Sequential Intravenous-Oral Administration of Ciprofloxacin vs Ceftazidime in Serious Bacterial Respiratory Tract lnfections*

The ethcacy and safety of sequential intravenous/oral ciprofloxacin in rnoderate to severe respiratory tract infections (RTI) were cornpared with those of ceftazidirne in a prospective clinical trial. Sixty-six patients received IN ciprofloxacin (200 to 300 rng twice daily), followed by oral ciprofloxacin(500 rng twice daily). Fifty-six patients received intravenous ceftazidime (1 to 2 g two to three times daily). Ciprofloxacin was as effective as ceftazidime and produced a 91 percent clinical cure rate. Signfficantly more pretreatment bacterial isolates were susceptible to ciprofloxacin, and ciprofloxacin had a significantly higher rate of sputum bacterial eradication than did ceftazidime. Ciprofloxacin showed broad in vitro antibacterial activity with particularly low minimal inhibitory concentrations for Gram-negative organisms. Ciprofloxacin was well tolerated; there were few adverse effects. Ciprofloxacin was an effective and welltolerated treatment for severe RTI that had the advantages of broad in vitro antibacterial activity, twice-daily dosing, and sequential availability in an intravenous and oral formulation. (Chest 1989; 96:528-37)