b6cd715a5077c0af2d0e7633737ffbad pmc_11672814.pdf 881b7148aa0f619b0231a8cc3eff2627c1388aab pmc_11672814.pdf 3cf01fcae910471e391b16760d702e3473fade6aaa715b17874d1a618e0e68ed pmc_11672814.pdf Title: Ciprofloxacin for the Treatment of Infections Caused by Carbapenemase-Producing Gram-Negative Bacteria "2279 Subject: Background: There is no experience with ciprofloxacin for the treatment of carbapenemase-producing Gram-negative bacteria (CP-GNB) infections. Methods: This is a retrospective single-centre study where we describe the clinical evolution of all consecutive adult patients who received ciprofloxacin monotherapy for the treatment of CP-GNB infections. Primary outcomes were clinical failure (defined as death, lack of clinical improvement or a switch to another drug) at day 14 and 30-day all-cause mortality. Results: Nineteen patients were included. Fifteen (79%) were men, the median age was 74 years (IQR 66–79) and the median Charlson comorbidity index was five (IQR 3–6.5). The most frequent infections were: nine complicated urinary tract infections, three soft tissue infections and three intra-abdominal infections. Twenty CP-GNBs were isolated (one patient had a coinfection): nine VIM-type-producing Enterobacterales, nine OXA-48-type-producing Enterobacterales and two VIM-type-producing Pseudomonas aeruginosa. Six (32%) patients had positive blood cultures, and one presented with septic shock. The median duration of ciprofloxacin treatment was 14 days (IQR 10–15). One patient presented with clinical failure at day 14. There was no 30-day mortality. Two patients exhibited microbiological recurrence at day 90. There were no reported adverse effects. Conclusions: Monotherapy with ciprofloxacin may be an alternative treatment for selected, clinically stable patients with ciprofloxacin-susceptible CP-GNB infections. Keywords: fluoroquinolones; OXA; VIM; multidrug-resistant; carbapenem-resistant Author: Pablo Rubiñan, Belén Viñado, Nuria Fernández-Hidalgo, Nieves Larrosa, Abiu Sempere, David Campany, Dolors Rodríguez-Pardo, Juan José González-López, Xavier Nuvials, Ester del Barrio-Tofiño, Laura Escolà-Vergé and Ibai Los-Arcos Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Thu Nov 28 08:45:28 2024 CET ModDate: Tue Dec 3 03:47:06 2024 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 502599 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- JUXSQN+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 LWOTNB+URWPalladioL-Bold Type 1 Custom yes yes yes 16 0 BEJYCE+URWPalladioL-Roma Type 1 Custom yes yes yes 22 0 IQHQQY+URWPalladioL-Ital Type 1 Custom yes yes yes 27 0 CMFVHJ+VnURWPalladioL Type 1 Custom yes yes yes 32 0 IPTERD+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 70 0 PKIULP+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 78 0 LMIWHX+PalatinoLinotype-Italic TrueType WinAnsi yes yes yes 86 0 UUVYDF+PalatinoLinotype-Bold TrueType WinAnsi yes yes yes 90 0 COUULP+PalatinoLinotype-Roman TrueType WinAnsi yes yes yes 94 0 CAMXTK+EURM10 Type 1 Builtin yes yes yes 112 0 TNBSFT+CMSY10 Type 1 Builtin yes yes yes 123 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-02-06 02:44:45 CET RepresentationInformation: pmc_11672814.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-01-25 02:29:53 CET Size: 502599 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 272 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Results Destination: section.2 Item: Title: Discussion Destination: section.3 Item: Title: Material and Methods Destination: section.4 Children: Item: Title: Patients and Settings Destination: subsection.4.1 Item: Title: Outcomes and Definitions Destination: subsection.4.2 Item: Title: Microbiological Methods Destination: subsection.4.3 Item: Title: Statistical Methods Destination: subsection.4.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.6 Info: Title: Ciprofloxacin for the Treatment of Infections Caused by Carbapenemase-Producing Gram-Negative Bacteria "2279 Author: Pablo Rubiñan, Belén Viñado, Nuria Fernández-Hidalgo, Nieves Larrosa, Abiu Sempere, David Campany, Dolors Rodríguez-Pardo, Juan José González-López, Xavier Nuvials, Ester del Barrio-Tofiño, Laura Escolà-Vergé and Ibai Los-Arcos Subject: Background: There is no experience with ciprofloxacin for the treatment of carbapenemase-producing Gram-negative bacteria (CP-GNB) infections. Methods: This is a retrospective single-centre study where we describe the clinical evolution of all consecutive adult patients who received ciprofloxacin monotherapy for the treatment of CP-GNB infections. Primary outcomes were clinical failure (defined as death, lack of clinical improvement or a switch to another drug) at day 14 and 30-day all-cause mortality. Results: Nineteen patients were included. Fifteen (79%) were men, the median age was 74 years (IQR 66 79) and the median Charlson comorbidity index was five (IQR 3 6.5). The most frequent infections were: nine complicated urinary tract infections, three soft tissue infections and three intra-abdominal infections. Twenty CP-GNBs were isolated (one patient had a coinfection): nine VIM-type-producing Enterobacterales, nine OXA-48-type-producing Enterobacterales and two VIM-type-producing Pseudomonas aeruginosa. Six (32%) patients had positive blood cultures, and one presented with septic shock. The median duration of ciprofloxacin treatment was 14 days (IQR 10 15). One patient presented with clinical failure at day 14. There was no 30-day mortality. Two patients exhibited microbiological recurrence at day 90. There were no reported adverse effects. Conclusions: Monotherapy with ciprofloxacin may be an alternative treatment for selected, clinically stable patients with ciprofloxacin-susceptible CP-GNB infections. 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