Ciprofloxacin aureus

Intranasal S. aureus increases the risk of S. aureus exit-site infections, tunnel infections, peritonitis, and subsequent catheter loss.49 Several measures have been used to decrease the risk of peritonitis caused by S. aureus, including mupirocin cream applied daily around the exit site, intranasal mupirocin cream twice daily for 5 days each month, or rifampin 300 mg orally twice daily for 5 days, repeated every 3 months.49 Mupirocin use is preferred over rifampin to prevent the development of resistance to rifampin, although mupirocin resistance has also been reported.49 Other measures that have been used to decrease both S. aureus and P. aeruginosa infections include gentamicin cream applied twice daily and ciprofloxacin otic solution applied daily to the exit site.49... 

Fluoroquinolones Not approved by the United States Food and Drug Administration for use in children except for anthrax (ciprofloxacin). MRSA, methicillin-resistant 5. aureus MSSA, methicillin-sensitive 5. aureus. 

Gram-positive Gram-negative MRSA, methicillin-resistant Staphylococcus aureus, ORSA, oxacillin- resistant Staphylococcus aureus, GAR, garenoxacin CIP, ciprofloxacin LVX, levofloxacin GAT, gatifloxacin MXF, moxifloxacin GEM, gemifloxacin. 

Ferrero L, Cameron B, Crouzet J Analysis of gyrA and grIA mutations in stepwise-selected ciprofloxacin-resistant mutants of Staphylococcus aureus. Antimicrob Agents Chemother 1995 39 1554. [PMID 7492103]... 

Serai, C., et al. 2003. Influence of P-glycoprotein and MRP efflux pump inhibitors on the intracellular activity of azithromycin and ciprofloxacin in macrophages infected by Listeria monocytogenes or Staphylococcus aureus. J Antimicrob Chemother 51 1167. 

Antistaphylococcal penicillins Methicillin [meth i SILL in], naf-cillin [naf SILL in], oxacillin [ox a SILL in], cloxacillin [klox a SILL in], and dicloxacillin [dye klox a SILL in] are penicillinase-resistant penicillins. Their use is restricted to the treatment of infections caused by penicillinase-producing staphylococci. Because of its toxicity, methicillin is rarely used. Methicillin-resistarft strains of Staphylococcus aureus (MRSA), currently a serious source of nosocomial (hospital-acquired) infections, are usually susceptible to vancomycin, and rarely to ciprofloxacin or rifampin. 

The effectiveness of moxifloxacin (MIC,) 0.06-0.125 mg L ) against methicil-lin-sensitive S. aureus (MSSA) is four- to eight-fold greater than that of ciprofloxacin, ofloxacin, and levofloxacin, although its in vitro activity against methicillin-resistant S. aureus (MRSA) is less powerful (MIQo 1-8 mg L 1) [33,149,150, 182,186],... 

An increased expression of efflux pumps, which prevents accumulation of the quinolone in the bacterial cell. Thus, the efflux pump NorA is responsible for the reduced sensitivity of S. aureus to hydrophilic fluoroquinolones such as norfloxacin, ciprofloxacin and ofloxacin, whereas quinolones such as sparfloxacin, trovafloxacin and moxifloxacin are not as greatly affected thereby. 

Dajcs JJ, et al. Effectiveness of ciprofloxacin, levofloxacin, or moxifloxacin for treatment of experimental Staphylococcus aureus keratitis. Antimicrob. Agents Chemother., 2004, 48, 1948-1952. 

Vancomycin, daptomycin or linezolid (to cover staphylococci including methicillin-resistant Staphylococcus aureus (MRSA), streptococci and enterococci) plus metronidazole (to cover anaerobes) plus gentamicin, ciprofloxacin, ceftazidime or aztreonam (to cover Gram-negative organisms including Pseudomonas). 

Definitive therapy is guided by the results of culture but commonly used regimens include flucloxacillin with or without fusidic acid (for Staphylococcus aureus), cefotaxime or co-amoxiclav (in children), and ciprofloxacin (for coliforms). Short courses of therapy (3 weeks) may suffice for acute osteomyelitis. 

Ciprofloxacin is well known for its wide range of bactericidal activity, especially against S. aureus. Staphylococcus epidermidis, and P. aeruginosa This preparation has the ideal antimicrobial spectrum for refractory otitis however topical therapy should not be considered alone for more serious infections such as those with underlying osteomyelitis. 

A 66-year-old kidney transplant recipient developed a gangrenous lesion on the left foot infected with S. aureus and Escherichia coli. He was given ciprofloxacin and chndamycin for 6 weeks and then fusidic acid 1500 mg/day for 2 weeks. He became Ul, with myalgia and no active movement of his legs, and rhabdomyolysis was established by laboratory tests. He had also taken atorvastatin 10 mg/day and he slowly recovered after withdrawal of both atorvastatin and fusidic acid. 

AeschUmarm, J.R., Kaatz, G.W., and Rybak, M.J. (1999) The effects of NorA inhibition on the activities of levofloxacin, ciprofloxacin and norfloxacin against two genetically related strains of Staphylococcus aureus in an in-vitro infection model. The Journal of Antimicrobial Chemotherapy, 44 (3), 343-349. 

J. J. Campion, P. J. McNamara, and M. E. Evans, Pharmacodynamic modeling of ciprofloxacin resistance in Staphylococcus aureus. Antimicrob Agents Chemother 49 209-219... 

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