Active substance: Ciprofloxacin
+ free Cipro pill.
Volunteers were advised to avoid exposure to sunlight throughout the treatment period.
The study design was approved by the local ethics committee of Paris Bichat-Cergy Pontoise.
All the participants gave their written informed consent before entering the study. Regimens Volunteers were randomly assigned into 6 groups of 8 individuals each, receiving either 250 mg every 12 h, 500 mg every 24 h, 500 mg every 12 h, 750 mg every 24 h, 750 mg every 12 h, or 1000 mg every 24 h of oral ciprofloxacin for a total of 14 days.
These regimens were chosen in order to generate pharmacokinetic variability within range of clinically relevant total daily doses. Each intake was observed, and its time recorded.
Analysis focused on viridans group streptococci VGS in the pharyngeal flora and Escherichia coli in the fecal flora for several reasons: these bacterial species are present in all subjects, they are involved in various clinical infections bacteremia, endocarditis, urinary tract infections, and are recognized sources of horizontal gene transfer within the commensal flora.
We determined for each of these target species the susceptibility to quinolones of the global population dominant flora and we also detected the emergence of quinolone-resistant subpopulations subdominant flora.
Suceptibility to ciprofloxacin of the dominant flora We used a procedure specifically designed to estimate susceptibility to fluoroquinolones of the dominant flora as a whole. After growth, we isolated ten separate colonies from each plate, identified as VGS and E.
These ten colonies were mixed, and susceptibility to fluoroquinolones of the mixture was tested using minimum inhibitory concentration MIC in duplicate by the agar dilution method and mutant prevention concentration MPC in triplicate, as described.
Geometric means of these replicates were used in the analysis. MICs of the colonies growing on selective media were determined by the agar dilution method.
Endpoints Resistance to nalidixic acid and ciprofloxacin in E. Emergence of resistance was defined by the detection of resistant strains at day 7, 14 or 42 in subjects in whom only susceptible strains were detected and resistant strains were not detected before treatment.
A novel approach in the management of right-sided endocarditis: percutaneous vegectomy using the AngioVac cannula. Future Cardiol. Ann Thorac Surg.
Available followup after 6 mos shows a much smaller risk. Oral antibiotic therapy for the treatment of infective endocarditis: a systematic review. BMC Infect Dis.
The largest study used ciprofloxacin and rifampin for right-sided disease with equivalent results to traditional IV therapy Heldman 1996 but still was not sufficiently powered.
Other smaller studies offer varying quality and outcomes. Endocarditis caused by Staphylococcus aureus: A reappraisal of the epidemiologic, clinical, and pathologic manifestations with analysis of factors determining outcome.