Indication
Ciprofloxacin is indicated for the treatment of Respiratory Tract Infections,Urinary tract infections, Pelvic Inflammatory Diseases, Infectious Diarrhea (Shigella dysenteriae, Vibrio cholera), Typhoid fever, Intra-abdominal infections, Prostatitis, Skin and Soft Tissue Infections, Bone and Joint Infections, Gonorrhea, Neutropenic patients with fever due to bacterial infection, Meningitis, Surgical prophylaxis.
Pharmacology
Ciprofloxacin is a synthetic fluoroquinolone. It has bactericidal activity against a wide range of gram-positive and gram-negative organisms. It inhibits bacterial DNA synthesis by binding with the bacterial enzyme-DNA gyrase and topoisomerase IV which are responsible for DNA supercoiling.
Dosage
Tablet: Adult:
Respiratory Tract Infections: 500 to 750 mg twice daily (7 to 14 days)
Urinary tract infections: 250 to 750 mg twice daily (3 to 10 days)
Pelvic Inflammatory Diseases: 500 to 750 mg twice daily (14 days)
Infectious Diarrhea (Shigella dysenteriae, Vibrio cholera): 500 mg twice daily (1 to 5 days)
Typhoid fever: 500 mg twice daily (7 days)
Intra-abdominal infections: 500 to 750 mg twice daily (5 to 14 days)
Prostatitis: 500 to 750 mg twice daily (2 to 6 weeks)
Skin and Soft Tissue Infections: 500 to 750 mg twice daily (7 to 14 days)
Bone and Joint Infections: 500 to 750 mg twice daily (max. 3 months)
Gonorrhea: 500 mg as a single dose
Neutropenic patients with fever due to bacterial infection: 500 to 750 mg twice daily co- administered with appropriate antibacterials.
Meningitis: 500 mg as a single dose.
Surgical prophylaxis: 500 mg as a single dose, 60 minutes before procedure.
Suspension: Pediatric:
10-20 mg/kg (max. 750 mg) twice daily (10 to 21 days). The duration of therapy depends on the type and severity of infection.
Extended release tablet: In uncomplicated urinary tract infection (acute cystitis), the recommended dose of extended release tablet is 1000 mg tablet once daily for three days.For IV infusion:
Urinary Tract Infection: Mild to Moderate: 200 mg 12 hourly for 7-14 days; Severe or Complicated: 400 mg 12 hourly for 7-14 days
Lower Respiratory Tract infection: Mild to Moderate: 400 mg 12 hourly for 7-14 days; Severe or Complicated: 400 mg 8 hourly for 7-14 days
Nosocomial Pneumonia: Mild/Moderate/Severe: 400 mg 8 hourly for 10-14 days
Skin and Skin Structure: Mild to Moderate: 400 mg 12 hourly for 7-14 days; Severe or Complicated: 400 mg 8 hourly for 7-14 days
Bone and Joint Infection: Mild to Moderate: 400 mg 12 hourly for more than 4-6 weeks; Severe/Comlicated: 400 mg 8 hourly for more than 4-6weeks
Intra abdominal (Acute abdomen): Complicated: 400 mg 12 hourly for 7-14 days
Acute Sinusitis: Mild/Moderate: 400 mg 12 hourly for 10 days
Chronic Bacterial Prostatitis: Mild/Moderate: 400 mg 12 hourly for 28 Days.
Interaction
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.
Contradiction
It is contraindicated in patients who have known hypersensitivity to Ciprofloxacin or other quinolones.
Side Effect
Side effects include- nausea and other gastrointestinal disturbances, headache, dizziness, joint pain and skin rashes.
Pregnancy
There are no adequate and well-controlled studies in pregnant women. Ciprofloxacin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus and mother. Ciprofloxacin is excreted in human milk. Due to the potential risk of articular damage, Ciprofloxacin should not be used during lactation.
Precaution
Patients receiving Ciprofloxacin should be instructed to drink fluids liberally. It should be used with caution in patients with suspected or known CNS disorders such as epilepsy or other factors which predispose to seizures and convulsion. Avoid in patients with known QT prolongation, hypokalemia.
Overdose
Overdose following Ciprofloxacin administration may lead to seizures, hallucinations, confusion, abdominal discomfort, renal and hepatic impairment as well as crystalluria, haematuria, & reversible renal toxicity.
Storage
Keep below 30?øC temperature, protected from light & moisture. Keep out of the reach of children.