Ciprofloxacin (Cipro)

Cipro is a fluoroquinolone antibiotic used to kill sensitive bacteria. It works by stopping the production of essential proteins needed by the bacteria to survive.

Therapeutic actions:
Ciprofloxacin is a new fluoroquinolone that is highly active against many diverse microorganisms. At concentrations of less than 1 microgram/mL it is active against most gram-negative bacteria, including Enterobacteriaceae, Haemophilus, Neisseria, and other Pasteurellaceae, Vibrionaceae, and various species of Pseudomonas and Acinetobacter. Most staphylococci, including strains resistant to methicillin, are also susceptible to ciprofloxacin. Streptococci are not highly susceptible to ciprofloxacin, and obligate anaerobes are generally resistant to this and other quinolones. Ciprofloxacin, like other quinolones, inhibits DNA gyrase, but its bactericidal effects are not completely reversible by inhibitors of protein or RNA synthesis. Thus, unlike many other quinolones, ciprofloxacin may have multiple lethal effects. Resistance is less readily selected in vitro by ciprofloxacin than by nalidixic acid, and single-step mutants usually remain susceptible to clinically achievable concentrations. Resistance mediated by mutations in genes altering DNA gyrase and expression of outer membrane proteins has been described for ciprofloxacin and other quinolones. The antimicrobial spectrum and potency of ciprofloxacin, coupled with its rapid bactericidal effects, make this fluoroquinolone a promising new antimicrobial agent.

What is it used for?:
Adults:
• Urinary Tract Infections;
• Acute Uncomplicated Cystitis in females;
• Chronic Bacterial Prostatitis;
• Lower Respiratory Tract Infections;
• Acute Sinusitis;
• Skin and Skin Structure Infections;
• Bone and Joint Infections;
• Complicated Intra-Abdominal Infections;
• Infectious Diarrhea;
• Typhoid Fever (Enteric Fever);
• Uncomplicated cervical and urethral gonorrhea;
• Pediatric patients (1 to 17 years of age)
• Complicated Urinary Tract Infections and Pyelonephritis; Adult and Pediatric Patients:
• Inhalational anthrax(post-exposure).

Contraindications and cautions:
• joint problems;
• kidney disease;
• epilepsy or seizures;
• allergy to any ingredient in Cipro or to any other fluoroquinolone (eg. levofloxacin);
• recent received a live, oral typhoid vaccination or you are taking cisapride or tizanidine;
• Don’t use dairy products alone when taking ciprofloxacin. They could make the drug less effective;
• Taking ciprofloxacin can make your skin more sensitive to sunlight. Avoid exposure to sunlight, sun lamps, or tanning beds.

Side effects: Less serious: anxiety; diarrhea; dizziness; loss of appetite; vision changes; nausea; restlessness; nightmares; stomach upset; headache; vomiting.

Interactions:
• the risk of serious side effects, including irregular heartbeat, may be increased by cisapride or class 1A or class III antiarrhythmics (eg. quinidine, procainamide, amiodarone, sotalol);
• Corticosteroids (eg. prednisone) because they may increase the risk of tendon problems
• Arsenic, nonsteroidal anti-inflammatory drugs (NSAIDs) (eg. ibuprofen), or probenecid may provoke side effects, such as seizures;
• the actions and side effects of anticoagulants (eg. warfarin), arsenic, cyclosporine, methadone, methotrexate, sulfonylureas (eg. glyburide), theophyllines, tizanidine, or xanthines (eg. theophylline) may be increased if taking them together with Cipro;
• Cipro may decrease effectiveness of hydantoins (eg. phenytoin) or live, oral typhoid vaccine.