian High Forest, showing the geographical expansion of the Carrion's disease. Mymensingh Med J, 2004 Jul, 13(2), 201 - 2 High ear piercing--a dangerous craze; Chowdhury WA et al.; Ear piercing is a primitive tradition among the human being . It reflects the culture of many religions, tribes, and communities, predominately adopted by the females . We reported a sixteen years old girl with painful swelling of both pinnas for last one month following piercing the pinna . She was treated locally by general practitioner without significant improvement . On examination frank abscess were detected in both pinna . Under general anesthesia incision drainage and deep curettage was done . She was treated with ciprofloxacin 750 mg 12 hourly for 2 weeks and recovery was uneventful . After one month she developed unsightly cauliflower ear . With this report we want to sensitize our community regards the risk of transmission of needle prick diseases and deformity of pinna following ear piercing Antimicrob Agents Chemother, 2004 Aug, 48(8), 3175 - 8 Rv2686c-Rv2687c-Rv2688c, an ABC fluoroquinolone efflux pump in Mycobacterium tuberculosis; Pasca MR et al.; The Mycobacterium tuberculosis Rv2686c-Rv2687c-Rv2688c operon, encoding an ABC transporter, conferred resistance to ciprofloxacin and, to a lesser extent, norfloxacin, moxifloxacin, and sparfloxacin to Mycobacterium smegmatis . The resistance level decreased in the presence of the efflux pump inhibitors reserpine, carbonyl cyanide m-chlorophenylhydrazone, and verapamil . Energy-dependent efflux of ciprofloxacin from M . smegmatis cells containing the Rv2686c-Rv2687c-Rv2688c operon was observed. Southeast Asian J Trop Med Public Health, 2004 Mar, 35(1), 109 - 12 Case report: Brucellosis: a re-emerging disease in Thailand; Manosuthi W et al.; Brucellosis is a zoonotic disease prevalent in many countries, but it has been reported only once in Thailand, 36 years ago . We describe here two consecutive cases of brucellosis in Bangkok, Thailand . Both cases presented with prolonged fever and weight loss . Blood cultures taken from 2 patients yielded Brucella melitensis . The slide agglutination test of blood samples were also positive, with a titer of 1:64 for antibodies to Brucella . The first patient responded to a combination of doxycycline, gentamicin, and ciprofloxacin; the other responded to doxycycline and rifampicin . Brucellosis is a potential public health threat, therefore, preventive measures should be actively implemented . This clinical syndrome should be included in the differential diagnosis of patients presenting with prolonged fever, particularly those with contact to animals which could serve as reservoirs. J Biomed Mater Res, 2004 Aug 15, 70B(2), 389 - 96 Improved collagen bilayer dressing for the controlled release of drugs; Sripriya R et al.; A novel bilayer dressing has been developed from bovine succinylated collagen . The dressing contains an antibiotic, Ciprofloxacin, for both immediate and time-regulated release for controlling the infection, as the infected open wounds need special care . The dressing consists of a sponge and a film, both prepared from succinylated bovine collagen . The sponge has a smooth surface on one side; its rough surface on the other side forms the bilayer system with the film . Both sponge and film act as an anionic reservoir to hold the cationic Ciprofloxacin . The drug, after dispersing in poly (N-vinyl-2-pyrrolidione) (PVP) solution is allowed to spread in the bilayer system by diffusion . The drug stays in the bilayer system because of ionic binding, but starts releasing when comes in contact with the wound . Release of the drug is immediate, but it is regulated by ionic binding between the drug and succinylated collagen . The wound exudates, and there is a polarity-controlled release of the drug from the bilayer system . The PVP and bilayer system permits only time-regulated release, and the system lasts up to 5 days with therapeutically sufficient drug availability . Pathol Biol (Paris), 2004 Jul, 52(6), 308 - 13 {Anethole dithiolethione: an antioxidant agent against tenotoxicity induced by fluoroquinolones}; Pouzaud F et al.; Tendinopathy and tendon rupture are the adverse effects observed with fluoroquinolone antibiotics in old patients . The aim of this study was to investigate the effect of anethole dithiolethione (5-{p-methoxyphenyl}3H-1,2-dithiole-3-thione) on the oxidative stress induced by three fluoroquinolones (pefloxacin, ofloxacin, ciprofloxacin) incubated with rabbit tenocyte cell line . Anethole dithiolethione is a well known antioxidant and glutathione inducer . Anethole dithiolethione is widely used in human therapy for its choleretic, sialogogic properties and recently proposed as cytoprotective agent in lung precancerous lesions prevention in smokers . In this purpose, protection against oxidative stress induced by fluoroquinolones has been assessed using cytofluorimetric probes to quantify cytotoxicity and reactive oxygen species production . Fluorescence signal was quantified in 96-well microplates, using cold light cytofluorometer . Significant reactive oxygen species production was detected after 45 minutes for all fluoroquinolones tested . Anethole dithiolethione has been evaluated on this parameter . Anethole dithiolethione significantly (*: P<0.05) reduces and normalizes reactive oxygen species induced by fluoroquinolones . So, anethole dithiolethione (Sulfarlem), well known for its antioxidant and glutathione inducing properties, good tissue diffusion and good tolerance in humans, could be beneficially associated to fluoroquinolones, and be proposed as a therapeutic adjuvant to prevent oxidative stress and tendinous adverse effects induced by xenobiotics and more precisely by fluoroquinolones. Eye Contact Lens, 2004 Apr, 30(2), 90 - 4 Evaluation of the corneal effects of topical ophthalmic fluoroquinolones using in vivo confocal microscopy; Kovoor TA et al.; PURPOSE: To compare the effects of several fluoroquinolone antibiotics on the corneal epithelium and stroma using in vivo confocal microscopy . METHODS: Five antibiotic solutions were evaluated: 1) 0.3% ofloxacin (Oflox) solution with 0.005% benzalkonium chloride (BAC); 2) 0.3% gatifloxacin (Gati) solution with 0.005% BAC; 3) 0.3% ciprofloxacin (Cipro) solution with 0.006% BAC; 4) 0.5% levofloxacin (Levo) with 0.005% BAC; and 5) 0.5% moxifloxacin (Moxi) solution with no BAC . Preservative-free artificial tears (Tears) were used as a control . New Zealand white rabbits were used for this study (six per solution group) . Ten days prior to exposure to any solution, central corneal epithelial thickness and stromal thickness were measured using in vivo confocal microscopy through focusing . Images of the superficial epithelium were also acquired . Both eyes of each rabbit then received one drop of the assigned solution six times the first day and then four times per day for 6 days . On day 7, in vivo confocal microscopy was repeated . RESULTS: A significant decrease in epithelial thickness was induced by 7 days of exposure to Levo, Gati, Oflox, and Cipro (P < 0.05, two-way repeated-measures ANOVA, Tukey test) . Tears and Moxi, which do not contain BAC, did not induce significant changes in epithelial thickness . No significant changes in stromal thickness were detected (P = 0.266), and no keratocyte activation was observed for any of the solutions evaluated . CONCLUSION: We have previously used confocal microscopy to establish a correlation between epithelial thinning (due to superficial cell loss) and slight ocular irritation . The results of this study suggest that Moxi induces less damage to the corneal epithelium than other antibiotic solutions, perhaps because it does not contain BAC. Ther Drug Monit, 2004 Aug, 26(4), 401 - 7 A population pharmacokinetic-metabolism model for individualizing ciprofloxacin therapy in ophthalmology; Di Marco MP et al.; The purpose of this study was to construct a population pharmacokinetic (PK) metabolism (MB) model to describe ciprofloxacin (C) concentrations in plasma and vitreous and aqueous humors in 26 patients . Ciprofloxacin was given as a 3-day oral prophylactic treatment to 26 patients before vitrectomy . Plasma, vitreous, and aqueous humor samples were collected from patients at different times on the day of surgery . Patients were phenotyped for CYP 1A2 activity using caffeine . Ciprofloxacin and caffeine concentrations were determined using validated HPLC assays . All concentrations of ciprofloxacin were simultaneously modeled using a four-compartment PK-MB model . Creatinine clearance and CYP 1A2 activity were modeled as surrogate markers of renal and hepatic clearances, respectively . Population PK was performed with IT2S, and simulations were performed with ADAPT-II . No eye infections were observed in any of the patients enrolled in the study, and there were only minimal effects on vitreous and aqueous concentrations after ocular drops were added to the oral treatments . The model that best described the concentrations of ciprofloxacin in serum and in aqueous and vitreous humor was a four-compartment PK linear model . Simulated AUCs of ciprofloxacin mean concentrations in the aqueous and vitreous humors were 17 +/- 9 and 10 +/- 8% of the systemic AUC, respectively . The terminal elimination half-life of the compound was (mean +/- SD) 5.0 +/- 2.8 hours . The apparent volume of distribution (Vss/F) was calculated to be 122.1 +/- 39.7 L . This PK-MB model may be very useful in optimizing treatments of various eye infections with ciprofloxacin . The results of this study suggest that giving ciprofloxacin orally for 2 days preceding surgery may prevent endophthalmitis from occurring, consequently abrogating the need for administering antibiotics via intraocular injections. Cornea, 2004 Aug, 23(6), 620 - 9 In vitro drug-induced spoliation of a keratoprosthetic hydrogel; Chirila TV et al.; PURPOSE: To investigate in vitro the effects of selected drugs on the spoliation of poly(2-hydroxyethyl methacrylate) (PHEMA), a synthetic acrylic hydrogel currently used for the manufacture of a keratoprosthesis, AlphaCor . The experiments were carried out both in the presence of simulated aqueous humor (SAH) and in its absence . METHODS: Disks of PHEMA were incubated and shaken with 9 commonly prescribed drugs at 37 degrees C in sterile conditions for 1 week . Samples were incubated either in SAH only (controls), in each drug preparation, or in each drug for 1 week followed by 1 week in SAH . The drugs selected for this study were steroids (prednisolone, dexamethasone, fluorometholone, medroxyprogesterone), antiglaucoma drugs (timolol maleate and pilocarpine), and antibiotics (chloramphenicol, cephazolin, and ciprofloxacin), as commercially available formulations . Following incubation, the PHEMA specimens were examined visually and then histologically, after staining with alizarin red for the presence of calcium in the spoliating sediments/deposits . RESULTS: Although only 5 of the drug formulations (dexamethasone as Maxidex, fluorometholone as FML, pilocarpine as Isopto Carpine, chloramphenicol as Chlorsig, and medroxyprogesterone as Depo-Ralovera) induced spoliation of the hydrogel in the absence of SAH, all drugs induced spoliation after postincubation in SAH, and calcium was detected in the majority of samples . The deposits on the hydrogel specimens incubated first in cephazolin (as Cefazolin-BC), pilocarpine (as Isopto Carpine), and chloramphenicol (as Chlorsig) and then in SAH did not contain calcium, despite its presence in SAH . CONCLUSIONS: The study appears to confirm our earlier clinical observations that topical medication may play a role in the spoliation of the hydrogel ophthalmic devices . Presence of calcium in the deposits seems to be correlated to the nature of drug . Although the incidence of spoliation in real clinical situations is much lower than suggested by this extreme-case in vitro simulation, topical therapy after implantation of AlphaCor should be carefully considered, kept to the minimum required, and additive-free where possible. Br J Biomed Sci, 2004, 61(2), 75 - 7 In vitro susceptibility of Blastocystis hominis isolated from patients with irritable bowel syndrome; Yakoob J et al.; This study aims to determine the growth pattern and in vitro susceptibility of clinical isolates of Blastocystis hominis to different concentrations of metronidazole, furazolidone and ciprofloxacin . Stool specimens from 25 consecutive patients with irritable bowel syndrome presenting to the gastroenterology department of Aga Khan University Hospital between January and May 2003 are examined by microscopy and cultured for B . hominis . Drug susceptibility assays are performed for metronidazole, furazolidone, and ciprofloxacin using final concentrations of 0.01 mg/mL and 0.1 mg/mL . The effect of the drugs is assessed after B . hominis culture for 48 h . With furazolidone and metronidazole, 68% (17/25) and 60% (15/25) of B . hominis isolates, respectively, failed to grow at drug concentrations of both 0.01 mg/mL and 0.1 mg/mL . However, ciprofloxacin failed to suppress growth completely at both concentrations . B . hominis resistance to furazolidone, metronidazole and ciprofloxacin at 0.01 mg/mL was 32% (8/25), 40% (10/25) and 100% (25/25), respectively . B . hominis isolates varied in their degree of susceptibility to the three drugs studied, being greater with furazolidone than with metronidazole, and complete resistance with ciprofloxacin. Sheng Wu Yi Xue Gong Cheng Xue Za Zhi, 2004 Jun, 21(3), 350 - 4 {Research on carboxymethyl chitosan acting as the adjuvant for implantable degradable microspheres}; Yin C et al.; As a kind of biomaterial, carboxymethyl chitosan (CMC) has excellent biodegradable and bioacceptable capabilities using . This study was aimed to probe into the feasibility of CMC to prepare the implantable sustained release Ciprofloxacin Hydrochloride (CPX) microspheres(MS), and to go further into the pharmaceutic technology, the morphology and the characteristics of in vitro release of the microspheres . First, we prepared the microspheres by emulsification and cross-linking technology . Then, scanning electron microscopy (SEM), infrared spectrum (IR) and differential thermal analysis (DTA) were used to detect the structure and morphology of the MS . The in vitro release of CPX/CMC-MS and the CPX content of the MS were detected through continuous-flow releasing system . We found that the structure and morphology of the MS were affected by the conditions of preparation such as emulsification and cross-linking temperature, ionic strength and stirring speed, that the releasing time of CPX was more than 7 days, and that the releasing behaviors of the microspheres conformed to the Higuchi model . So we drew the conclusions that CMC could be used as a kind of absorbable and implantable adjuvant for sustained release, the technology of emulsification and cross-linking was proved to be feasible, stable and simple. Ann Pharm Fr, 2004 May, 62(3), 177 - 85 {Pharmacokinetics and dose adaptation of ofloxacine, pefloxacine and ciprofloxacine during haemodialysis and continuous ambulatory peritoneal dialysis}; Daniel JP et al.; Fluoroquinolones present various pharmacokinetic properties . That's the way we carried out a bibliographic summary about the pharmacokinetics of pefloxacin, ofloxacin and ciprofloxacin in patients hit by chronic renal failure, under haemodialysis or under continuous ambulatory peritoneal dialysis . Then, we will describe how to adapt drug dose according to the degree of renal insufficiency and the used molecule. Chang Gung Med J, 2004 Apr, 27(4), 292 - 9 The effects of ciprofloxacin on chest radiographic regression in patients with drug intolerance or resistant tuberculosis; Yang CK et al.; BACKGROUND: The aim of this study was to identify the clinical efficacy of ciprofloxacin as a second-line anti-tuberculosis agent in pulmonary tuberculosis patients with drug intolerance or resistance . METHODS: There were 20 patients with drug related adverse effects or drug resistance enrolled in the ciprofloxacin treatment group (CG) . There were also 32 patients enrolled in the non-ciprofloxacin treatment group (NCG) that maintained conventional drug regimens or the addition of other drugs like streptomycin . The radiographic presentation was evaluated using score grading . The speed and outcome of regression in the chest radiographic presentations were also evaluated . RESULTS: Data showed the CG had significantly more rapid regression than the NCG in drug-resistant patients (p < 0.01) . For the adversely effected patients in the CG, the mean scores of pre- and post-treatment were 3.1+/-0.2 and 2.2+/-0.3 (p < 0.001), respectively . For the adversely effected patients in the NCG, the mean score of pre-treatment was 3.7+/-0.4 and post-treatment mean score was 3.0+/-0.4 (p < 0.05) . For the drug-resistant patients in the CG, the mean scores of pre- and post-treatment were 4.3+/-0.4 and 3.4+/-0.5 (p < 0.05), respectively . For the drug-resistant patients in the NCG, the mean score of pre-treatment was 3.7+/-0.3 and post-treatment mean score was 3.2+/-0.3 (no significant difference) . Obviously, the CG had the same effects compared with the NCG in adverse-effect group . On the other hand, the CG had the tendency of more rapid radiographic regression and better radiographic outcomes than the NCG in drug-resistant patients . CONCLUSIONS: Ciprofloxacin provides a better option for second-line drug treatment for pulmonary tuberculosis when patients cannot use conventional anti-tuberculosis agents. Anal Sci, 2004 Jun, 20(6), 967 - 70 Spectral properties of the association nanoparticle system of ciprofloxacin-phloxine and its application to fluorescence analysis; Zou J et al.; There is a fluorescence peak at 570 nm, and a maximum absorption peak at 560 nm for phloxine (PHLO) in a pH 7 water solution . Under these conditions, the ciprofloxacin cation (CPFX+) and PHLO- combine into hydrophobic CPFX-PHLO association molecule by means of static gravitation . There are stronger van der Waals forces and hydrophobic forces among the CPFX-PHLO molecules . Thus, they aggregate automatically to the (CPFX-PHLO)n association nanoparticle in red-violet color . That was characterized by scan electron microscopy (SEM), hyperfiltration and dialysis tests . In 0.04 M HCl, the red-violet nanoparticles exhibited a Rayleigh scattering peak at 470 nm, a resonance scattering peak at 580 nm, a maximum absorption wavelength at 565 nm, and a fluorescence peak at 450 nm . The fluorescence analytical conditions of CPFX have been considered . The CPFX concentration in the range of 1.0 x 10(-6)-4.0 x 10(-5) M is linear to the fluorescence intensity, F450nm . The detection limit was achieved at 4.0 x 10(-7) M CPFX . The CPFX in real samples was determined with satisfactory results. Clin Infect Dis, 2004 Jun 15, 38(12), 1736 - 41 Epub 2004 May 25. Population-based laboratory surveillance for Escherichia coli-producing extended-spectrum beta-lactamases: importance of community isolates with blaCTX-M genes; Pitout JD et al.; A prospective, population-based laboratory surveillance study was conducted to define the epidemiology of extended-spectrum beta -lactamase-producing Escherichia coli infections in the Calgary Health Region during the years 2000-2002 . The incidence was 5.5 cases per 100,000 population per year . The annualized incidence of 3.9 cases per 100,000 population for January through March was significantly lower than the incidence for the other quarters of the year (6.0 per 100,000 population; P<.01) . Seventy-one percent of subjects had community-onset disease . Patients aged > or =65 years (22.0 vs . 3.8 cases per 100,000 population per year; P<.0001) and women (9.2 vs . 1.7 cases per 100,000 population per year; P<.0001) had significantly higher rates of infection . Polymerase chain reaction identified 23 (15%) of 157 isolates as positive for blaCTX-M genes from the CTX-M-I subgroup and 87 (55%) from the CTX-M-III subgroup . Ciprofloxacin resistance was independently associated with CTX-M- beta -lactamases (odds ratio, 14.2; 95% confidence interval, 3.69-54.84) . Strains of E . coli with blaCTX-M genes commonly cause community-onset infections, and women and older patients are at highest risk. Bioorg Med Chem Lett, 2004 Aug 2, 14(15), 3923 - 4 Antituberculous activity of some aryl semicarbazone derivatives; Sriram D et al.; During the course of our work on the synthesis and screening of new drugs for tuberculosis, we have identified N1-(4-acetamido phenyl)-N4-(2-nitro benzylidene) semicarbazone (1b), which inhibited in vitro Mycobacterium tuberculosis H(37)Rv; 100% inhibition at 1.56 microg/mL . This paper is first of its kind in which aryl semicarbazones are reported to possess antimycobacterials potency greater than p-aminosalicylic acid, ethionamide, ethambutol, ciprofloxacin and kanamycin. Int J Clin Pharmacol Ther, 2004 Jun, 42(6), 336 - 41 Bioequivalence of two oral ciprofloxacin tablets formulations; Cuadrado A et al.; The relative bioavailability of a new 750 mg tablet formulation of ciprofloxacin (test formulation supplied by Dr . August Wolff GmbH and Co., Germany) was compared with that of Ciprobay tablets 750 mg (reference formulation from Bayer Vital GmbH and Co., Germany) . Twenty-four healthy volunteers (12 male and 12 female) were included in this single-dose, 2-sequence, crossover randomized study . Blood samples were obtained prior to dosing and at 0.5, 0.75, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 18, 24 and 30 hours after drug administration . Plasma concentrations of ciprofloxacin were determined by HPLC . No differences were found when the in vitro dissolution profiles of both formulations were compared . The pharmacokinetic parameters AUC(0-t), AUC(0-infinity), Cmax and Cmax/AUC(0-infinity) were tested for bioequivalence after log-transformation of data, and ratios of tmax were evaluated nonparametrically . The parametric analysis revealed the following mean values for the test/reference ratios (90% standard confidence intervals in parenthesis (ln-transformed data): 1.01 (0.95-1.07) for AUC(0-t), 0.99 (0.93-1.05) for AUC(0-infinity), 1.05 (0.97-1.14) for Cmax and 1.06 (0.97-1.15) for Cmax/AUC(0-infinity) . The nonparametric confidence interval for tmax was 0.77-1.15 . All parameters showed bioequivalence between both formulations as their confidence intervals were within the bioequivalence acceptable range of 0.80-1.25 limits; the 90% confidence interval for tmax slightly exceeded limits of bioequivalence . We conclude that both formulations show bioequivalence for both the rate and the extent of absorption. J Clin Pathol, 2004 Jul, 57(7), 780 - 1 Gonococcal endocarditis: a rare complication of a common disease; Shetty A et al.; This report describes a case of gonococcal endocarditis in a 28 year old male patient with no history of previous valvular heart disease . More cases of gonococcal endocarditis (a rare complication of gonorrhoea) may occur with the increase in the incidence of gonorrhoea and the increase in resistance to ciprofloxacin, which is currently used as the first line agent for the treatment of gonorrhoea in 75% of genitourinary medicine clinics. Dig Surg, 2004, 21(3), 197 - 201 Epub 2004 Jun 23. Incidence and therapeutic outcome of pouchitis for ulcerative colitis in Japanese patients; Ikeuchi H et al.; AIM: The aim of this study was to examine the cumulative risk of pouchitis following restorative proctocolectomy for UC and FAP in Japanese patients, and to assess the response to medical treatment and its outcome . PATIENTS AND METHODS: 521 patients with UC and 117 FAP patients underwent proctocolectomy and received a J-shaped IPAA at our department of surgery . We investigated these patients using PDAI for the diagnostic criteria of pouchitis . RESULTS: Pouchitis occurred in only 32 UC patients (6.1%) . The cumulative risk of developing pouchitis for a UC patient was 7% at 5 years after and 12% at 10 years after surgery . The medical treatment of acute pouchitis was usually oral metronidazole (250 mg twice daily) for 2 weeks or oral ciprofloxacin (200 mg thrice daily) in patients who could not tolerate metronidazole . Single episodes of pouchitis occurred in 21 patients (65.6%) and chronic or frequent relapses of pouchitis in 11 patients (34.4%) . Three patients (9.4%) required re-ileostomy . Two patients (6.3%) required pouch excision . There were no patients with complicated dysplasia . CONCLUSION: The cumulative risk of pouchitis in Japanese UC patients is lower than that of western countries. J Am Vet Med Assoc, 2004 Jun 1, 224(11), 1804 - 7, 1788-9 Clinical resolution of Brucella canis-induced ocular inflammation in a dog; Vinayak A et al.; A 2-year-old spayed female mixed-breed dog was referred with an 8-month history of recurrent bilateral anterior uveitis and hyphema secondary to infection with Brucella canis . Treatment with doxycycline PO and atropine and prednisone acetate topically prior to referral had failed to resolve the ocular inflammation . Successful control of ocular inflammation was achieved after initiation of treatment with gentamicin SC and ciprofloxacin and doxycycline PO . The finite indirect fluorescent antibody (IFA) titer was reduced by half, and results of an agar gel immunodiffusion (AGID) test became negative after rifampin was added to the treatment protocol . Treatment with gentamicin was eventually discontinued because of evidence of renal toxicosis and cutaneous reactions to repeated injections . Thirty-five months after initial examination of the dog, results of the AGID test were still negative, the finite IFA titer was stable, and ocular inflammation had resolved, suggesting that the ocular infection may have been eliminated . To our knowledge, this represents the first report of the successful treatment of ocular inflammation caused by B canis infection in a dog. Res Vet Sci, 2004 Oct, 77(2), 143 - 51 Detection of enrofloxacin and its metabolite ciprofloxacin in equine hair; Dunnett M et al.; Hair analysis to detect drug administration has not been studied extensively in horses . This study aimed to (a) develop an analytical method for enrofloxacin and its metabolite ciprofloxacin in mane and tail hair, (b) relate measured values to doses, routes of administration, hair colour, and (c) demonstrate long-term detectability . Samples were extracted in trifluoroacetic acid at 70 degrees C . Extracts were cleaned-up by solid-phase extraction and analysed by high-performance liquid chromatography with UV-diode array detection . Analyte recoveries were > 87% . Horses were sampled after therapeutic enrofloxacin administration either orally at 7.5 mg/kg daily for 3-13 days or twice daily for 10-14 days (Group 1, n=7) or intravenously at 5.0 mg/kg daily for 12 and 15 days (Group 2, n=2) . Enrofloxacin and ciprofloxacin were detected at concentrations up to 452 and 19 ng/mg, respectively, up to 10 months post-treatment . In vitro, enrofloxacin and ciprofloxacin were extensively bound to melanin (> 96%) and in vivo, their uptake was 40-fold greater in black than white hair . Enrofloxacin and ciprofloxacin concentrations correlated to enrofloxacin dose (r2=0.777 and r2=0.769) . Enrofloxacin:ciprofloxacin ratios were 21:1 and 13:1 following intravenous and oral administration, respectively . Longitudinal analyte distributions correlated to treatment-sampling interval. Otolaryngol Head Neck Surg, 2004 Jun, 130(6), 736 - 41 Topical ciprofloxacin/dexamethasone otic suspension is superior to ofloxacin otic solution in the treatment of granulation tissue in children with acute otitis media with otorrhea through tympanostomy tubes; Roland PS et al.; OBJECTIVE: Comparison of topical ciprofloxacin/dexamethasone otic suspension (CIP/DEX) to ofloxacin otic solution (OFL) for treatment of granulation tissue in children with AOMT . STUDY DESIGN: 599 children aged >/=6 months to 12 years with AOMT of up to 3 weeks' duration were enrolled . Patients received either CIP/DEX 4 drops twice daily for 7 days or OFL 5 drops twice daily for 10 days . Granulation tissue severity was graded at clinic visits on days 1, 3, 11, and 18 . RESULTS: Granulation tissue was present in 90 of 599 AOMT patients (15.0%) at baseline . CIP/DEX treatment was superior to OFL for reduction of granulation tissue at the day 11 visit (81.3% compared with 56.1%, P = 0.0067) and the day 18 visit (91.7% compared with 73.2%, P = 0.0223) . Both topical otic preparations are safe and well tolerated in pediatric patients . CONCLUSION: CIP/DEX was superior to OFL in the treatment of granulation tissue in children with AOMT. Biochem Pharmacol, 2004 Jul 15, 68(2), 395 - 402 Role of CYP1A2 and CYP2E1 in the pentoxifylline ciprofloxacin drug interaction; Peterson TC et al.; In this study the drug interaction between ciprofloxacin (CIPRO) and pentoxifylline (PTX) was investigated and the role of CYP1A2 in the drug interaction was determined with the aid of a selective CYP1A2 inhibitor, furafylline (FURA), and the Cyp1A2 knockout mouse . Serum concentrations of PTX (83.4+/-1 micromol/l) and metabolite-1 (M-1) (13.7+/-2.8 micromol/l) following a single injection of PTX (100 mg/kg i.p.) were significantly higher (P<0.05) in mice treated with CIPRO (25 mg/kg i.p . 9 days) compared to serum concentrations of PTX (46.3+/-0.5 micromol/l) and M-1 (6.4+/-1.1 micromol/l) in mice administered saline . Murine hepatic microsomes were incubated with PTX alone or the combination of PTX and CIPRO . The metabolism of PTX in the murine hepatic microsomes containing both CIPRO and PTX was significantly decreased compared to microsomes incubated with PTX alone, suggesting that CIPRO may inhibit the metabolism of PTX . To further clarify the role of CYP1A2 in the metabolism of PTX in mice, the effect of a selective CYP1A2 mechanism based inhibitor, FURA, on the metabolism of PTX was investigated and our results indicate that FURA inhibited metabolism of PTX . We then investigated PTX elimination in the Cyp1A2 knockout mouse . Blood levels of PTX were assessed at 2 and 20 min following a single injection of PTX (32 mg/kg i.v) . Serum concentration of PTX was determined in Cyp1A2 knockout mice compared to Cyp1A2 wild type control mice . The serum concentration of PTX in Cyp1A2 wild type mice (n=9) was 22.2+/-3.2 micromol/l at 20 min following injection of PTX . The serum concentration of PTX in Cyp1A2 knockout mice (n=11) was significantly elevated at 20 min following injection of PTX compared to Cyp1A2 wild type mice . These results clearly indicate that inhibition of CYP1A2 catalytic activity that occurs in the Cyp1A2 knockout mice is sufficient to alter metabolism of PTX and result in markedly elevated levels in serum of Cyp1A2 knockout mice . The results of Western analysis in murine microsomes suggest that CYP1A2 protein levels were not altered by CIPRO indicating that CIPRO did not downregulate Cyp1A2 . The results of Western analysis also indicated that CIPRO treatment increased CYP2E1 in mouse microsomes and the implications of these will be discussed. J Pharm Biomed Anal, 2004 Jun 29, 35(4), 689 - 95 A single spectroscopic flow-through sensing device for determination of ciprofloxacin; Pascual-Reguera MI et al.; A simple flow injection UV spectrophotometric sensing device was developed for the determination of ciprofloxacin . The method is based on its transient retention and concentration on Sephadex SP C-25 cation-exchange gel beads packed in the flow cell and the continuous monitoring of its native absorbance on the solid phase at 277 nm . The procedure is carried out without any derivatisation . Formic acid/NaOH 1.75 M at pH 2.2 is used as carrier solution in a simple monochannel FIA manifold . When the analytical signal reached the maximum value, ciprofloxacin was eluted from the solid support by the carrier solution itself . The response of the sensor was linear in the concentration range 0.5-10 microg ml(-1) with an RSD (%) of 0.79, a detection limit (3sigma criterion) of 0.035microg ml(-1) and a sampling rate of 16 h(-1) . Application to the analysis of pharmaceutical samples testifies the utility of this sensor . J Vet Pharmacol Ther, 2004 Jun, 27(3), 139 - 46 Allometric analysis of ciprofloxacin and enrofloxacin pharmacokinetics across species; Cox SK et al.; The purpose of this study was to examine the allometric analysis of ciprofloxacin and enrofloxacin using pharmacokinetic data from the literature . The pharmacokinetic parameters used were half-life, clearance and volume of distribution . Relationships between body weight and the pharmacokinetic parameter were based on the empirical formula Y = aW(b), where Y is half-life, clearance or volume of distribution, W the body weight and a is an allometric coefficient (intercept) that is constant for a given drug . The exponential term b is a proportionality constant that describes the relationship between the pharmacokinetic parameter of interest and body weight . A total of 21 different species of animals were studied . Results of the allometric analyses indicated similarity between clearance and volume of distribution as they related to body weight for both drugs . Results of the current analyses indicate it is possible to use allometry to predict pharmacokinetic variables of enrofloxacin or ciprofloxacin based on body size of species . This could provide information on appropriate doses of ciprofloxacin and enrofloxacin for all species. Support Care Cancer, 2004 Sep, 12(9), 657 - 62 Outcomes of treatment pathways in outpatient treatment of low risk febrile neutropenic cancer patients; Escalante CP et al.; BACKGROUND: We treated low-risk febrile neutropenic cancer patients utilizing two standard outpatient antibiotic pathways: oral ampicillin/clavulanate (500 mg) and ciprofloxacin (500 mg) or intravenous ceftazidime (2 g) and clindamycin (600 mg) every 8 h . The objectives were to determine the success of outpatient treatment of low-risk febrile neutropenia, to identify factors predicting outpatient failure, and to determine mortality related to the febrile episode . METHODS: Eligibility criteria included solid tumor diagnosis, stable vital signs, temperature > or =38.0 degrees C, absolute neutrophil count (ANC) of <1000/ml, patient compliance, no significant organ dysfunction, ability to tolerate oral medication and fluids for oral pathway, residence within 30 miles of the institution, 24-h caregiver, and telephone and transportation access . RESULTS: There were 257 febrile episodes in 191 patients meeting the criteria . Patients were treated during March 1998 through February 2000 . Median age was 48 (range, 17-77) years, and 60% (n = 153) had an entry ANC of <100/ml; 205 (80%) febrile episodes successfully responded to outpatient treatment, and 52 (20%) were hospitalized . Logistic regression analysis showed the following were related to hospitalization: mucositis >grade 2 (p < 0.002); Zubrod performance status > or =2 (p = 0.029); ANC <100/ml (p = 0.039), and age > or =70 years (p = 0.048) . CONCLUSIONS: Outpatient treatment of low-risk febrile neutropenic cancer patients utilizing standard treatment pathways is associated with minimal morbidity and mortality and should be considered an acceptable standard of care with appropriate infrastructure available to provide strict and careful follow-up while on treatment . Certain factors are associated with higher risk of hospitalization and should be further examined in eligible patients with low-risk febrile neutropenia. Treat Respir Med, 2004, 3(2), 97 - 105 Chronic rhinosinusitis: management for optimal outcomes; Aukema AA et al.; Chronic rhinosinusitis is characterized by nasal purulence accompanied by malaise, postnasal drip and nasal dryness or crusting . It is a condition that is very difficult to treat and can be very disabling to the patients . A clinical diagnosis is based on history and evaluation with endoscopy, and computerized tomographic scanning . The etiology of chronic rhinosinusitis is multifactorial and comprises a vicious cycle of pathophysiological, anatomical, and constitutive factors . Predisposing factors include ciliary impairment, allergy, nasal polyposis, and immune deficiency . Treatment is aimed at reducing mucosal inflammation and swelling, controlling infection, and restoring aeration of the nasal and sinus mucosa . The choice of treatment is influenced by many factors including past medication, duration of symptoms and the presence of allergy/nasal polyps . Pharmacologic treatment, with local or systemic corticosteroids such as mometasone furoate, fluticasone propionate, beclometasone dipropionate or oral prednisolone coupled with nasal lavage with isotonic saline solutions are the cornerstones of disease management . Systemic antibiotics including amoxicillin/clavulanic acid, ciprofloxacin, clarithromycin, and trimethoprim/sulfamethoxazole (cotrimoxazole) are often administered to patients with chronic sinusitis and underlying bacterial infection . In patients with underlying allergy, additional treatment with antihistamines should be considered . Aeration of the sinuses may temporarily be improved with local nasal decongestants such as oxymetazoline . If symptoms persist after aggressive medical treatment, surgery should be considered . Surgery should be functional and involve widening the natural drainage openings of the sinuses and preserving the ciliated epithelium as much as possible . In the case of nasal polyposis surgery is more aggressive involving removal of the diseased polypous mucosa . It is recommended that medical treatment should be continued post sinus surgery. Sichuan Da Xue Xue Bao Yi Xue Ban, 2004 May, 35(3), 313 - 5 {Study on the gene mutation of quinolone-resistant Mycobacterium tuberculosis isolated from Sichuan Province}; Zhao MC et al.; OBJECTIVE: To investigate the molecular mechanism of quinolone-resistance of M . tuberculosis and characterize the gene mutation in Sichuan Province . METHODS: Susceptibility of the clinical isolates to quinolones (ofloxacin, ciprofloxacin and sparfloxacin) was tested by the absolute concentration method . GyrA gene quinolone reasistance-determining region (QRDR) mutations M . tuberculosis were detected with PCR-SSCP and DNA sequencing . RESULTS: Of 68 clinical isolates of M . tuberculosis, 25 high-resistant, 11 low-resistant and 10 sensitive isolates were noted to have abnormal gyrA SSCP profile and different gyrA sequences from the standard strain H37Rv, and 14 sensitive and 8 low-resistant isolates were found with no mutation of gyrA gene . DNA sequencing unveiled Ser-->Thr mutation at codon 95, Asp-->Gly at codon 94, Ala-->Val at codon 90, and Ala-->Val at codon 83 . CONCLUSION: This study confirmed the strong correlation between the quinolone-resistance and the mutation of gyrA gene, which might be a major molecular mechanism of quinolone-resistance in M . tuberculosis . The types of mutations exhibit no difference between Sichuan Province and other areas in China. Bioorg Med Chem Lett, 2004 Jun 21, 14(12), 3027 - 32 A novel mixed-ligand antimycobacterial dimeric copper complex of ciprofloxacin and phenanthroline; Saha DK et al.; A novel mixed-ligand Cu(II) complex of ciprofloxacin (cfH) and phenanthroline, is found to crystallize as a dimeric moiety containing monocationic and dicationic species . Two such dimeric moieties are found in the same unit cell leading to a dicationic cluster . The higher negative redox potential for this cluster dampens its antimycobacterial activity against M . smegmatis. Poult Sci, 2004 May, 83(5), 830 - 4 Comparison of a bioassay and a liquid chromatography-fluorescence-mass spectrometry(n) method for the detection of incurred enrofloxacin residues in chicken tissues; Schneider MJ et al.; Regulatory monitoring for most antibiotic residues in edible poultry tissues is often accomplished with accurate, although expensive and technically demanding, chemical analytical techniques . The purpose of this study is to determine if a simple, inexpensive bioassay could detect fluoroquinolone (FQ) residues in chicken muscle above the FDA established tolerance (300 ppb) comparable to a liquid chromatography-fluorescencemass spectrometry(n) method . To produce incurred enrofloxacin (ENRO) tissues (where ENRO is incorporated into complex tissue matrices) for the method comparison, 40-d-old broilers (mixed sex) were orally dosed through drinking water for 3 d at the FDA-approved dose of ENRO (50 ppm) . At the end of each day of the 3-d dosing period and for 3 d postdosing, birds were sacrificed and breast and thigh muscle collected and analyzed . Both methods were able to detect ENRO at and below the tolerance level in the muscle, with limits of detection of 26 ppb (bioassay), 0.1 ppb for ENRO, and 0.5 ppb for the ENRO metabolite, ciprofloxacin (liquid chromatography-fluorescence-mass spectrometry(n)) . All samples that had violative levels of antibiotic were detected by the bioassay . These results support the use of this bioassay as a screening method for examining large numbers of samples for regulatory monitoring . Positive samples should then be examined by a more extensive method, such as liquid chromatography-fluorescence-mass spectrometry(n), to provide confirmation of the analyte. Poult Sci, 2004 May, 83(5), 796 - 802 Influence of enrofloxacin administration and alpha-tocopheryl acetate supplemented diets on oxidative stability of broiler tissues; Carreras I et al.; The objective of this study was to assess the oxidative stability and presence of antibiotic residues in tissues of broilers fed diets supplemented with alpha-tocopheryl acetate and treated with enrofloxacin . The activities of antioxidant enzymes and antibiotic concentrations in chicken breast, leg, and liver were determined . Iron-induced TBA-reactive substances (TBARS) and vitamin E were evaluated in muscles . The antioxidant effectiveness of vitamin E was reflected by TBARS values being lower in antioxidant-supplemented treatments than in the other dietary groups . On the other hand, antioxidant enzyme activities were not substantially affected by dietary treatments . The concentration of enrofloxacin in tissues was considerable, even after withdrawal 12 d before slaughter . Contrary to the findings in previous studies, enrofloxacin was not extensively metabolized to ciprofloxacin . Supplementation of the diet with 100 mg/kg of alpha-tocopheryl acetate did not have a significant effect on the level of antibiotic found in breast muscle samples . When comparing treatments without antibiotic withdrawal time, alpha-tocopheryl acetate supplementation led to a significant decrease in enrofloxacin level in leg and liver samples . These results showed that mutual interactions between different molecules could modify the drug residues in the tissue, which should be taken into account when considering the drug administration and the establishment of a correct withdrawal time. Mov Disord, 2004 May, 19(5), 595 - 7 Propriospinal myoclonus after treatment with ciprofloxacin; Post B et al.; The clinical and electrophysiological features of a truncal myoclonus in a 55-year-old man are described . The electromyographic characteristics point toward propriospinal myoclonus . It is suggested that a myoclonic generator was released after use of ciprofloxacin, by antagonising the gamma-aminobutyric acid metabolism . J Clin Microbiol, 2004 May, 42(5), 2241 - 6 Rapid detection of point mutations in the gyrA gene of Helicobacter pylori conferring resistance to ciprofloxacin by a fluorescence resonance energy transfer-based real-time PCR approach; Glocker E et al.; As a result of the increasing resistance of Helicobacter pylori against first-line antibiotics, other drugs, such as quinolones, will be needed for eradication therapy in the future . We developed a real-time PCR to detect mutations in the gyrA gene associated with ciprofloxacin resistance of H . pylori, thereby contributing to the selection of patients who could be treated by ciprofloxacin-based therapy. Curr Med Res Opin, 2004 Apr, 20(4), 469 - 76 Drug costs and bacterial susceptibility after implementing a single-fluoroquinolone use policy at a university hospital; Rapp RP et al.; The University of Kentucky Hospital investigated the feasibility of choosing a sole fluoroquinolone for its formulary in an effort to reduce costs without affecting clinical outcomes . A three-step process was used to plan, implement, and monitor the selection program . Based on the range of clinical indications, safety profile, local susceptibility, cost, and dosing convenience, levofloxacin was chosen over ciprofloxacin and gatifloxacin as the sole fluoroquinolone . Since the implementation of the program in May 2001, susceptibility to levofloxacin has been maintained or increased for the most common pathogens . In addition, University Hospital has saved nearly 100,000 dollars in antibiotic acquisition costs during the first 12 months after the switch . This assessment did not take into account effects in clinical outcomes, such as clinical failures (such as readmission rates), mortality, and adverse events, or measure changes in overall medical expenditures beyond drug acquisition costs . In the future, monitoring of overall patient care and medical care costs, in addition to susceptibility patterns and drug costs, will allow for a better understanding of the long-term benefits of this switch. J Chromatogr A, 2004 Apr 23, 1034(1-2), 25 - 32 Multiresidue determination of fluoroquinolones in milk by column liquid chromatography with fluorescence and ultraviolet absorbance detection; Marazuela MD et al.; Column liquid chromatography with fluorescence (FLD) and UV-diode array detection (UV-DAD) was used for the simultaneous determination of ciprofloxacin (CIPRO), enrofloxacin (ENRO), marbofloxacin (MARBO), danofloxacin (DANO) and sarafloxacin (SARA) residues in milk, using norfloxacin (NOR) as internal standard . Two solid-phase extraction (SPE) cartridges, were evaluated for sample clean-up and preconcentration, Strata X, based on a modified styrene-divinylbenzene polymer, and Strata Screen A, a mixed anion exchanger/C8 reversed-phase sorbent . The fluoroquinolones (FQs) were separated on a polar endcapped column (AQUA C18) . The recoveries for raw milk spiked with the antibiotics at three concentrations close to the maximum residue limit (MRL), were 80-103% for ENRO, CIPRO and DANO, with relative standard deviations (R.S.D.) lower than 6.6% . SARA recoveries were 70% (R.S.D . = 7%) and values in the order of 95% (R.S.D . = 1.5%) were obtained for MARBO at the MRL level . The quantification limits ranged from 2.4 to l0 ng ml(-1) and are below the MRL established for these drugs by the European Union . The method was successfully applied to the analysis of ENRO and its metabolite CIPRO in an incurred milk sample. Expert Opin Pharmacother, 2004 Apr, 5(4), 819 - 27 The management of leptospirosis; Faucher JF et al.; How to quickly identify patients who should be treated for leptospirosis is a challenge . The interest of polymerase chain reaction (PCR) assays is currently being evaluated and rapid tests which can be used outside of the specialised laboratory, have recently been developed . Leptospires are sensitive to many antibiotics and few clinical studies have been made to compare different treatment options . Doxycycline is standard therapy in early leptospirosis treatment and chemoprophylaxis . Intravenous penicillin has been considered the drug of choice in late and severe disease, although it is now challenged by ceftriaxone, which use is easier . Ciprofloxacin may be combined with standard therapy in uveitis . Adjunctive therapies proposed in the management of severe forms of leptospirosis and Jarisch-Herxheimer reactions, are reviewed. Environ Toxicol Chem, 2004 Apr, 23(4), 1035 - 42 Effects of pharmaceutical mixtures in aquatic microcosms; Richards SM et al.; Pharmaceuticals have a wide range of biological properties and are released into the environment in relatively large amounts, yet little information is available regarding their effects or potential ecological risks . We exposed outdoor aquatic microcosms to combinations of ibuprofen (a nonsteroidal anti-inflammatory drug), fluoxetine (a selective serotonin reuptake inhibitor), and ciprofloxacin (a DNA gyrase-inhibiting antibiotic) at concentrations of 6, 10, and 10 microg/L, respectively (low treatment {LT}); 60, 100, and 100 microg/L, respectively (medium treatment {MT}); and 600, 1,000, and 1,000 microg/L, respectively (high treatment {HT}) . We maintained these concentrations for 35 d . Few responses were observed in the LT; however, effects were observed in the MT and HT . Fish mortality occurred in the MT (<35 d) and in the HT (<4 d) . Phytoplankton increased in abundance and decreased in diversity (number of taxa) in the HT, with consistent trends being observed in the MT and LT . Zooplankton also showed increased abundance and decreases in diversity in the HT, with consistent trends being observed in the MT . Multivariate analyses for zooplankton and phytoplankton suggested interactions between these communities . Lemna gibba and Myriophyllum spp . showed mortality in the HT; growth of L . gibba was also reduced in the MT . Bacterial abundance did not change in the HT . All responses were observed at concentrations well below the equivalent pharmacologically active concentrations in mammals . Although the present data do not suggest that ibuprofen, fluoxetine, and ciprofloxacin are individually causing adverse effects in surface-water environments, questions remain about additive responses from mixtures. Jpn Heart J, 2004 Mar, 45(2), 353 - 8 A case of mitral stenosis complicated with seronegative Brucella endocarditis; Yavuz T et al.; Brucellosis is a multisystemic disease . The most common cause of death from the disease is endocarditis . The aortic valve is most commonly affected . The disease rarely involves the mitral valve . A 30 year-old woman presented with complaints of chills and fever up to 38 degrees C at night, fatigue, palpitations, and dyspnea for the previous 3 weeks . Cardiac auscultation revealed a diastolic murmur in the mitral area . Her temperature was 38.3 degrees C . On echocardiographic examination, the mitral valve area was 0.62 cm (2) and an isoechoic mass thought to be a vegetation was detected on the anterior mitral leaflet . A diagnosis of infective endocarditis was made and vancomycin administration was commenced . Brucella melitensis was isolated in all three blood samples, however, the patient remained seronegative with Brucella agglutination titers of up to 1/160 . The antibiotic therapy was then shifted to doxycycline (200 mg/day), rifampicin (600 mg/day), and ciprofloxacin (1000 mg/day) . After 30 days of treatment, surgery was performed for the severely stenotic mitral valve and to remove the vegetation . The operation was successful . The postoperative period was uneventful . On the follow-up she had no complaints . In cases with Brucella endocarditis, after diagnosis, antibiotic therapy must be started immediately and when the clinical condition improves, surgical intervention should be performed when indicated. Am J Gastroenterol, 2004 Apr, 99(4), 656 - 61 The effect on the fetus of medications used to treat pregnant inflammatory bowel-disease patients; Moskovitz DN et al.; OBJECTIVES: We reviewed data to investigate the effect of 5-ASA drugs, metronidazole, ciprofloxacin, prednisone, 6-mercaptopurine, azathioprine, and cyclosporine on pregnancy outcomes in patients with inflammatory bowel disease (IBD) . METHODS: One hundred and thirteen female patients with a total of 207 documented conceptions were studied . Treatment information included: smoking history (patient and spouse), dates of conception and termination, and outcome of pregnancy (spontaneous abortion, therapeutic abortion, maternal or fetal illness resulting in abortion, premature birth, healthy full-term birth, multiple births, ectopic pregnancy, congenital defects), weight of baby, type of delivery (cesarian section, vaginal), medication history during each trimester (mean dose, maximum dose, frequency) . We analyzed the effect on pregnancy outcome of medication use during the first trimester or at any time during the pregnancy . RESULTS: Thirty-nine patients (34.5%) had ulcerative colitis (UC), 73 (64.5%) had crohn's disease (CD), and 1 patient (1%) had indeterminate colitis . For 100 of the 207 conceptions, the patients were on 5-ASA drugs at some time during the pregnancy, 49 on prednisone, 101 on an immunomodulator (6-MP/azathioprine), 27 on metronidazole, 18 on ciprofloxacin, and 2 on cyclosporine . In 85 (31%) of the conceptions, patients were on none of these medications . No significant differences were found among the groups in each pregnancy with respect to outcome (p values 0.091 to 0.9) . In multivariate analyses controlling for age of mother, there was no evidence that 5-ASA type drugs or any type of drug influenced pregnancy outcome . CONCLUSIONS: In 113 female patients with 207 conceptions none of the drugs used to treat IBD is associated with poor pregnancy outcomes. Cornea, 2004 Apr, 23(3), 255 - 63 Concentrations of levofloxacin, ofloxacin, and ciprofloxacin in human corneal stromal tissue and aqueous humor after topical administration; Healy DP et al.; OBJECTIVE: To evaluate the penetration of commercially available levofloxacin 0.5%, ofloxacin 0.3%, and ciprofloxacin 0.3% topical ophthalmic solutions in human corneal stromal and aqueous humor tissues . METHODS: A total of 67 patients scheduled to undergo penetrating keratoplasty for treatment of stromal scar or dystrophy, keratoconus, pellucid marginal degeneration, or endothelial disease were enrolled in this prospective, double-blind, 3-center study . To be considered for inclusion, patients had to have an intact corneal epithelium and minimal or no corneal edema (pachymetry < 650 microm) . After informed consent was obtained, patients were randomized to receive 1 drop of levofloxacin 0.5%, ofloxacin 0.3%, or ciprofloxacin 0.3% topical ophthalmic solution at approximately 15 and 10 minutes before surgery . Approximately 0.1 mL of aqueous fluid was aspirated by paracentesis through the trephination wound at the onset of surgery, followed by excision of the affected cornea and removal of its epithelium . Specimens were stored frozen at -70 degrees C until assayed by high-performance liquid chromatography . RESULTS: All 3 fluoroquinolones were well tolerated . A total of 65 corneas and 59 aqueous fluid samples were obtained and assayed . The mean +/- standard deviation corneal concentrations of ciprofloxacin, ofloxacin, and levofloxacin following a 2-drop administration were 9.92 +/- 10.99 microg/g (n = 18), 10.77 +/- 5.90 microg/g (n = 23), and 18.23 +/- 20.51 microg/g (n = 24), respectively . Although corneal stromal levels were highest in the levofloxacin group, the high degree of interpatient variability prevented demonstration of statistically significant differences when compared with ofloxacin (P = 0.377) . In contrast, levofloxacin concentrations were approximately twice as high as ciprofloxacin, and this difference reached statistical significance (P = 0.014) . The corresponding aqueous humor concentrations of ciprofloxacin, ofloxacin, and levofloxacin were 0.135 +/- 0.231 microg/mL (n = 15), 0.135 +/- 0.111 microg/mL (n = 20), and 0.372 +/- 0.546 microg/mL (n = 24, P < 0.001 versus ciprofloxacin and ofloxacin) . CONCLUSION: The topical administration of all 3 agents was well tolerated in patients undergoing penetrating keratoplasty . Two drops of levofloxacin 0.5% solution results in a 1.7- to 2.7-fold greater penetration into human corneal stromal and aqueous humor tissues than ofloxacin 0.3% or ciprofloxacin 0.3% . The mean intracorneal concentrations of all three agents following 2 drops exceeds the MIC90 for the majority of pathogens causing bacterial keratitis . Topical levofloxacin appears to offer pharmacokinetic and pharmacodynamic advantages over ofloxacin and ciprofloxacin in terms of enhanced transcorneal penetration; however, clinical comparative trials are needed to confirm these relative advantages. Int J Antimicrob Agents, 2004 Apr, 23(4), 390 - 3 A reverse-phase HPLC assay for the simultaneous determination of enrofloxacin and ciprofloxacin in pig faeces; Sunderland J et al.; A reverse-phase HPLC assay is described for the simultaneous assay of enrofloxacin (ENR) and ciprofloxacin (CPX) in pig faeces . Extraction used dichloromethane, 2-propanol and 0.3M ortho-phosphoric acid (1:5:4 v/v/v) . Separation was achieved using a Spherisorb S5 C8 column, heated to 50 degrees C and a mobile phase of 0.16% ortho-phosphoric acid (adjusted to pH 3.0 with tetrabutylammonium hydroxide solution) with 20 ml acetonitrile per litre solution . The method used fluorescence detection (Ex 310 nm; Em 445 nm), a flow rate of 1 ml/min and a 20 microl injection volume . Retention times were approximately 6 min for ciprofloxacin and 10 min for enrofloxacin . The linearity range for both compounds was 0-20 mg/kg, lowest limit of quantification 0.3 mg/kg and recoveries were >92%. J Appl Microbiol, 2004, 96(5), 1143 - 50 Phenotypic properties, drug susceptibility and genetic relatedness of Stenotrophomonas maltophilia clinical strains from seven hospitals in Rio de Janeiro, Brazil; Travassos LH et al.; AIMS: To investigate phenotypic aspects including biotyping, drug susceptibility and production of extracellular enzymes and genetic diversity of Stenotrophomonas maltophilia clinical strains obtained from seven hospitals in Rio de Janeiro, Brazil . METHODS AND RESULTS: Thirty-nine S . maltophilia strains were investigated by biotying, susceptibility testing, extracellular enzymes detection and by randomly amplified polymorphic DNA (RAPD)-PCR . Biotyping distinguished 13 biotypes among 39, and one of them was prevalent . The majority of the strains produced DNase, gelatinase and haemolysin . Protease, lipases and phospholipase C activities were observed in highly variable amounts . None of the strains was elastase producer . The percentage of full susceptibility, by agar dilution, was 100, 94.8, 81.6 and 26.3% for trimethoprim/sulphametoxazole, ticarcillin/clavulanate, ciprofloxacin and ceftazidime, respectively . Thirty-three RAPD-PCR profiles were obtained suggesting multiple sources of acquisition . CONCLUSIONS: The results pointed out the necessity of monitoring S . maltophilia especially in critical hospital wards, to assure effective control measures . SIGNIFICANCE AND IMPACT OF THE STUDY: Despite of the genetic diversity among the strains, in two situations it was observed indistinguishable RAPD-PCR profiles among strains isolated from different patients who had been hospitalized in the same hospital ward, suggesting the possibility of nosocomial transmission that until now has been rarely related. Int J STD AIDS, 2004 Apr, 15(4), 240 - 2 Efficacy of azithromycin 1g single dose in the management of uncomplicated gonorrhoea; Habib AR et al.; This paper describes the efficacy of azithromycin 1g single dose in the management of uncomplicated gonorrhoea either with or without chlamydial co-infection . Three hundred and one patients were treated for gonorrhoea between January 2000 and June 2001; 226/301 (75.1%) were treated with azithromycin 1g stat dose while the rest were treated with different regimens . Ninety-seven of 301 (32.2%) of all isolated strains were found to be resistant to at least one antibiotic where penicillin constituted the majority (23%) . Ch