This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Thomas R. Frieden, MD, MPH; Richard J. Mangi, MD

JAMA. 1990;264(11):1438-1440.

Abstract
More than $2.4 billion is spent annually on oral antibiotics. Their inappropriate use is common, and newer ones offer expanded and expensive opportunities for abuse. Ciprofloxacin, an oral quinolone with systemic absorption and broad antimicrobial spectrum, illustrates this pattern. Since its release in the US in October 1987, ciprofloxacin has rapidly become one of the most frequently prescribed oral antibiotics. We have observed widespread inappropriate use of ciprofloxacin and describe several patterns of misuse. The activity of ciprofloxacin against streptococci, anaerobic organisms, and Mycoplasma ranges from intermediate to poor. Properly used, ciprofloxacin can extend the range of oral therapy. However, ciprofloxacin is inappropriate initial therapy for common outpatient infections, including otitis media, sinusitis, pharyngitis, and pneumonia.

(JAMA. 1990;264:1438-1440)

Author Affiliations
From the Infectious Disease Sections, Yale University School of Medicine (Dr Frieden) and Hospital of St Raphael (Dr Mangi), New Haven, Conn. Dr Frieden is now with the Centers for Disease Control, Atlanta, Ga.

Footnotes
Reprint requests to 125 Worth St, Box 22, New York, NY 10013 (Dr Frieden).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Oral Moxifloxacin vs High-Dosage Amoxicillin in the Treatment of Mild-to-Moderate, Community-Acquired, Suspected Pneumococcal Pneumonia in Adults
Petitpretz et al.
Chest 2001;119:185-195.
ABSTRACT | FULL TEXT  

Minimizing quinolone resistance: are the new agents more or less likely to cause resistance?
Thomson
J Antimicrob Chemother 2000;45:719-723.
FULL TEXT  

The next generation: fluoroquinolones in the management of acute lower respiratory infection in adults
Moss and Finch
Thorax 2000;55:83-85.
FULL TEXT  

Will pneumococci put quinolones in their place?
Legg and Bint
J Antimicrob Chemother 1999;44:425-427.
FULL TEXT  

Pharmacodynamic Comparisons of Levofloxacin, Ciprofloxacin, and Ampicillin against Streptococcus pneumoniae in an In Vitro Model of Infection
Lacy et al.
Antimicrob. Agents Chemother. 1999;43:672-677.
ABSTRACT | FULL TEXT  

Uncomplicate the Treatment of Uncomplicated Urinary Tract Infections
Ditmanson and Apgar
Arch Intern Med 1996;156:111-112.
ABSTRACT  

Outpatient Treatment of Community-Acquired Pneumonia in Adults
Pomilla and Brown
Arch Intern Med 1994;154:1793-1802.
ABSTRACT  

Lesson of the Week: Dangers of oral fluoroquinolone treatment in community acquired upper respiratory tract infections
Korner et al.
BMJ 1994;308:191-192.
FULL TEXT  

New Macrolide Antibiotics
Friedman
ANN INTERN MED 1992;117:533-534.
ABSTRACT  

Endophthalmitis Caused by Streptococcal Species
Mao et al.
Arch Ophthalmol 1992;110:798-801.
ABSTRACT  

Outbreak of Invasive Group A Streptococcal Infections in a Nursing Home: Lessons on Prevention and Control
Auerbach et al.
Arch Intern Med 1992;152:1017-1022.
ABSTRACT  

CIPROFLOXACIN IS INADEQUATE FOR CHLAMYDIAL URETHRITIS
JWatch General 1990;1990:4-4.
FULL TEXT