PURPOSE: To evaluate the penetration capability of Levofloxacin and Ciprofloxacin into prostatic tissue, we analysed the concentration of each drug in serum and prostatic tissue simultaneously after oral administration. MATERIALS AND METHODS: Eleven patients with benign prostatic hyperplasia treated with transurethral resection of the prostate were entered in this study. A single dose of 200mg Levofloxacin(LVFX) and 250mg ciprofloxacin(CPFX) were administered orally. Two hours after administration, blood and prostatic tissue samples were taken during operation. Concentration of each drug in serum and prostatic tissue was measured simultaneously by high performance liquid chromatography. RESULTS: The mean concentration of LVFX in serum was 1.970 +/- 0.759 microgram/ml, which was significantly higher than that of CPFX(0.903 +/- 0.291 microgram /ml)(p < 0.05). The mean concentration of LVFX in prostatic tissue(2.256 +/- 1.121 microgram/g), however, was not significantly different from that of CPFX(2.395 +/- 0.846 microgram/g). And the concentration ratio(tissue/serum concentration) of LVFX and CPFX was 1.16 and 2.76, respectively. CONCLUSIONS: These results show that LVFX is not superior to CPFX with respect to the penetration capability into prostatic tissue. Considering that the concentration of LVFX in prostatic tissue was higher than that in serum and not different from that of CPH, LVFX may be another potential effective agent in treating patients with chronic bacterial prostatitis.
Administration, Oral ; Chromatography, Liquid ; Ciprofloxacin* ; Humans ; Levofloxacin* ; Prostate ; Prostatic Hyperplasia ; Prostatitis

PURPOSE: In this prospective study, we evaluated the clinical significance of inflammatory cytokines in women with acute uncomplicated pyelonephritis undergoing antimicrobial therapy. MATERIALS AND METHODS: We analyzed 26 female patients diagnosed with acute uncomplicated pyelonephritis between September 2007 and March 2008. Body temperature, white blood cell (WBC) counts, serum C-reactive protein (CRP), and serum and urine interleukin (IL)-6 and IL-8 were measured before and 12 hours, 24 hours, and 4 days after the intravenous administration of empirical ciprofloxacin. RESULTS: Initial serum CRP levels were correlated with initial serum IL-6 and initial urine IL-8 levels. Twenty-four hours after the start of antibiotic treatment, the CRP level and urine IL-8 level continued to be high, whereas serum IL-6 levels decreased significantly (26.1+/-32.4 vs 9.9+/-23.5pg/dl, p<0.01). When we divided the patients into mild (CRP<15mg/dl, n=14) and severe (CRP> or =15mg/dl, n=12) groups according to initial CRP levels, the serum IL-6 level decreased significantly in both the mild (14.2+/-4.0 vs 4.0+/-1.7pg/dl, p<0.01) and the severe (41.1+/-12.7 vs. 22.7+/-16.4pg/dl, p<0.01) groups within 24 hours, whereas CRP and urine IL-8 levels did not change significantly in either group. CONCLUSIONS: Clinically, initial serum IL-6 and urine IL-8 levels were increased according to disease severity. Moreover, the serum IL-6 level decreased rapidly after antibiotic treatment within 24 hours. Serum IL-6 levels are a better indicator of the severity of disease and the therapeutic effect of empirical parenteral antibiotic use in patients with acute uncomplicated pyelonephritis than were either CRP or WBC counts.
Administration, Intravenous ; Body Temperature ; C-Reactive Protein ; Ciprofloxacin ; Cytokines ; Female ; Humans ; Interleukin-6 ; Interleukin-8 ; Interleukins ; Leukocytes ; Prospective Studies ; Pyelonephritis

OBJECTIVETo observe the DNA release from Pseudomonas aeruginosa (P. aeruginosa) during spontaneous growth and exposure to different concentrations of ciprofloxacin (Cipro) in vitro.

METHODSThe P. aeruginosa 1244 strain (ATCC 27317) was selected because it was sensitive to Cipro in vitro. The minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of Cipro against this strain were determined, respectively. Different concentrations of Cipro were cultured with this strain at 37 degrees C for 4 h and 24 h. The samples of culture supernatant were filtered and electrophoresed in 1.8% agarose with SYBR Gold stain. Then the images of the gel sheets were photographed.

RESULTSThe MIC and MBC of Cipro were 0.25 - 0.5 mg/L. The free bacterial DNA in 4 h culture samples with or without Cipro could not be detected by this method. The certain amount of free bacterial DNA molecules in 24 h culture samples without antibiotic appeared at the two zones whose molecular weights were more than 2000 bp and less than 100 bp. The large amount of free bacterial DNA molecules showed at three zones in 24 h culture samples with Cipro when its concentrations were much lower than its MIC. In terms of DNA molecular weight, the first two zones were above 2000 bp, and the third zone was below 100 bp. There was no detectable DNA release from bacteria in 24 h culture samples when Cipro was at or above its MIC.

CONCLUSIONSThe certain amount of bacterial DNA were released from P. aeruginosa in the spontaneous growth. Different concentrations of Cipro had quite differential effects on the DNA release from P. aeruginosa in quantities and molecular weights in vitro.

Anti-Infective Agents ; administration & dosage ; pharmacology ; Ciprofloxacin ; administration & dosage ; pharmacology ; DNA, Bacterial ; metabolism ; Dose-Response Relationship, Drug ; In Vitro Techniques ; Microbial Sensitivity Tests ; Pseudomonas aeruginosa ; drug effects ; metabolism

OBJECTIVETo prepare the controlled-release delivery gutta-percha points containing metronidazole compound (CDGMC) and to determine its release rate in vitro.

METHODSThe drug points were made by using compound drugs and gutta-percha as a carrier, and CDGMC were prepared followed by enveloping a release membrane outward. The best formula was selected according to the release parameters of the drugs extracted in the release experiments in vitro. The CDGMC were placed into the extracted teeth after root canals were routinely prepared. The non-drug CDGMC was used as the control. The absorbency of the drugs in normal saline (37 degrees C, pH 7.4) was determined timely. The percentage of release and cumulated release of the drugs were calculated according to the concentrations of drugs in medium.

RESULTSThe in vitro experiments showed that this system contained 1,880 micrograms of metronidazole and 267 micrograms of ciprofloxacin. The experiments in healthy single root canal showed that the drug release amounts around the perioapical area were metronidazole 88.54 micrograms/ml and ciprofloxacin 9.05 micrograms/ml in 10 days.

CONCLUSIONCDGMC can continuously release effective drug concentrations more than 10 days and could be considered as an ideal method for clinical application.

Anti-Infective Agents, Local ; administration & dosage ; pharmacokinetics ; Ciprofloxacin ; administration & dosage ; pharmacokinetics ; Delayed-Action Preparations ; chemical synthesis ; pharmacokinetics ; Dental Pulp Cavity ; drug effects ; metabolism ; Drug Delivery Systems ; Gutta-Percha ; Humans ; Metronidazole ; administration & dosage ; pharmacokinetics ; Root Canal Therapy ; methods

An 81-year-old woman with a history of temporal lobe epilepsy-induced psychotic episodes was initially admitted to a general hospital where she was started on a course of oral antibiotics for community-acquired pneumonia, and ciprofloxacin eye drops to treat nasolacrimal duct obstruction. After one week, the patient was discharged back to a nursing home with these medications. However, she was admitted to our psychiatric ward two days later due to a relapse of psychosis. Another six days later, she developed breakthrough seizures associated with subtherapeutic serum phenytoin levels. Having explored all possible causes of reduced serum phenytoin levels, ciprofloxacin eye drops was discontinued in the patient, resulting in gradual return of phenytoin levels to the therapeutic range, with no further seizures observed in the patient.
Administration, Oral ; Aged, 80 and over ; Anti-Bacterial Agents ; administration & dosage ; Ciprofloxacin ; administration & dosage ; adverse effects ; Drug Interactions ; Epilepsy, Temporal Lobe ; drug therapy ; Female ; Hospitalization ; Humans ; Ophthalmic Solutions ; adverse effects ; Phenytoin ; blood ; Psychotic Disorders ; drug therapy ; Seizures ; chemically induced

INTRODUCTIONInfection-related complications after transrectal ultrasound guided prostatic biopsy (TRPB) could be life threatening. Our centre observed sepsis after TRPB despite prophylactic oral ciprofloxacin. We reviewed all cases of post-TRPB sepsis with their bacteriology and evaluated if the addition of intramuscular (I/M) gentamicin to standard prophylaxis before TRPB could reduce its incidence.

MATERIALS AND METHODSIn a single urological centre, we performed an interventional study that compared a prospective group with retrospective control. The latter is known as the "cipro-only" group included consecutive patients who underwent TRPB between 1 September 2003 and 31 August 2004. The addition of I/M gentamicin 80 mg half an hour before TRPB started on 1 September 2004. All subsequent patients who underwent TRPB until 31 August 2005 were included in the "cipro+genta" group. Patients who did not receive the studied antibiotics were excluded.

RESULTSThere were 374 patients in the "cipro+genta" group and 367 patients in the "cipro-only" group with comparable profiles. There were 12 cases of post-TRPB sepsis in the "cipro-only" group and 5 cases in the "cipro+genta" group. Ciprofloxacin-resistant Escherichia coli (E. coli) was the only pathogen isolated in both groups. In the "cipro-only" group, 9 patients had positive blood cultures and 8 were sensitive to gentamicin. In the "cipro+genta" group, the only positive E. coli was gentamicin-resistant. One patient in the "cipro+genta" group was admitted to the intensive care unit with septicaemia.

CONCLUSIONThe addition of I/M gentamicin to oral ciprofloxacin is a safe and effective prophylactic antibiotic regime in reducing the incidence of post-TRPB sepsis.

Administration, Oral ; Adult ; Aged ; Antibiotic Prophylaxis ; methods ; Biopsy ; Ciprofloxacin ; administration & dosage ; therapeutic use ; Drug Resistance, Bacterial ; Escherichia coli ; drug effects ; isolation & purification ; Gentamicins ; administration & dosage ; Humans ; Injections, Intramuscular ; Male ; Middle Aged ; Prospective Studies ; Prostate ; diagnostic imaging ; pathology ; Rectum ; Ultrasonography

Ciprofloxacin is a broad-spectrum antibiotic used to treat a variety of infections. However, acute kidney injury is a rarely reported side effect. Ciprofloxacin-related nephrotoxicity typically manifests as acute tubulointerstitial nephritis. To the best of our knowledge, few cases of acute tubular necrosis as a complication of ciprofloxacin have been reported to date. We herein describe a case involving a 41-year-old woman treated with intravenous ciprofloxacin at 200 mg twice daily for gastroenteritis. One day after initiation of treatment, her serum creatinine level increased from 0.95 to 3.83 mg/dL and she experienced impaired hearing. Five days later, renal biopsy demonstrated acute tubular necrosis. The acute tubular necrosis encountered in this patient resolved; however, short-term hemodialysis was required. This is the first reported case of acute kidney injury associated with ciprofloxacin use in Korea.
Acute Kidney Injury ; Administration, Intravenous* ; Adult ; Biopsy ; Ciprofloxacin* ; Creatinine ; Female ; Gastroenteritis ; Hearing ; Hearing Loss* ; Humans ; Korea ; Necrosis* ; Nephritis, Interstitial ; Renal Dialysis

Purpose: Although oral antibiotic therapy remains the most common treatment modality for chronic bacterial prostatitis (CBP), it is known to have problems, such as potential adverse effects and the development of bacterial resistance. We compared the effects of oral and local injection therapies, with fluoroquinolones, in patients diagnosed as having chronic bacterial prostatitis/seminal vesiculitis, from Tc-99m ciprofloxacin imaging. Materials and Methods: The study randomly included 79 patients with symptom of prostatitis, who also showed hot uptake in the prostate or seminal vesicle on Tc-99m ciprofloxacin imaging. A total of 53 patients received oral antibiotics for 3 months. In 26 patients, a local injection of ciprofloxacin into the prostate and/or seminal vesicle was performed via the transperineal route, with transrectal ultrasonography guidance. Four- glass tests and Tc-99m ciprofloxacin imaging were performed, and the patients were asked to complete National institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) questionnaires at the baseline and 3 months after the initiation of therapy. Results: The total score or subscores from the NIH-CPSI and bacteriological study after treatment was significantly decreased in both groups compared to that before treatment. The complete cure rate, based on the Tc-99m ciprofloxacin imaging findings, was significantly higher in the local injection (23.1%) than the oral therapy group (16.9%, p<0.024). In the local injection group, 15 men (57.7%) showed transient hematuria and/or bloody ejaculation, but without any serious side effects. Conclusions: A transperineal lesional injection of fluoroquinolone will be a valuable therapeutic alternative in men with chronic bacterial prostatitis/ seminal vesiculitis; although a long term outcome study will be required.
Administration, Oral* ; Anti-Bacterial Agents ; Ciprofloxacin ; Ejaculation ; Fluoroquinolones ; Glass ; Hematuria ; Humans ; Male ; Outcome Assessment (Health Care) ; Prostate ; Prostatitis ; Surveys and Questionnaires ; Radioisotopes ; Seminal Vesicles ; Ultrasonography

PURPOSE: To evaluate the concentrations of commercially available ofloxacin 0.3%, levofloxacin 0.5%, and ciprofloxacin 0.3% topical ophthalmic solutions in human aqueous humor. METHODS: Patients scheduled to undergo phacoemulsification and posterior chamber lens insertion for treatment of cataract were enrolled in this prospective study. After informed consent was obtained, patients were randomized to receive 1 drop of ofloxacin 0.3%, levofloxacin 0.5%, or ciprofloxacin 0.3% topical ophthalmic solution 5 times at 1-hour intervals from 6pm one day before surgery and 3 further times at 5-min intervals immediately before surgery. After aspirating approximately 0.1 mL of aqueous fluid by paracentesis, surgery was commenced. We recorded the interval between the last drop and paracentesis. Specimens were stored at -70 degrees C until assayed by high-performance liquid chromatography. RESULTS: Thirty-four patients were enrolled. 14 male and 19 patients female. The mean age was 59.4 years. The mean concentrations of levofloxacin, ofloxacin and ciprofloxacin in aqueous humor were 577.8 ng/ml, 279.6 ng/ml and 53.0 ng/ml, respectively. The differences of concentration among the three groups were statistically significant. CONCLUSIONS: The concentration of levofloxacin 0.5% solution was highest, followed in order by ofloxacin 0.3% and ciprofloxacin 0.3%.
Administration, Topical* ; Aqueous Humor* ; Cataract ; Chromatography, Liquid ; Ciprofloxacin* ; Female ; Humans* ; Informed Consent ; Levofloxacin* ; Male ; Ofloxacin* ; Ophthalmic Solutions ; Paracentesis ; Phacoemulsification ; Prospective Studies

PURPOSE: Mycobacterium abscessus belongs to the group of rapid-growing atypical mycobacterium. The organism is ubiquitous and is found in soil, dust, and water. Although it rarely causes disease in humans, Mycobacterium abscessus has been associated with soft tissue infection. To the best of our knowledge, this is the first case report of facial soft tissue Mycobacterium abscessus infection in a healthy child in Korea. METHODS: A 12-year-old girl presented with an erythematous skin lesion with serous discharge on her chin, which had been present for 3 weeks. On her history, she had a laceration wound on her chin at public bath and the lesion was repaired at emergency department immediately. Although conventional soft tissue infecton treatment, her lesion remains unhealed state and had serous discharge for 2 months. Moreover, we found a 1cm sized nodular mass on her chin. Therefore we performed excision operation and referred the specimen to the laboratory for microbial and histopathologic study. RESULTS: Pathology report confirmed the mass was enlarged lymph node with chronic necrotizing granulomatous inflammation with central microabscess. Non-Tuberculous mycobacterium identification test through tissue specimen resulted Mycobacterium abscessus. We prescribed clarithromycin for three weeks by oral administration as well as performed wound debridement and mass excision via previous wound. This way, her lesion appeared to be complete healing with minimal scarring. There were no evidence of inflammation sign or palpable mass. CONCLUSION: Although the prevalence is rare, Mycobacterium abscessus infections of soft tissue should be considered even in a healthy child with a lesion caused by trauma or which fails to respond to conventional treatment.
Administration, Oral ; Baths ; Child ; Chin ; Cicatrix ; Ciprofloxacin ; Clarithromycin ; Debridement ; Dust ; Emergencies ; Humans ; Inflammation ; Korea ; Lacerations ; Lymph Nodes ; Mycobacterium ; Nontuberculous Mycobacteria ; Organotechnetium Compounds ; Prevalence ; Skin ; Soft Tissue Infections ; Soil