Ciprofloxacin
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Lack of efficacy: case report A 42-year-old woman developed resistance exhibited lack of efficacy during treatment with ciprofloxacin for bacterial peritonitis and pneumonia [duration of treatment to reaction onset not stated]. The woman presented with a 3-week history of vomiting and abdominal-distension. Additionally, she experienced loss of appetite, loss of weight and painful feet. She had a strong history of alcohol use and smoking. Apart from that, she had a history of penicillin allergy. From the findings of her physical examination and the abdominal examination, the initial diagnosis of chronic liver disease secondary to alcohol abuse with grade 1 hepatic encephalopathy was made. The laboratory investigations, observations of the ascitic tap, susceptibility test and the findings from 16SrRNA technology for gene sequencing revealed the presence of Bordetella bronchiseptica in the peritoneal fluid. Opacification on the right upper lobe was seen in the initial chest-X-ray. However, the chest-Xray carried out 3 days later, indicated worsening condition involving the almost entire right lung. A day following the second chest-Xray, sputum sample was withdrawn for examination, which showed the same susceptibility as the ascitic fluid sample which was withdrawn previously. The woman was started on IV ciprofloxacin at the dose of 400mg with 12 hours interval, followed by drainage of ascitic fluid. Improvement was not seen in her symptoms associated with bacterial peritonitis, despite the ciprofloxacin treatment. On the day 3 after the initiation of the antibiotic therapy, she suddenly developed severe respiratory distress; attempts of resusicitation were not successful, which ultimately resulted in her death. Dlamini NR, et al. Spontaneous bacterial peritonitis and pneumonia caused by bordetella bronchiseptica. Journal of Infection in Developing Countries 6: 588-591, No. 7, Jul 2012. Available from: URL: http://doi.org/10.3855/jidc.2074 803505232
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Reactions 3 Oct 2020 No. 1824
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