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Antimicrobial Agents and Chemotherapy, May 2001, p. 1487-1492, Vol. 45, No. 5
Department of Medical Microbiology & Infectious Diseases, Erasmus University Medical Center
Rotterdam, 3000 DR Rotterdam,1 and
Department of Medical Microbiology, Canisius Wilhelmina
Hospital, Nijmegen,3 The Netherlands, and
ALZA Corporation, Mountain View, California2
Received 12 July 2000/Returned for modification 12 November
2000/Accepted 7 February 2001
Animal and clinical data show that high ratios of the area under
the concentration-time curve and the peak concentration in blood to the
MIC of fluoroquinolones for a given pathogen are associated with a
favorable outcome. The present study investigated whether improvement
of the therapeutic potential of ciprofloxacin could be achieved by
encapsulation in polyethylene glycol (PEG)-coated long-circulating
sustained-release liposomes. In a rat model of unilateral
Klebsiella pneumoniae pneumonia (MIC = 0.1 µg/ml), antibiotic was administered at 12- or 24-h intervals at
twofold-increasing doses. A treatment period of 3 days was started
24 h after inoculation of the left lung, when the bacterial count
had increased 1,000-fold and some rats had positive blood cultures. The
infection was fatal within 5 days in untreated rats. Administration of
ciprofloxacin in the liposomal form resulted in delayed ciprofloxacin
clearance and increased and prolonged ciprofloxacin concentrations in
blood and tissues. The ED50 (dosage that results in 50%
survival) of liposomal ciprofloxacin was 3.3 mg/kg of body weight/day
given once daily, and that of free ciprofloxacin was 18.9 mg/kg/day once daily or 5.1 mg/kg/day twice daily. The ED90 of
liposomal ciprofloxacin was 15.0 mg/kg/day once daily compared with
36.0 mg/kg/day twice daily for free ciprofloxacin; 90% survival could not be achieved with free ciprofloxacin given once daily. In summary, the therapeutic efficacy of liposomal ciprofloxacin was superior to
that of ciprofloxacin in the free form. PEG-coated liposomal ciprofloxacin was well tolerated in relatively high doses, permitting once daily administration with relatively low ciprofloxacin clearance and without compromising therapeutic efficacy.
0066-4804/01/$04.00+0 DOI: 10.1128/AAC.45.5.1487-1492.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
Improved Efficacy of Ciprofloxacin Administered in Polyethylene
Glycol-Coated Liposomes for Treatment of Klebsiella
pneumoniae Pneumonia in Rats
*
Corresponding author. Mailing address: Department of
Medical Microbiology & Infectious Diseases, Erasmus University Medical Center Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands. Phone: 31 10 4087666. Fax: 31 10 4089454. E-mail:
bakker{at}kmic.fgg.eur.nl.
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