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Volume 13
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10.3390/antibiotics13121138
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Article

Ciprofloxacin for the Treatment of Infections Caused by Carbapenemase-Producing Gram-Negative Bacteria †

by
Pablo Rubiñan
1,
Belén Viñado
2,
Nuria Fernández-Hidalgo
3,4,5,
Nieves Larrosa
2,3,4,
Abiu Sempere
6,
David Campany
7,
Dolors Rodríguez-Pardo
3,4,5,
Juan José González-López
2,3,4,
Xavier Nuvials
3,8,9,
Ester del Barrio-Tofiño
2,
Laura Escolà-Vergé
3,4,10,*,‡ and
Ibai Los-Arcos
3,4,5,*,‡
1
Infectious Diseases Unit, Internal Medicine Department, Complexo Hospitalario Universitario de Vigo, 36312 Vigo, Spain
2
Microbiology Department, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain
3
Department of Medicine, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
4
CIBERINFEC, ISCIII—CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, 28029 Madrid, Spain
5
Infectious Diseases Department, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain
6
Infectious Diseases Department, Hospital Clinic de Barcelona, 08036 Barcelona, Spain
7
Pharmacy Department, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain
8
Critical Care Department, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain
9
Sepsis Organ Dysfunction and Resuscitation (SODIR) Research Group, Vall d’Hebron Institut de Recerca (VHIR), 08035 Barcelona, Spain
10
Infectious Diseases Unit, Internal Medicine Department, Hospital de la Santa Creu i Sant Pau, Institut de Recerca Sant Pau, 08025 Barcelona, Spain
*
Authors to whom correspondence should be addressed.
†
This work was presented in part at: Rubiñán, P.; Viñado, B.; Fernández-Hidalgo, N.; Larrosa, N.; Sempere, A.; Campany, D.; Rodríguez-Pardo, D.; González-López, J.J.; Nuvials, X.; Barrio-Tofiño, E.d.; et al. Ciprofloxacin for the treatment of infections caused by carbapenemase-producing Gram-negative bacteria. In Proceedings of the 27th Congress of Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC), Madrid, Spain, 30 May 2024.
‡
These authors share senior authorship.
Antibiotics 2024, 13(12), 1138; https://doi.org/10.3390/antibiotics13121138
Submission received: 21 October 2024 / Revised: 16 November 2024 / Accepted: 21 November 2024 / Published: 26 November 2024
(This article belongs to the Special Issue Multidrug-Resistant Gram-Negative Bacteria Infections: Current Epidemiology, Prognosis and Treatment Options)
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Abstract

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 fluoroquinolones; OXA; VIM; multidrug-resistant; carbapenem-resistant

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MDPI and ACS Style

Rubiñan, P.; Viñado, B.; Fernández-Hidalgo, N.; Larrosa, N.; Sempere, A.; Campany, D.; Rodríguez-Pardo, D.; González-López, J.J.; Nuvials, X.; del Barrio-Tofiño, E.; et al. Ciprofloxacin for the Treatment of Infections Caused by Carbapenemase-Producing Gram-Negative Bacteria. Antibiotics 2024, 13, 1138. https://doi.org/10.3390/antibiotics13121138

AMA Style

Rubiñan P, Viñado B, Fernández-Hidalgo N, Larrosa N, Sempere A, Campany D, Rodríguez-Pardo D, González-López JJ, Nuvials X, del Barrio-Tofiño E, et al. Ciprofloxacin for the Treatment of Infections Caused by Carbapenemase-Producing Gram-Negative Bacteria. Antibiotics. 2024; 13(12):1138. https://doi.org/10.3390/antibiotics13121138

Chicago/Turabian Style

Rubiñan, Pablo, Belén Viñado, Nuria Fernández-Hidalgo, Nieves Larrosa, Abiu Sempere, David Campany, Dolors Rodríguez-Pardo, Juan José González-López, Xavier Nuvials, Ester del Barrio-Tofiño, and et al. 2024. "Ciprofloxacin for the Treatment of Infections Caused by Carbapenemase-Producing Gram-Negative Bacteria" Antibiotics 13, no. 12: 1138. https://doi.org/10.3390/antibiotics13121138

APA Style

Rubiñan, P., Viñado, B., Fernández-Hidalgo, N., Larrosa, N., Sempere, A., Campany, D., Rodríguez-Pardo, D., González-López, J. J., Nuvials, X., del Barrio-Tofiño, E., Escolà-Vergé, L., & Los-Arcos, I. (2024). Ciprofloxacin for the Treatment of Infections Caused by Carbapenemase-Producing Gram-Negative Bacteria. Antibiotics, 13(12), 1138. https://doi.org/10.3390/antibiotics13121138

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