Summary
Ciprofloxacin has a reduced activity against anaerobic pathogens. Therefore, a combination of ciprofloxacin with an antimicrobial agent active against anaerobes, such as metronidazole, seems to be interesting for the treatment of mixed aerobic/anaerobic infections. High metronidazole concentrations (10 mg/l or 40 mg/l) neither affected the bactericidal efficacy of ciprofloxacin on aerobic pathogens, such asEscherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa andEnterococcus faecalis, nor on the anaerobic pathogensClostridium perfringens andClostridium difficile, as demonstrated by kill-kinetic curves. The same high concentrations, as well as lower therapeutically achievable concentrations (2 mg/l or 5 mg/l) of metronidazole in combination with ciprofloxacin were slightly more potent for the tested clostridia than ciprofloxacin or metronidazole alone.
Zusammenfassung
Ciprofloxacin weist gegenüber anaeroben Keimen eine herabgesetzte Aktivität auf. Insbesondere bei aeroben/anaeroben Mischinfektionen ist die Kombination von Ciprofloxacin mit einem Anaerobier-aktiven Therapeutikum wie z. B. Metronidazol wichtig. Wie sich anhand von Bakterizidiekinetiken zeigen ließ, wird weder die bakterizide Effizienz von Ciprofloxacin auf aerobe pathogene Keime, wie z. B.Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa undEnterococcus faecalis, noch auf anaerobe Pathogene, wie z. B.Clostridium perfringens undClostridium difficile, durch hohe Metronidazolkonzentrationen (10 mg/l oder 40 mg/l) beeinträchtigt. Sowohl in hohen als auch in therapeutisch erreichbaren Metronidazolkonzentrationen erweist sich die Kombination mit Ciprofloxacin als aktiver auf die getesteten Clostridium-Stämme als die Substanzen alleine.
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Werk, R., Schneider, L. Ciprofloxacin in combination with metronidazole. Infection 16, 257–260 (1988). https://doi.org/10.1007/BF01650774
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DOI: https://doi.org/10.1007/BF01650774