Cipro (ciprofloxacin) is a fluoroquinolone antibiotic medication that is used to treat infections caused by bacteria.
How does it work?
This pharmaceutical agent belongs to a fluoroquinolone group. Ciprofloxacin has an antimicrobial effect, affecting a wide range of microorganisms that have a pathological effect on the human body. The mechanism of action is characterized by the ability to inhibit the enzymes of bacterial DNA gyrase. As a result, the reproduction of bacteria is disrupted. The positive features of the fluoroquinolone group include the ability to influence both microbes that are at rest and microorganisms that are at the stage of reproduction.
What bacteria does Cipro treat?
Cipro has a wide spectrum of antimicrobial activity, it is the most active against gram-negative bacteria, and the effect on anaerobes is less pronounced. It kills Staphylococcus aureus, Streptococcus pyogenes, Staphylococcus epidermidis, Campylobacter jejuni, Enterobacter cloacae, Citrobacter diversus, Escherichia coli, Citrobacter freundii, Haemophilus influenzae, Klebsiella pneumoniae, Haemophilus parainfluenzae, Morganella morganii, Proteus mirabilis, Neisseria gonorrhoeae, Proteus vulgaris, Providencia rettgeri, Pseudomonas aeruginosa, Providencia stuartii, Salmonella typhi, Shigella flexneri, Serratia marcescens, Shigella sonnei, Acinetobacter spp., Staphylococcus hominis, Aeromonas caviae, Staphylococcus saprophyticus, Aeromonas hydrophila, Staphylococcus haemolyticus, Acinetobacter calcoaceticus, Brucella melitensis, Edwardsiella tarda, Campylobacter coli, Enterobacter aerogenes, Klebsiella oxytoca, Haemophilus ducreyi, Legionella pneumophila, Mycobacterium tuberculosis, Neisseria meningitidis, Moraxella catarrhalis, Pasteurella multocida, Vibrio cholerae, Salmonella enteritidis, Vibrio parahaemolyticus, Yersinia enterocolitica, Vibrio vulnificus, Chlamydia trachomatis.
Indications for use
Cipro is prescribed to treat the following diseases and infections:
- airways – acute / chronic bronchitis, pneumonia, cystic fibrosis, bronchiectasis;
- ENT organs – otitis media, sinusitis, sinusitis, mastoiditis, frontal sinusitis, tonsillitis, pharyngitis;
- abdominal cavity – bacterial infections of the gastrointestinal tract, biliary tract, peritonitis, salmonellosis, cholera;
- kidney and urinary tract – pyelonephritis, cystitis;
- pelvic organs and genitals – prostatitis, adnexitis, salpingitis, endometritis, gonorrhea, chlamydia;
- skin and soft tissues – infected ulcers, wounds, burns, abscesses, phlegmon;
- bones and joints – osteomyelitis, septic arthritis.
Also, the antibiotic is prescribed to treat sepsis, infections against the background of immu-nodeficiency, and prevent infections during surgical interventions, prevent and treat pulmonary anthrax.
The drug can only be prescribed by a doctor since there are many diseases that require special medical supervision.
How to take this medicine?
Cipro is available in the form of tablets of 250 mg and 500 mg.
While taking the drug, you should refrain from activities that require increased attention. Contact with direct sunlight should also be avoided.
The dosage regimen is selected by a doctor individually. On average, a patient needs to take 250-750 mg 1-2 times a day. The duration of treatment is 7-10 days to 4 weeks. Dp not exceed the daily dose without doctor’s advice.
Cipro is usually tolerated well.
In rare cases, it can cause side effects:
- digestive system: nausea, loss of appetite, vomiting, diarrhea, pseudomembranous colitis, constipation, abdominal and epigastric pain, hiccups, abdominal discomfort, ulcers, flatulence, soreness and dryness of the oral mucosa, bleeding in the gastrointestinal tract cholestatic jaundice, pancreatitis, necrosis of liver cells, hepatitis;
- respiratory system: dyspnea, pulmonary embolism, respiratory distress, pleural effusion, bronchospasm; support and movement system: myalgia, arthralgia, tenosynovitis; Genitourinary system: crystalluria, fre-quent urination, hematuria, polyuria, cylindruria, proteinuria, urinary retention, acidosis, hemorrhagic cys-titis, vaginitis, nephritis, gynecomastia;
- sensory organs and nervous system: headache, agitation, dizziness, anxiety, nightmares, insomnia, con-fusion, phobias, depression, fatigue, impaired sense of smell and taste, visual impairment (diplopia, change in color vision, eye pain (nystagmus), transient hearing impairment, tinnitus, mood changes, increased intracranial pressure, impaired gait, paresthesia, ataxia, sweating, tremors, toxic psychosis, convulsions, hallucinations, paranoia, migraine;
- blood and circulatory system: lowering blood pressure, arrhythmia, cardiovascular collapse, paroxysmal tachycardia, cerebral thrombosis, leukopenia, anemia, leukocytosis, thrombocytosis, thrombocytopenia, a change in prothrombin level;
- allergic reactions: petechiae, rash, blisters, skin vasculitis, papules, Stevens-Johnson syndrome, erythema multiforme exudative, Lyell’s syndrome, exfoliative dermatitis, swelling of the extremities, lips, neck, face, conjunctiva, skin itching, urticaria, angioneurotic edema, angioneurotic edema, angioeurosis;
- others: eosinophilia, hyperpigmentation, fever, transient increase in the activity of liver transaminases, alkaline phosphatase, urea, creatinine, serum triglycerides, potassium, glucose, bilirubin; photosensitization, candidiasis, dysbiosis; in the place of intravenous administration – burning sensation, pain, phlebitis.
- Hypersensitivity to ciprofloxacin or any component of the drug, as well as to other antimicrobial drugs from the group of fluoroquinolones;
- The simultaneous use of ciprofloxacin and tizanidine (risk of a pronounced decrease in blood pressure, drowsiness);
- Pseudomembranous colitis;
- Children under 18 years of age (except for the treatment of complications caused by Pseudomonas aeruginosa in children with pulmonary cystic fibrosis aged 5-17 years; prevention and treatment of pul-monary anthrax);
- Pregnancy, breastfeeding;
- The simultaneous use of ciprofloxacin with methotrexate.
Interaction with other drugs
Avoid combining Cipro and any of the following drugs: aminoglycosides, beta-lactam antibiotics, clindamycin, vancomycin, metronidazole, bismuth preparations, sucralfate, antacids that contain magne-sium, aluminum or calcium ions, ranitidine, cimetidine, vitamins with trace elements, zinc, iron sulfate, didanosine, azlocillin, probenecid, aminophylline, caffeine, theophylline, warfarin and other oral anticoag-ulants, cyclosporin, non-steroidal anti-inflammatory drugs, drugs that alkalize urine (sodium bicarbonate, citrates, carbonic anhydrase inhibitors).
Pregnancy and breastfeeding
This antibiotic is contraindicated for use during pregnancy.
Since ciprofloxacin is excreted in breast milk, it should not be used with breastfeeding. If it is necessary to use use this drug during lactation, a woman should stop breastfeeding.
An overdose of Cipro can cause the above-mentioned side effects. Treatment: gastric lavage, use of emetics, consumption of a large amount of fluid, supportive therapy; there is no specific antidote.
Use the drug with caution if you have any of the following conditions/diseases:
- elderly age;
- impaired renal function (creatinine clearance less than 60 ml / min):
- glucose-6-phosphate dehydrogenase deficiency;
- epilepsy (including history);
- peritoneal dialysis;
- impaired liver function;
- myasthenia gravis;
- severe cerebral arteriosclerosis, cerebrovascular accident;
- mental illness (depression, psychosis);
- tendon damage with previous treatment with quinolones;
- increased risk of lengthening the QT interval or pirouette type arrhythmias (for example, congenital lengthening of the QT interval, heart disease (heart failure, myocardial infarction, bradycardia), electrolyte imbalance (for example, with hypokalemia, hypomagnesemia);
- simultaneous use of drugs that extend the QT interval (including antiarrhythmic classes IA and III, tricyclic antidepressants, macrolides, antipsychotic drugs);
- simultaneous use with CYP4501A2 isoenzyme inhibitors, (including theophylline, methylxanthin, caffeine, duloxetine, clozapine, ropinirole, olanzapine), organic brain damage or stroke;
- a history of convulsions.
In rare cases, treatment with ciprofloxacin can cause crystalluria, especially if the urine has an alkaline or neutral environment and therefore a sufficient amount of fluid should be prescribed to patients.
If a skin rash or other symptoms indicate an increased sensitivity to the drug, you should stop taking the drug. Very rarely, after taking the first dose of the drug, an anaphylactic reaction and shock (a decrease in blood pressure, heart rhythm and breathing disorders) can develop.
In rare cases, the antibiotic can cause tendovaginitis and even tendon rupture (for example, the Achilles tendon). The patient should be informed that he or she should stop taking the drug and consult a doctor in case of pain or inflammatory changes in the tendon area.
The drug can cause phototoxic reactions, so the patient should avoid UV radiation during treatment with this antibiotic. Treatment with the drug should be discontinued in case of phototoxic reactions.
During ciprofloxacin therapy, pseudomembranous enterocolitis of varying severity may develop. Symptoms of this disease can be severe and prolonged diarrhea. Do not use drugs that inhibit intestinal motility.
In experimental studies, it was found that ciprofloxacin does not have a teratogenic effect.
This medicine can cause headache and dizziness, a feeling of weakness, which can affect the driving of a vehicle and the maintenance of moving mechanisms, as well as activities associated with high psychophysical activity.