Cipro

Cipro is a broad-spectrum antimicrobial agent from the group of fluoroquinolones. It has a bactericidal propery. The drug inhibits the bacterial DNA gyrase enzyme, as a result of which DNA replication and the synthesis of bacterial cellular proteins are disrupted. Ciprofloxacin, the main component of Cipro, acts both on reproducing organisms and those in the dormant phase. Gram-negative aerobic bacteria are sensitive to ciprofloxacin is enterobacteria including Escherichia coli, Salmonella spp., Shigella spp., Citrobacter spp., Klebsiella spp., Enterobacter spp., Proteus mirabilis, Proteus vulgaris, Serratia marcescenst. , Morganella morganii, Vibrio spp., Yersinia spp. Some intracellular pathogens: Legionella pneumophila, Brucella spp., Chlamydia trachomatis, Listeria monocytogenes, Mycobacterium tuberculosis, Mycobacterium kansasii, Mycobacterium avium-intracellulare.

Gram-positive aerobic bacteria are also sensitive to ciprofloxacin: Staphylococcus spp. (S.aureus, S.haemolyticus, S.hominis, S.saprophyticus), Streptococcus spp. (St. pyogenes, St. agalactiae). Most methicillin-resistant staphylococci are also resistant to ciprofloxacin.

The sensitivity of bacteria Streptococcus pneumoniae, Enterococcus faecalis is moderate. Corynebacterium spp., Bacteroides fragilis, Pseudomonas cepacia, Pseudomonas maltophilia, Ureaplasma urealyticum, Clostridium difficile, Nocardia asteroides are resistant to the drug. The drug effect on Treponema pallidum is not well established.

Indications for use

Infections and inflammatory diseases caused by microorganisms sensitive to ciprofloxacin:

• respiratory tract;
• ETN organs;
• kidneys and urinary tract;
• urinogenital system;
• digestive system (including mouth, teeth, jaws);
• gall bladder and biliary tract;
• skin integuments, mucous membranes and soft tissues;
• musculoskeletal system.

Cipro is indicated for the treatment of sepsis and peritonitis, as well as for the prevention and treatment of infections in patients with reduced immunity (as a part of immunosuppressive therapy).

Contraindications

• Pregnancy;
• Period of breastfeeding;
• Children and adolescents under 18 years of age;
• Increased sensitivity to ciprofloxacin or other drugs from the group of fluoroquinolones;
• Pseudomembranous colitis.

Pregnancy

Cipro is contraindicated during pregnancy and lactation.

Dosage and administration

Cipro dose depends on disease severity, infection type, the body condition, the age, weight and kidney function.

Common recommended doses:

• uncomplicated diseases of the kidneys and urinary tract – 0.25 g, and in complicated cases, 0.5 g 2 times a day;
• diseases of the lower respiratory tract of moderate severity – 0.25 g, and in more severe cases, 0.5 g, 2 times a day;
• the treatment of gonorrhea, a single dose of ciprofloxacin – 0.250-0.5 g;
• gynecological diseases, enteritis and colitis with severe course and high fever, prostatitis, osteomyelitis – 0.5 g 2 times a day (for the treatment of banal diarrhea, you can use a dose of 0.25 g 2 times a day);
• other infections – 2 times a day, 0.5 g each;
• severe, life-threatening, including streptococcal pneumonia, infections of bones and joints, septicemia, peritonitis – 2 times a day, 0.75 g.

Cipro should be taken on an empty stomach washed down with plenty of water. Patients with severe renal impairment should be prescribed a half drug dose.

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

Overdose

The specific antidote is not developed. It is necessary to carefully monitor the patient’s condition, do gastric lavage, carry out the commonly-applied emergency measures, ensure an adequate flow of fluid. With the help of hemo- or peritoneal dialysis, only a small (less than 10%) amount of the drug can be excreted.

Interactions

• With the simultaneous use of ciprofloxacin with didanosine, the absorption of ciprofloxacin decreases due to the formation of ciprofloxacin with aluminum and magnesium salts contained in didanosine.
• The simultaneous administration of ciprofloxacin and theophylline can result in 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 administration 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 appointment of these drugs should be at least 4 hours.
• With the simultaneous use of ciprofoxacin and cyclosporine, the nephrotoxic effect of the latter is enhanced.