Long-Term Ciprofloxacin Treatment for the Prevention of Biliary Stent Blockage: A Prospective Randomized Study

Sung, Joseph J. Y.; Sollano, Jose D.; Chi Wai Lai; Ismael, Albert; Man Yee Yung; Tumala, Isabel; Chung, S. C. Sydney
November 1999
American Journal of Gastroenterology;Nov1999, Vol. 94 Issue 11, p3197
Academic Journal
OBJECTIVE: In vitro experimental and animal studies have shown that quinolones reduce the adherence of bacteria on a polyethylene tube and prevent stent blockage. Our aim was to see whether ciprofloxacin prevents stent blockage in patients with malignant stricture of the biliary tract. METHODS: Patients with inoperable biliary or pancreatic tumor not involving the bifurcation of the common hepatic duct were recruited. They were randomized to receive either endoscopic stenting alone or stenting with prophylactic treatment of ciprofloxacin (200 mg i.v. before stenting, followed by 250 mg orally twice per day). In each follow-up visit, clinical symptoms of cholangitis were documented and blood samples taken for blood counts, serum levels of bilirubin, and alkaline phosphatase. Stent blockage was defined as clinical symptom(s) of cholangitis with biochemical or radiological evidence of stent dysfunction. RESULTS: Fifty-eight patients were recruited into the study. Three patients in the stenting group and three in the ciprofloxacin group were excluded after randomization. Eleven patients received stenting alone and five patients receiving ciprofloxacin had previous endoscopic stenting. Thirteen patients (50%) in the ciprofloxacin group and eight patients (31%) in the stenting group died before stent blockage. Ten patients (38%) in each group had stent blockage during the follow-up at 20 wk. The median stent patency was 11.6 wk and 11.9 wk in the ciprofloxacin group and the stenting group, respectively. Kaplan Meier analysis of stent patency showed no difference between the two groups. Among patients who received endoscopic stenting for the first time, there was a trend favoring ciprofloxacin treatment, but the difference was not significant. The 30-day and 20-wk mortality between the groups were comparable. CONCLUSION: Long-term use of ciprofloxacin does not prevent blockage of polyethylene biliary stents.


Related Articles

  • Ciprofloxacin.  // Reactions Weekly;5/4/2013, Issue 1451, p15 

    The article presents a case study of a 60-year-old man who developed a bullous fixed drug eruption while receiving ciprofloxacin.

  • Variation in the mutation frequency determining quinolone resistance in Chlamydia trachomatis serovars L2 and D. Jan Rupp; Werner Solbach; Jens Gieffers // Journal of Antimicrobial Chemotherapy (JAC);Jan2008, Vol. 61 Issue 1, p91 

    : Objectives Quinolone resistance of chlamydiae is supposed to be extremely rare. To assess the risk for the emergence of chlamydial quinolone resistance, we analysed the occurrence of resistant mutants in a quantitative perspective. : Methods Infectious elementary bodies of Chlamydia...

  • In vitro Antimicrobial Activity of Liposomes Containing Ciprofloxacin,Meropenem and Gentamicin Against Gram-Negative Clinical Bacterial Strains. Gubernator, Jerzy; Drulis-Kawa, Zuzanna; Dorotkiewicz-Jach, Agata; Doroszkiewicz, Wlodzimierz; Kozubek, Arkadiusz // Letters in Drug Design & Discovery;May2007, Vol. 4 Issue 4, p297 

    The antimicrobial activity of two cationic liposomes containing three antibiotics were tested in vitro. Ciprofloxacin loaded in liposomes exhibited a 2-4 times higher antimicrobial activity compared with the free drug. The bacterial sensitivity to liposomal meropenem were similar as to free...

  • Optimizing use of ciprofloxacin: a prospective intervention study. Babette C. van Hees; Erica de Ruiter; Ed H. Wiltink; Bartelt M. de Jongh; Matthijs Tersmette // Journal of Antimicrobial Chemotherapy (JAC);Jan2008, Vol. 61 Issue 1, p210 

    : Objectives Antimicrobial resistance to ciprofloxacin is increasing. The objective of this study was to reduce the number of inappropriate prescriptions and to improve the quality of ciprofloxacin prescriptions by means of educational intervention. : Methods In a teaching hospital five units...

  • Effect of GrlA mutation on the development of quinolone resistance in Staphylococcus aureus in an in vitro pharmacokinetic model. Yoshimi Oonishi; Junichi Mitsuyama; Keizo Yamaguchi // Journal of Antimicrobial Chemotherapy (JAC);Nov2007, Vol. 60 Issue 5, p1030 

    Objectives To investigate the effect of GrlA mutation on the development of quinolone resistance in Staphylococcus aureus in an in vitro pharmacokinetic (PK) model and to examine the relationship between the emergence of resistance and PK/pharmacodynamic parameters. Methods A wild-type and a...

  • Selection of quinolone resistance in Streptococcus pneumoniae exposed in vitro to subinhibitory drug concentrations. Laetitia Avrain; Mark Garvey; Narcisa Mesaros; Youri Glupczynski; Marie-Paule Mingeot-Leclercq; Laura J. V. Piddock; Paul M. Tulkens; Raymond Vanhoof; Françoise Van Bambeke // Journal of Antimicrobial Chemotherapy (JAC);Nov2007, Vol. 60 Issue 5, p965 

    Objectives Does exposure to subinhibitory concentrations of quinolones favour overexpression of efflux pumps or selection of target site mutations? Methods ATCC 49619 (fully susceptible) and SP32 (clinical isolate with PmrA-mediated efflux and mutation in ParE) were exposed for 24 h in broth to...

  • Bacterial Resistance to Ciprofloxacin in Greece: Results from the National Electronic Surveillance System. Vatopoulos, A.C.; Kalapothaki, V.; Legakis, N.J. // Emerging Infectious Diseases;May/Jun99, Vol. 5 Issue 3, p471 

    Provides information on the 1997 susceptibility data from the National Electronic System for Surveillance of Antimicrobial Resistance which revealed that Greece has high rates of ciprofloxacin resistance. Frequency of ciprofloxacin-resistant isolates for most species; Factors that may...

  • Legionella pneumonia caused by Legionella pneumophila serogroup 2: second case report in Japan. Makoto Furugen; Michio Koide; Motoo Baba; Yoko Sato; Hiromitsu Teruya; Yui Naha; Maki Tamayose; Morikazu Akamine; Teruhito Uchihara; Eriko Atsumi; Shusaku Haranaga; Satomi Yara; Futoshi Higa; Masao Tateyama; Jiro Fujita // Journal of Infection & Chemotherapy (Springer Science & Business;Apr2008, Vol. 14 Issue 2, p161 

    Abstract  A 56-year-old man with a 3-day history of a chilly sensation and general fatigue presented to a hospital in his neighborhood. He was diagnosed as having pneumonia and immediately treated with intravenous ceftriaxone sodium, but his respiratory condition deteriorated and he...

  • Ciprofloxacin-resistant Salmonella enterica Typhimurium and Choleraesuis from Pigs to Humans, Taiwan. Po-Ren Hsueh; Lee-Jene Teng; Sung-Pin Tseng, Nell O.; Chao-Fu Chang; Jen-Hsien Wan, Nell O.; Jing-Jou Yan; Chun-Ming Lee, Nell O.; Yin-Ching Chuang; Wen-Kuei Huang; Dine Yang, Nell O.; Jainn-Ming Shyr, Nell O.; Kwok-Woon Yu, Nell O.; Li-Shin Wang, Nell O.; Jang-Jih Lu; Wen-Chien Ko; Jiunn-Jong Wu; Feng-Yee Chang; Yi-Chueh Yang, Nell O.; Yeu-Jun Lau; Yung-Ching Liu // Emerging Infectious Diseases;Jan2004, Vol. 10 Issue 1, p60 

    We evaluated the disk susceptibility data of 671 nontyphoid Salmonella isolates collected from different parts of Taiwan from March 2001 to August 2001 and 1,261 nontyphoid Salmonella isolates from the National Taiwan University Hospital from 1996 to 2001. Overall, ciprofloxacin resistance was...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics