SEQUENTIAL INTRAVENOUS ORAL CIPROFLOXACIN COMPARED WITH PARENTERAL CEFTRIAXONE IN THE TREATMENT OF HOSPITALIZED-PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA/

The efficacy and safety of sequential (intravenous/oral) ciprofloxacin were compared with the efficacy and safety of ceftriaxone for the tre atment of hospitalized patients with acute bacterial pneumonia. In thi s prospective, controlled, double-blind, randomized multicenter trial, 227 patients were enrolled and received either intravenous ciprofloxa cin (400 mg every 12 hours) followed by oral ciprofloxacin (500 mg eve ry 12 hours) or intravenous ceftriaxone followed by intramuscular ceft riaxone (1 g every 24 hours). Ninety-six patients (50, ciprofloxacin; 46, ceftriaxone) were valid for efficacy; 91% had community-acquired p neumonia. Clinical cure, observed in 44 (90%) of 49 ciprofloxacin pati ents and in 38 (84%) of 45 ceftriaxone patients, was statistically equ ivalent for the two treatment groups, using a 95% confidence interval (CI) = -0.092, 0.198. Bacteriologic eradication was effective for 45 ( 94%) of 48 ciprofloxacin patients and for 42 (100%) of 42 ceftriaxone patients (95% CI = -0.189, 0.074), Both ciprofloxacin and ceftriaxone were effective in eradicating Streptococcus pneumoniae organisms in 21 (91%) of 23 patients and 17 (100%) of 17 patients, respectively; Haem ophilus influenzae organisms in 18 of 18 patients and 8 of 8 patients, respectively; and Moraxella catarrhalis organisms in 4 of 4 patients and 2 of 2 patients, respectively. Both treatments were well tolerated , although ciprofloxacin had a higher rate of injection site reactions than ceftriaxone (10% and 3%, respectively) (P = .024). This study is the first demonstrating sequential ciprofloxacin therapy to be as saf e and effective as parenteral ceftriaxone in the treatment of hospital ized patients with pneumonia.