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Antimicrobial Agents and Chemotherapy, May 2001, p. 1487-1492, Vol. 45, No. 5
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

Irma A. J. M. Bakker-Woudenberg,1,* Marian T. ten Kate,1 Luke Guo,2 Peter Working,2 and Johan W. Mouton3

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.


* 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.


Antimicrobial Agents and Chemotherapy, May 2001, p. 1487-1492, Vol. 45, No. 5
0066-4804/01/$04.00+0   DOI: 10.1128/AAC.45.5.1487-1492.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.






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Copyright © 2001 by the American Society for Microbiology. All rights reserved.