Clindamycin Ciprofloxacin

As patients improve clinicaUy, the route of administration should be reevaluated. Streamlining therapy from parenteral to oral (switch therapy) has become an accepted practice for many infections outside the bloodstream and CNS. Criteria that should be present to justify a switch to oral therapy include (1) overall clinical improvement, (2) lack of fever for 24 to 48 hours, (3) decreased WBC count, and (4) a functioning gastrointestinal tract. Drugs that exhibit excellent oral bioavaUabifity when compared with intravenous formulations include ciprofloxacin, clindamycin, doxycycline, gatifloxacin, levofloxacin, metronidazole, moxifloxacin, linezolid, and trimethoprim-sulfamethoxazole. 

Deppeimann K-M, Boeckh M, Grineisen S, Shokiy F, Bomer K, Koeppe P, Krasemann C, Wagner J, Lode H. Brief report combination effects of ciprofloxacin, clindamycin, and met ronida le intravenous invohinteers../4i i JAfei (1989) 87 (Siq>pl 5A), 46 - 8. ... 

Other Imipenem/cilistatin, meropenem, ertapenem, or extended-spectrum penicillins with B-lactamase inhibitor 1. Ciprofloxacin with metronidazole 2. Aztreonam with clindamycin or metronidazole 3. Antianaerobic cephalosporins.3... 

Pelvic Inflammatory Disease Cefotetan or cefoxitin with doxycycline 1. Clindamycin with gentamicin 2. Ampicillin-sulbactam with doxycycline 3. Ciprofloxacin with doxycycline and metronidazole... 

Insufficiency SO years) peripheral neuropathy Enterobacteriaceae, P. aeruginosa, Enterococcus spp., anaerobes Vancomycin PLUS (1) piperacillin/tazobactam (2) imipenem/cilastatin or meropenem (3) cefepime or ceftazidime and clindamycin or metronidazole (4) ciprofloxacin or levofloxacin and clindamycin or metronidazole... 

Skin/soft tissue Catheter-related Vancomycin or linezolid or daptomycin /J-Lactamase inhibitor combo or clindamycin plus ciprofloxacin or carbapenem Vancomycin ... 

D. Although ciprofloxacin is the primary agent recommended for prophylaxis against anthrax, doxycycline is an equally effective agent. Amoxicillin (A) is not as effective. The macrolides (B) and (C) also are not as effective. Clindamycin (E) is not indicated for this use. 

Bacillus anthracis Anthrax pneumonia Ciprofloxacin or doxycycline plus a penicillin another [alternative] agent Clarithromycin clindamycin chloramphenicol imipenem rifampin vancomycin... 

Moxifloxacin is more effective against anaerobes than ciprofloxacin or sparflox-acin, but has approximately the same activity as clindamycin (Tab. 14.8). In 2005 it was approved by the FDA as the first quinolone for the treatment of complicated intra-abdominal infections. 

Clindamycin (to cover staphylococci, streptococci and anaerobes) plus gentamicin, ciprofloxacin, ceftazidime or aztreonam (to cover Gram-negative organisms including Pseudomonas). 

A fluoroquinolone (ciprofloxacin 0,4 g orally every 12 hours or levotloxacin 0.5-0.75 g orally every 24 hours) plus clindamycin 0.3-0.6 g orally every 8 hours or metronidazole 0.5 g orally every 8 hours Aminoglycoside + clindamycin 0.6-0.9 g IV every 8 hours or metronidazole 0.5 g IV every 8 hours or... 

Clinically important, potentially hazardous interactions with alfentanil, aminophylline, amisulpride, amoxicillin, ampicillin, anticonvulsants, astemizole, atorvastatin, benzodiazepines, bromocriptine, buprenorphine, bupropion, carbamazepine, cilostazol, ciprofloxacin, cisapride, clindamycin, colchicine, cyclosporine, dasatinib, digoxin, dihydroergotamine, diltiazem, disopyramide, enoxacin, eplerenone, ergotamine, eszopiclone, everolimus, fluconazole, fluoxetine, fluvastatin, gatifloxacin, HMG-CoA reductase inhibitors, imatinib, itraconazole, ketoconazole, lomefloxacin, lorazepam, lovastatin, methadone, methylprednisolone, methysergide, midazolam, mizolastine, moxifloxacin, nitrazepam, norfloxacin, ofloxacin, paroxetine, pimozide, pravastatin, quinolones, ranolazine, repaglinide, rupatadine, sertraline, sildenafil, simvastatin, sparfloxacin, sulpiride, tacrolimus, terfenadine, triazolam, troleandomycin, vardenafil, verapamil, vinblastine, warfarin, zaleplon, zolpidem, zuclopenthixol... 

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