Drugs name: Ciprofloxacin
Ciprofloxacin is an antimicrobial broad-spectrum antibiotic which belongs to fluoroquinolone group. Like other fluoroquinolone antibiotics Ciprofloxacin has bactericidal effect which is associated with inhibiting the enzyme DNA-gyrase, resulting in broken of DNA replication and synthesis of cellular proteins in bacteria.
Ciprofloxacin is active against gram-negative bacteria such as Escherichia coli, Salmonella, Shigella, Klebsiella, Enterobacter, Haemophilus, Haemophilus, Pseudomonas aeruginosa; intracellular microorganims: Legionella pneumophila, Brucella, Chlamydia trachomatis, Mycobacterium; gram-positive bacteria: Streptococcus, Staphylococcus and others.
Streptococcus pneumoniae, Enterococcus faecalis are moderately sensitive to Ciprofloxacin.
Ciprofloxacin does not act on Corynebacterium spp., Bacteroides fragilis, Pseudomonas cepacia, Pseudomonas maltophila, Ureaplasma urealyticum, Clostridium difficile, Nocardia asteroides.
Ciprofloxacin is indicated for the treatment of infections caused by sensitive to the medication microorganis:
- Respiratory tract infections;
- Infections of the ear, nose and throat;
- Infections of the urinary tract;
- Genital infections (gonorrhea, prostatitis, adnexitis, postpartum infection);
- Infections of the digestive system (including the mouth, teeth, jaw), gall bladder and bile ducts;
- Infections of the skin, mucous membranes and soft tissues;
- Infections of the musculoskeletal system;
- Prevention and treatment of infections in patients with reduced immunity (during therapy with immunosuppressive drugs).
Contraindications and cautions
Ciprofloxacin is contraindicate for use in:
- Pseudomembranous colitis
- Deficiency of glucose-6-phosphate dehydrogenase
- Lactation (breastfeeding);
- Children and adolescents under 18 years of age;
- Hypersensitivity to ciprofloxacin or another fluoroquinolon
Ciprofloxacin should be used with caution in:
- Cerebral atherosclerosis
- Mental diseases
- Severe hepatic or renal impairment
- Elderly patients
Ciprofloxacin is generally well tolerated and side effects are not common. Possible Ciprofloxacin side effects include:
- Digestive system: nausea, vomiting, diarrhea, pseudomembranous colitis, flatulence, anorexia, cholestatic jaundice (especially in patients with previous liver disease), hepatitis, hepatic necrosis, elevated liver transaminases, alkaline phosphatase, LDH, bilirubin.
- Central and peripheral nervous system: headache, dizziness, fatigue, anxiety, tremors, increased intracranial pressure, peripheral paralgeziya, insomnia, nightmares, confusion, depression, hallucinations and other manifestations of psychotic reactions, syncope, migraine, thrombosis of cerebral arteries.
- Senses organs: taste and smell disorders, visual disturbances (diplopia, changes in color vision), tinnitus, hearing loss.
- Cardiovascular system: tachycardia, cardiac arrhythmias, hypotension, flushing.
- Hemopoiesis system: eosinophilia, leucopenia, thrombocytopenia, neutropenia, granulocytopenia, anemia, thrombocytosis, haemolytic anemia.
- Musculoskeletal system: arthritis, tendonitis, tendon rupture, arthralgia, myalgia.
- Urinary system: crystalluria, interstitial nephritis, glomerulonephritis, dysuria, polyuria, albuminuria, hematuria, increased urea, creatinine, urinary retention, decreased kidney function.
- Allergic reactions: itching, urticaria, angioedema, Stevens-Johnson syndrome, arthralgia, vasculitis, erythema nodosum, exudative erythema multiforme, Lyell’s syndrome.
- Adverse reactions associated with the chemotherapeutic effects: candidiasis.
- Other: general weakness, photosensitivity, increased sweating, hyperglycemia.
When Ciprofloxacin is applied simultaneously with didanosine the absorption of ciprofloxacin is reduced due to the formation of complexes with ciprofloxacin contained in didanosine salts of magnesium and aluminum.
Due to decreased activity of microsomal oxidation processes in hepatocytes ciprofloxacin increases the concentration of theophylline iother xanthine.
Ciprofloxacin decreases prothrombin index when is used in in combination with hypoglycemic agents
Ciprofloxacin increases the risk of seizures when used with antidiabetic drugs.
Simultaneous treatment with antacids, as well as products containing aluminum ions, zinc, iron and magnesium, may decrease the absorption of ciprofloxacin, therefore, the interval between the appointment of these drugs should not be less than 4 hours
With the simultaneous use of ciprofloxacin and cyclosporin nephrotoxicity is enhanced.
Metoclopramide increases the absorption of ciprofloxacin, which reduces the time required to reach its maximum concentration in plasma.
Uricosuric drugs may cause slower excretion (50%) and increased plasma concentrations of ciprofloxacin.
Ciprofloxacin increases the effects of other antibiotics.