The pharmacokinetics of ciprofloxacin and its effect on the oropharyngeal bacterial flora were examined in 21 ill patients being treated for methicillin-resistant Staphylococcus aureus infections or colonization or both. Oral ciprofloxacin (750 mg twice a day) produced peak and trough concentrations in serum of 2.56 +/- 1.80 and 0.97 +/- 0.81 micrograms/ml and steady-state salivary and nasal secretory concentrations of 1.29 +/- 1.0 and 1.84 +/- 0.91 micrograms/ml, respectively. Because of technical problems, nasal secretory concentrations were felt to represent rough approximations of true values. Oral ciprofloxacin therapy did not promote colonization of the oropharynx by gram-negative bacilli
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