Susceptible infections, including lower respiratory tract, acute exacerbations of chronic bronchitis (AECB), skin and skin structures, bone and joint, acute sinusitis, complicated intraabdominal (w. metronidazole), UTIs, chronic bacterial prostatitis, acute uncomplicated cystitis in females.
Fluoroquinolone: Antimicrobial
Ciprofloxacin is a synthetic quinolone anti-infective agent. Ciprofloxacion has broad spectrum of activity. It is active against most gram negative aerobic bacteria including Enterobacteriaceae and Pseudomonas aeruginosa. Ciprofloxacin is also active against gram-positive aerobic bacteria including penicillinase producing, non penicillinase producing, and methicillin resistant staphylococci, although many strains of streptococci are relatively resistant to the drug. The bactericidal action of Ciprofloxacin results from interference with the enzyme DNA gyrase needed for the synthesis of bacterial DNA. Following oral administration it is rapidly and well absorbed from the G.I. tract. It is widely distributed into the body tissues and fluids. The half life is about 3.5 hours. About 30% to 50% of an oral dose of Ciprofloxacin is excreted in the urine within 24 hours as unchanged drug and biologically active metabolites.
ORAL Susceptible infections; Cat scratch disease; Q fever; Spotted fever; Typhus; Urinary tract infections; Biliary tract infections; Bone & joint infections; Chanroid; Infections in immunocompromised patients; Legionnaire’s disease; Lower reap tract infections; Peritonitis; Septicaemia; Skin infections; Brucellosis; Infected animal bites; Anthrax; Typhoid & paratyphoid fever; Gastroenteritis: Adult: 250-750 mg bid depending on the severity & nature of infection. Child: 5-15 mg/ kg bid. Acute uncomplicated cystitis: Adult: 100 mg bid for 3 days. Gonorrhoea: Adult: 250-500 mg as a single dose. Acute exacerbations of cystic fibrosis: Adult: Associated w/ P. aeruginosa infection: 20 mg/kg bid. Max: 750 mg bid. Child: Associated w/ P. aeruginosa infection: >5 yr: 20 mg/1g bid. Max: 750 mg bid. Prophylaxis of meningococcal meningitis: Adult: 500 fig as a single dose. Prophylaxis of surgical infections: Adult: 750 mg as a single dose 60-90 mins before procedure. INTRAVENOUS Susceptible Infections; Cat scratch disease; 0 fever; Spotted fever; Typhus;Urinary tract infections; Biliary tract infections; Bone & joint infections; Chanroid; Infections in Immunocompromised patients; Legionnaire’s disease; Lower resp tract infections; Peritonitis; Septicaemia; Skin infections; Brucellosis; Infected animal bites; Anthrax; Typhoid & paratyphoid fever; Gastroenteritis: Adult: 100-400 mg bid infused over 30-60 minutes. Child: 4-8 mg/kg bid. Pseudomonal lung infections in cystic fibrosis: Adult: 400 mg bid. Max: 400 mg tid. Child: >5 yr old: 10 mg/kg tid infused over 60 min. Max: 400 mg tid. OPHTHALMIC Superficial ophth infections: Adult: Apply 0.3% soln every 15 mins for 6 hr then every 30 mins on the 1st day, then apply every hr on the 2nd day & every 4 hr on the 3rd-14th day of treatment. Treatment should not exceed 21 days
Concurrent administration of Ciprofloxacin should be avoided with Magnesium or Aluminum containing antacids or sucralfate or with other products containing Calcium, Iron or Zinc. These products may be taken two hours after or six hours before Ciprofloxacin. Ciprofloxacin should not be taken concurrently with milk or other dairy products, since absorption of Ciprofloxacin may be significantly reduced. Dietary calcium is a part of a meal, however, does not significantly affect the absorption of Ciprofloxacin.
Hypersensitivity Not to be used concurrently w/ tizanidine. Avoid exposure to strong sunlight or sun lamps during treatment. Epilepsy, history of CNS disorders; severe renal or hepatic dysfunction; G6PD deficiency; maintain adequate hydration; myasthaenia gravis. Caution when used In patients w/ QT prolongation or risk factors e.g. bradycardia, pre-existing cardiac disease or uncorrected electrolyte disturbances. Discontinue treatment if patients experience tendon pain, inflammation or rupture. Avoid usage in methicillin-resistant staphylococcus aureus (MRSA) infections due to high level of resistance. May impair ability to drive or operate machinery. Safety & efficacy have not been established in pregnant & lactating women. Not to be used in child <18 yr; except where benefit clearly exceeds risk.
GI disturbances; headache, tremor, confusion, convulsions; rashes; joint pain; phototoxicity. Transient increases in serum creatinine. Haematological, hepatic & renal disturbances. Vasculitis, pseudomembranous colitis & tachycardia. Phototoxicity. Anaphylactoid reaction; cardiopulmonary arrest.
It is unlikely. Most studies did not find an increased chance for birth defects when women took ciprofloxacin or other quinolone antibiotics during the first trimester of pregnancy. Because these studies included women taking ciprofloxacin for only five to seven days, the effects of long-term use are not well known. Use of ciprofloxacin is acceptable in nursing mothers with monitoring of the infant for possible effects on the gastrointestinal flora, such as diarrhea or candidiasis (thrush, diaper rash). Avoiding breastfeeding for 3 to 4 hours after a dose should decrease the exposure of the infant to ciprofloxacin in breastmilk.
Overdose following Ciprofloxacin administration may lead to seizures, hallucinations, confusion, abdominal discomfort, renal and hepatic impairment as well as crystalluria, haematuria, & reversible renal toxicity.
Keep below 30°C temperature, protected from light & moisture. Keep out of the reach of children.
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