Cipro

Cipro (ciprofloxacin) is an antibiotic used to treat a number of bacterial infections.

Indications for use

• Acute and chronic bronchitis, pneumonia, bronchiectasis, infectious complications of cystic fibrosis;
• Acute sinusitis;
• Cystitis, pyelonephritis;
• Complicated intra-abdominal infections;
• Chronic bacterial prostatitis;
• Uncomplicated gonorrhea, abdominal campylobacteriosis, shigellosis, traveler’s diarrhea;
• Infected ulcers, wounds, burns, abscesses, phlegmon;
• Osteomyelitis, septic arthritis;
• Infections in patients with neutropenia;
• Prevention and treatment of Bacillusanthracis infection;
• Treatment of complications caused by Pseudomonasaeruginosa in children with pulmonary cystic fibrosis from 6 to 17 years.

How does it work?

Ciprofloxacin is a broad-spectrum antibiotic from the group of fluoroquinolones. It has a bactericidal effect. It suppresses DNA gyrase and inhibits the synthesis of bacterial DNA.

It is highly active against most gram-negative bacteria: Pseudomonas aeruginosa, Haemophilus influenzae, Escherichia coli, Shigella spp., Salmonella spp., Neisseria meningitidis, Neisseria gonorrhoeae.

It is active against Staphylococcus spp. (including strains producing and not producing penicillinase, methicillin-resistant strains), some strains of Enterococcus spp., Campylobacter spp., Legionella spp., Mycoplasma spp., Chlamydia spp., Mycobacterium spp.

It is active against bacteria producing β-lactamases.

Ureaplasma urealyticum, Clostridium difficile, Nocardia asteroides are resistant to ciprofloxacin. The action against Treponema pallidum is not well understood.

How to take Cipro?

The drug should be taken on an empty stomach, with plenty of water. Patients with severe renal impairment should receive a half dose of the drug.

The duration of treatment depends on the severity of the disease, but treatment should always continue for at least two more days after the symptoms disappear. Typically, the duration of treatment is 7-10 days.

• Lower respiratory tract infections (mild or moderate): 0.5 g 2 times a day, in severe cases – 0.75 g 2 times. The course of treatment is 7-14 days;
• In acute sinusitis – 0.5 g 2 times a day. The course of treatment is 10 days;
• Infections of the skin and soft tissues (mild or moderate): 0.5 g 2 times a day, with a severe course – 0.75 g 2 times. The course of treatment is 7-14 days;
• Infections of bones and joints (mild or moderate): 0.5 g 2 times a day, with a severe course – 0.75 g 2 times. The course of treatment is up to 4-6 weeks;
• Urinary tract infections: 0.25-0.5 g 2 times a day, the course of treatment is 7-14 days;
• Chronic bacterial prostatitis: 0.5 g 2 times, the course of treatment is 28 days;
• Uncomplicated gonorrhea: 0.25-0.5 g once;
• Infectious diarrhea: 0.5 g 2 times a day, the course of treatment is 10 days;
• Complicated intra-abdominal infections: 0.5 g every 12 hours for 7-14 days;
• Prevention and treatment of pulmonary anthrax: 0.5 g 2 times a day for 60 days.

Side effects

• Digestive system: nausea, vomiting, diarrhea, abdominal pain, increased activity of hepatic transaminases, alkaline phosphatase, LDH, bilirubin, pseudomembranous colitis;
• Allergic reactions: skin itching, urticaria, Quincke’s edema, Stevens-Johnson syndrome, arthralgia;
• Hemopoietic system: eosinophilia, leukopenia, neutropenia, a change in the number of platelets;
• Central nervous system: headache, dizziness, feeling tired, sleep disturbances, nightmares, hallucinations, fainting, visual disturbances;
• Urinary system: crystalluria, glomerulonephritis, dysuria, polyuria, albuminuria, hematuria, a transient increase in serum creatinine;
• Cardiovascular system: tachycardia, cardiac arrhythmias, arterial hypotension;
• Adverse reactions associated with chemotherapeutic action: candidiasis;
• Other: vasculitis.

Contraindications

Do not take Cipro if you have any of the following conditions:

• hypersensitivity to the drug
• treatment with tizanidine (risk of a marked decrease in blood pressure, drowsiness) pregnancy and lactation
• age under 18 years (except for the treatment of complications caused by Pseudomonasaeruginosa in children with pulmonary cystic fibrosis from 6 to 17 years; prevention and treatment of pulmonary anthrax infected with Bacillusanthracis);
• lactose intolerance;
• lactase deficiency;
• glucose-galactose malabsorption
• epilepsy.

Overdose

Symptoms: increased side effects of the drug. There is no specific antidote. Treatment includes gastric lavage and other emergency measures, careful monitoring of the patient’s condition, sufficient fluid intake. Only a small (less than 10%) amount of ciprofloxacin can be withdrawn with hemo- or peritoneal dialysis.

Pregnancy and breastfeeding

Cipro is contraindicated for use during pregnancy and lactation. Ciprofloxacin penetrates into the placental barrier and is excreted in breast milk. Experimental studies have shown that the drug causes arthropathy.

Drug interactions

The simultaneous use of ciprofloxacin with didanosine decreases the absorption of ciprofloxacin due to the formation of complexes of ciprofloxacin with aluminum and magnesium salts contained in didanosine. The simultaneous use of ciprofloxacin and theophylline can lead to an increase in theophylline concentration in blood plasma due to competitive inhibition in the cytochrome P 450 binding sites, which leads to an increase in the half-life of theophylline and an increased risk of developing toxic effects associated with theophylline. The simultaneous use of antacids, as well as drugs containing aluminum, zinc, iron or magnesium ions, can cause a decrease in the absorption of ciprofloxacin, therefore, the interval between the use of these drugs should be at least 4 hours. The simultaneous use of ciprofloxacin and cyclosporine enhances the nephrotoxic effect of the latter.

Special recommendations

The drug is used with extreme caution in patients with a history of seizures, vascular diseases, and organic brain damage due to the risk of adverse reactions associated with the central nervous system. If severe and prolonged diarrhea occurs during or after treatment with Cipro, the diagnosis of pseudomembranous colitis should be excluded, which requires immediate drug withdrawal and appropriate treatment. If there is a pain in the tendons or the first signs of tendovaginitis, treatment should be discontinued due to the fact that isolated cases of inflammation and even rupture of tendons during treatment with fluoroquinolones were reported. During treatment with ciprofloxacin tablets, it is necessary to drink a sufficient amount of fluid while observing normal diuresis. During treatment, contact with direct sunlight should be avoided. Patients taking this antibiotic should be careful when driving a car and engaging in other potentially dangerous activities that require increased attention and speed of psychomotor reactions (especially with the simultaneous use of alcohol).

Storage

Store the drug in a dry, dark place at a temperature not exceeding 77° F. Keep out of the reach of children!