Skip to main content
Antimicrobial Agents and Chemotherapy logoLink to Antimicrobial Agents and Chemotherapy
. 1991 May;35(5):831–836. doi: 10.1128/aac.35.5.831

Comparative efficacies of ciprofloxacin, amoxicillin, amoxicillin-clavulanic acid, and cefaclor against experimental Streptococcus pneumoniae respiratory infections in mice.

J Gisby 1, B J Wightman 1, A S Beale 1
PMCID: PMC245115  PMID: 1854164

Abstract

Experimental respiratory infections were established in mice by intranasal inoculation of Streptococcus pneumoniae. Inoculation of 10(7) CFU of either S. pneumoniae 1629 or S. pneumoniae 7 produced a fatal pneumonia in nontreated mice 2 to 3 days after infection. Oral therapy was commenced 1 h after infection and was continued three times a day for 2 days. The doses used in mice produced peak concentrations in serum and lung tissue similar to those measured in humans. Ciprofloxacin failed to eliminate either strain of pneumococcus from mouse lungs at any of the doses tested (40, 80, or 160 mg/kg of body weight) by the end of therapy (33 h). Mice that received ciprofloxacin at 160 mg/kg were clear of S. pneumoniae 7 5 days later, whereas persistence and regrowth of S. pneumoniae 1629 resulted in the death of 20% of animals treated with ciprofloxacin. Therapy with cefaclor (20 mg/kg) produced an effect similar to that of ciprofloxacin. In contrast, amoxicillin (10 and 20 mg/kg) and amoxicillin-clavulanic acid (10/5 and 20/10 mg/kg) were significantly (P less than 0.05) more effective in eliminating both strains of S. pneumoniae from the lungs by the end of therapy and, by 168 h, had prevented mortality in 80 to 100% of treated animals. The efficacy of ciprofloxacin against these experimental pneumococcal respiratory infections was poor, despite good penetration into lung tissue, and is a reflection of the low in vitro activity of the quinolone against S. pneumoniae, one of the most common pathogens in community-acquired pneumonia.

Full text

PDF
831

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adam D., de Visser I., Koeppe P. Pharmacokinetics of amoxicillin and clavulanic acid administered alone and in combination. Antimicrob Agents Chemother. 1982 Sep;22(3):353–357. doi: 10.1128/aac.22.3.353. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Beumer H. M. Cefixime versus amoxicillin/clavulanic acid in lower respiratory tract infections. Int J Clin Pharmacol Ther Toxicol. 1989 Jan;27(1):30–33. [PubMed] [Google Scholar]
  3. Chrysanthopoulos C. J., Bassaris H. P. Use of oral ciprofloxacin in community-acquired pneumonia. J Chemother. 1989 Apr;1(2):103–106. doi: 10.1080/1120009x.1989.11738874. [DOI] [PubMed] [Google Scholar]
  4. Cooper B., Lawlor M. Pneumococcal bacteremia during ciprofloxacin therapy for pneumococcal pneumonia. Am J Med. 1989 Oct;87(4):475–475. doi: 10.1016/s0002-9343(89)80838-1. [DOI] [PubMed] [Google Scholar]
  5. Davies B. I., Maesen F. P., Baur C. Ciprofloxacin in the treatment of acute exacerbations of chronic bronchitis. Eur J Clin Microbiol. 1986 Apr;5(2):226–231. doi: 10.1007/BF02013995. [DOI] [PubMed] [Google Scholar]
  6. Ernst J. A., Sy E. R., Colon-Lucca H., Sandhu N., Rallos T., Lorian V. Ciprofloxacin in the treatment of pneumonia. Antimicrob Agents Chemother. 1986 Jun;29(6):1088–1089. doi: 10.1128/aac.29.6.1088. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Gonzalez M. A., Uribe F., Moisen S. D., Fuster A. P., Selen A., Welling P. G., Painter B. Multiple-dose pharmacokinetics and safety of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother. 1984 Nov;26(5):741–744. doi: 10.1128/aac.26.5.741. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Honeybourne D., Andrews J. M., Ashby J. P., Lodwick R., Wise R. Evaluation of the penetration of ciprofloxacin and amoxycillin into the bronchial mucosa. Thorax. 1988 Sep;43(9):715–719. doi: 10.1136/thx.43.9.715. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Kemmerich B., Borner K., Pennington J. E. Comparative efficacies of ciprofloxacin, ampicillin and chloramphenicol in treatment of experimental Haemophilus influenzae pneumonia. J Antimicrob Chemother. 1987 Jul;20(1):77–83. doi: 10.1093/jac/20.1.77. [DOI] [PubMed] [Google Scholar]
  10. Perlman P. E., Ginn D. R. Respiratory infections in ambulatory adults. Choosing the best treatment. Postgrad Med. 1990 Jan;87(1):175–184. doi: 10.1080/00325481.1990.11704532. [DOI] [PubMed] [Google Scholar]
  11. Raoof S., Wollschlager C., Khan F. Treatment of respiratory tract infections with ciprofloxacin. J Antimicrob Chemother. 1986 Nov;18 (Suppl 500):139–145. doi: 10.1093/jac/18.supplement_d.139. [DOI] [PubMed] [Google Scholar]
  12. Roosendaal R., Bakker-Woudenberg I. A., van den Berghe-van Raffe M., Vink-van den Berg J. C., Michel M. F. Comparative activities of ciprofloxacin and ceftazidime against Klebsiella pneumoniae in vitro and in experimental pneumonia in leukopenic rats. Antimicrob Agents Chemother. 1987 Nov;31(11):1809–1815. doi: 10.1128/aac.31.11.1809. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Schiff J. B., Small G. J., Pennington J. E. Comparative activities of ciprofloxacin, ticarcillin, and tobramycin against experimental Pseudomonas aeruginosa pneumonia. Antimicrob Agents Chemother. 1984 Jul;26(1):1–4. doi: 10.1128/aac.26.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Sides G. D., Franson T. R., DeSante K. A., Black H. R. A comprehensive review of the clinical pharmacology and pharmacokinetics of cefaclor. Clin Ther. 1988;11 (Suppl A):5–19. [PubMed] [Google Scholar]
  15. Smith G. M., Boon R. J., Beale A. S. Influence of clavulanic acid on the activity of amoxicillin against an experimental Streptococcus pneumoniae-Staphylococcus aureus mixed respiratory infection. Antimicrob Agents Chemother. 1990 Feb;34(2):210–214. doi: 10.1128/aac.34.2.210. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Thys J. P. Quinolones in the treatment of bronchopulmonary infections. Rev Infect Dis. 1988 Jan-Feb;10 (Suppl 1):S212–S217. doi: 10.1093/clinids/10.supplement_1.s212. [DOI] [PubMed] [Google Scholar]
  17. Vellend H. Role of fluoroquinolones in lower respiratory tract infections. Clin Invest Med. 1989 Feb;12(1):39–43. [PubMed] [Google Scholar]
  18. Wollschlager C. M., Raoof S., Khan F. A., Guarneri J. J., LaBombardi V., Afzal Q. Controlled, comparative study of ciprofloxacin versus ampicillin in treatment of bacterial respiratory tract infections. Am J Med. 1987 Apr 27;82(4A):164–168. [PubMed] [Google Scholar]
  19. Woodhead M. A., Macfarlane J. T., McCracken J. S., Rose D. H., Finch R. G. Prospective study of the aetiology and outcome of pneumonia in the community. Lancet. 1987 Mar 21;1(8534):671–674. doi: 10.1016/s0140-6736(87)90430-2. [DOI] [PubMed] [Google Scholar]

Articles from Antimicrobial Agents and Chemotherapy are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES