Efficacy of oral ofloxacin for single-dose perioperative prophylaxis in general surgery – a controlled randomized clinical study

Schwarz, Michael; Isenmann, Rainer; Thomsen, Jens T. W.; Gaus, Wilhelm; Beger, H. G.

doi:10.1007/s004230100245

Cited by 9 publications

(7 citation statements)

References 20 publications

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“…Most clinical experience has been gained with ciprofloxacin and ofloxacin (28). Oral administration of quinolones was efficacious in surgical prophylaxis, even after a single dose (6,39), and also facilitates prolonged therapy. In in vitro studies, Staphylococcus aureus penetrates and survives in bone cells, i.e., osteoblasts (25); therefore, quinolones, which penetrate intracellularly, might be of advantage.…”

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confidence: 99%

Penetration of Moxifloxacin into Bone Evaluated by Monte Carlo Simulation

Landersdorfer

Kinzig

Hennig

et al. 2009

Antimicrob Agents Chemother

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Moxifloxacin is a fluoroquinolone with a broad spectrum of activity and good penetration into many tissues, including bone. Penetration of moxifloxacin into bone has not yet been studied using compartmental modeling techniques. Therefore, we determined the rate and extent of bone penetration by moxifloxacin and evaluated its pharmacodynamic profile in bone via Monte Carlo simulation. Twenty-four patients (10 males, 14 females) undergoing total hip replacement received 400 mg moxifloxacin orally 2 to 7 h prior to surgery. Blood and bone specimens were collected. Bone samples were pulverized under liquid nitrogen by a cryogenic mill, including an internal standard. Drug concentrations were analyzed by high-performance liquid chromatography. We used ADAPT II (results reported), NONMEM, and WinBUGS for pharmacokinetic analysis. Quinolones are established in the treatment of osteomyelitis. Most clinical experience has been gained with ciprofloxacin and ofloxacin (28). Oral administration of quinolones was efficacious in surgical prophylaxis, even after a single dose (6, 39), and also facilitates prolonged therapy. In in vitro studies, Staphylococcus aureus penetrates and survives in bone cells, i.e., osteoblasts (25); therefore, quinolones, which penetrate intracellularly, might be of advantage.Moxifloxacin achieves high concentrations in many tissues. Good penetration into bone has been reported for several quinolones. The average bone/serum concentration ratio in humans at approximately 2 to 5 h postdosing was 0.33 to 0.54 for moxifloxacin (30,34,35).Resistance to the older quinolones has been emerging, and they do not show sufficient microbiological efficacy against S. aureus and coagulase-negative staphylococci and streptococci (28). Moxifloxacin has improved activity against gram-positive and anaerobic pathogens frequently encountered as causative agents in osteomyelitis (28), such as staphylococci, enterobacteriaceae, streptococci, and Haemophilus influenzae (19).Moxifloxacin has lower MICs than do levofloxacin, ciprofloxacin, ofloxacin, and norfloxacin for S. aureus (51), which is the most common pathogen of osteomyelitis. The main causative bacteria for osteomyelitis are S. aureus (methicillin susceptible or resistant), coagulase-negative staphylococci, propionibacteria, streptococci, and Pseudomonas aeruginosa (27). P. aeruginosa can cause osteomyelitis due to nosocomial infections or chronic unresolved middle ear infections in children.Studying the time course and extent of bone penetration before investigating the agent in a clinical trial is important (17,51). Bone penetration studies most often report the ratio of concentrations in bone and serum. However, the ratio of tissue concentrations to serum concentrations of a drug changes with time, a phenomenon known as system hysteresis, and therefore, the concentration ratio depends on the sampling time. Like in the present study, bone penetration of antimicrobials is most often studied in patients undergoing joint replacement, where only one bone sample can...

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mentioning

confidence: 99%

Penetration of Moxifloxacin into Bone Evaluated by Monte Carlo Simulation

Landersdorfer

Kinzig

Hennig

et al. 2009

Antimicrob Agents Chemother

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“…Our study showed that levofloxacin distributes into the ECF of rat pancreatic tissue (AUC pancreas /AUC blood , 0.97 ± 0.02) with IV and (AUC pancreas /AUC blood , 0.96 ± 0.03) with PO. The degree of tissue penetration with levofloxacin correlates well with other quinolones such as moxifloxacin,[21] ciprofloxacin,[22] ofloxacin[23] and gatifloxacin [24]. These facts suggest that equal bioavailability is achieved for levofloxacin with intravenous and oral formulations.…”

Section: Discussionmentioning

confidence: 81%

Quantitative determination of unbound levofloxacin by simultaneous microdialysis in rat pancreas after intravenous and oral doses

Liu

Xiao

et al. 2014

Journal of Pharmacy and Pharmacology

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“…Ayrıca, oral antibiyotiğin emilimini olumsuz etkileyebilecek birçok neden olabileceğinden, oral antibiyotik profilaksisi cerrahi alan infeksiyonlarını engelleme adına tercih edilen bir uygulama değildir. Buna karşın, son yıllarda yapılan bazı kontrollü çalışmalar gastrointestinal emilimi iyi olan antibiyotiklerle yapılan oral profilaksinin parenteral antibiyotikler kadar etkin olduğunu göstermiştir (26,27). Henüz rutin öneri düzeyinde olmamakla birlikte, ilerleyen yıllarda oral antimikrobiyal profilaksi cerrahide tercih edilebilecektir.…”

Section: Uygulama Yoluunclassified

Antibiotic prophylaxis in surgery

Öncü

2011

UCD

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Efficacy of oral ofloxacin for single-dose perioperative prophylaxis in general surgery – a controlled randomized clinical study

Abstract: The data demonstrate that single-dose oral ofloxacin is at least as effective as a standard intravenous prophylaxis in patients with colonic or pancreatic resection. It offers significant advantages regarding costs and ease of administration.

Cited by 9 publications

References 20 publications

Penetration of Moxifloxacin into Bone Evaluated by Monte Carlo Simulation

Penetration of Moxifloxacin into Bone Evaluated by Monte Carlo Simulation

Quantitative determination of unbound levofloxacin by simultaneous microdialysis in rat pancreas after intravenous and oral doses

Antibiotic prophylaxis in surgery

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