BACKGROUND Extrahepatic ethanol metabolism is postulated to take place via microbial oxidation in the colon, mediated by aerobic and facultative anaerobic bacteria. AIMS To evaluate the role of microbial ethanol oxidation in the total elimination rate of ethanol in humans by reducing gut flora with ciprofloxacin. METHODS Ethanol was administered intravenously at the beginning and end of a one week period to eight male volunteers. Between ethanol doses volunteers received 750 mg ciprofloxacin twice daily. RESULTS A highly significant (p=0.001) reduction in the ethanol elimination rate (EER) was detected after ciprofloxacin medication. Mean (SEM) EER was 107.0 (5.3) and 96.9 (4.8) mg/kg/h before and after ciprofloxacin, respectively. Faecal Enterobacteriaceae and The most important route of ethanol elimination is its metabolism in the liver, with small amounts excreted in the breath (0.7%), urine (0.3%), and sweat (0.1%).1 Three principal hepatic enzyme systems are involved: alcohol dehydrogenase (ADH), the microsomal ethanol oxidising system (MEOS), and catalase.2 It is generally agreed that the major part of ethanol is metabolised by cytosolic ADH.2 The contribution of the MEOS to ethanol elimination is limited, and only a minor part (1–5%) of the total metabolism in vivo is carried out by the cytochrome P450 dependent MEOS.3 Liver catalase can oxidise ethanol in vitro, but under physiological conditions catalase appears to play only a minor role in ethanol metabolism.2 Extrahepatic elimination of ethanol does, however, also occur. 60 yo, in patients taking corticosteroids, and in patients with kidney, lung or heart transplants. To reduce the development of drug-resistant bacteria, the use of fluoroquinolones should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria. Fluoroquinolones may exacerbate muscle weakness in persons with myasthenia gravis. Avoid use of this class of antibiotics in patients with a known history of myasthenia gravis. The mechanisms by which fluoroquinolones exert their toxic side effects in patients remains poorly understood. Fluoroquinolones have been reported to induce mitochondrial related oxidative stress and damage of mitochondiral DNA (Lawrence et al, 1996; Pouzaud et al, 2006; Li et al, 2010; Kalghatgi et al, 2013). These toxic effects may result from inhibiting mitochondrial “topoisomerase II-like” activity (Lawrence et al, 1999).
Metabolism of ciprofloxacin following intravenous and oral administration to calves and pigs. J. F. M. Nouws1, D. J. Mevius2. T. B. Vree3, A. M. Baars3. Ciprofloxacin film-coated tablets are indicated for the treatment of the. CYP450 1A2 isoenzyme, markedly inhibits the metabolism of agomelatine resulting in a.