Ciprofloxacin usage and bacterial resistance patterns in Crohn's disease patients with abscesses.

Abstract

BACKGROUND:

Ciprofloxacin is the antibiotic most frequently used in the treatment of Crohn's disease (CD). We attempted to identify the microorganisms present in CD-related intra-abdominal abscesses, their ciprofloxacin resistance patterns, and the clinical impact.

METHODS:

Microorganisms, their ciprofloxacin resistance, and clinical outcomes were retrospectively analyzed in 78 CD patients with intra-abdominal abscesses, who underwent percutaneous drainage between March 1991, and November 2011.

RESULTS:

The median time from diagnosis of CD to abscess drainage was 59.5 months (range, 1 to 178 mo). As for bacteriology, the no-growth proportion was 38.5% (n=30), and 69 microorganisms belonging to 11 genera were isolated from the other 48 (61.5%) patients. Of the 69 microorganisms, 65 were bacteria, including 30 (43.4%) gram-positive, 28 (40.6%) gram-negative aerobes, 7 (10.1%) gram-negative anaerobes, and 4 (4.1%) fungi. Streptococci spp. (25, 36.2%) were the most common bacteria, followed by Escherichia coli (18, 26.1%). Nineteen of the 28 gram-negative aerobes (67.9%) were resistant to ciprofloxacin, including 14 of 18 (77.8%) E. coli isolates. When we compared clinical characteristics and treatment outcomes in 17 patients with ciprofloxacin-resistant and 8 with ciprofloxacin-sensitive bacteria, we found that disease duration from diagnosis to drainage (97.2 vs. 50.7 mo, P=0.03) and median length of hospitalization (40 vs. 31 d, P=0.03) was significantly longer in the former.

CONCLUSIONS:

When gram-negative aerobes were isolated from abscesses in CD patients, more than two thirds were resistant to ciprofloxacin. Providers should consider this high rate of ciprofloxacin resistance when choosing first-line antibiotic treatment for CD-related intra-abdominal abscesses.

• Authors: Soo-Kyung Park, Kyung-Jo Kim, Sang-Oh Lee, Dong-Hoon Yang, Kee Wook Jung, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim, Chang Sik Yu
• Journal: Journal of clinical gastroenterology (J Clin Gastroenterol) Vol. 48 Issue 8 Pg. 703-7 (Sep 2014) ISSN: 1539-2031 [Electronic] United States
• PMID: 24296421 (Publication Type: Journal Article)

Chemical References

• Anti-Bacterial Agents
• Ciprofloxacin

Topics

• Abdominal Abscess (drug therapy, etiology, microbiology)
• Adolescent
• Adult
• Anti-Bacterial Agents (pharmacology, therapeutic use)
• Ciprofloxacin (pharmacology, therapeutic use)
• Crohn Disease (complications, drug therapy)
• Drainage (methods)
• Drug Resistance, Bacterial
• Female
• Hospitalization (statistics & numerical data)
• Humans
• Length of Stay
• Male
• Middle Aged
• Retrospective Studies
• Treatment Outcome
• Young Adult