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What is Cipro?

Cipro is an antimicrobial agent for systemic use. The drug inhibits the growth of pathogens that cause infectious diseases. The drug is available in the form of tablets of 250 mg, 500 mg, 750 mg, 1000 mg.

The active substance, ciprofloxacin, suppresses DNA gyrase and inhibits the synthesis of bacterial DNA. It’sh highly active against most gram-negative bacteria: Pseudomonas aeruginosa, Haemophilus influenzae, Escherichia coli, Shigella spp., Salmonella spp., Neisseria meningitidis, Neisseria gonorrhoeae.

The drug is active against Staphylococcus spp. (including strains producing and not producing penicillinase, methicillin-resistant strains), some strains of Enterococcus spp., Campylobacter spp., Legionella spp., Mycoplasma spp., Chlamydia spp., Mycobacterium spp., β-lactamase producing bacteria.

Bacteria resistant to this antibiotic: Ureaplasma urealyticum, Clostridium difficile, Nocardia asteroides.

The effect on Treponema pallidum is not well understood.

Indications

Cipro is used in the following cases:

  • infections of the middle ear (otitis media), sinuses of the nose (sinusitis, including sinusitis, frontal sinusitis, ethmoiditis, sphenoiditis, pansinusitis) caused by Gr-bacteria (gram-negative);
  • lower respiratory tract infection caused by Gy + bacteria (gram-negative) – chronic obstructive disease, pneumonia (except pneumococcal), cystic fibrosis (cystic fibrosis), bronchiectasis (local expansion of the bronchi);
  • intra-abdominal (intra-abdominal) infections;
  • infections of bones, joints;
  • kidney infection (pyelitis, pyelonephritis), urinary tract infection (urethritis, cystitis);
  • infection of soft tissues, skin caused by Gr + bacteria;
  • infections of the gastrointestinal tract (intestinal infections caused by enterotoxigenic strains of Escherichia coli, Campylobacter jejuni);
  • infections of the pelvic organs (adnexitis, prostatitis), including gonorrhea;
  • infection in patients with reduced immunity (in case of neutropenia).

Dosage and mode of application

The tablets are swallowed whole and washed down with a small amount of liquid. The drug can be taken regardless of the meal, but it is noted that taking it on an empty stomach accelerates the absorption of the active substance.

The duration of treatment will depend on the results of bacteriological studies, the course and severity of the disease. It is recommended to continue treatment for at least three days after the disappearance of the clinical symptoms and the normalization of temperature indicators in the patient.

It is necessary to avoid taking the medication with calcium-rich foods (juices with a high calcium content, yogurt, milk).

Dosing:

  • respiratory tract infections: 500–750 mg x2 times/day – 7–14 days;
  • complicated pyelonephritis: 500–750 mg x2 times/day – not less than 10 days, and in some cases (for example, with an abscess) – up to 21 days;
  • urinary tract infection: uncomplicated cystitis – 250–500 mg x2 times/day – 3 days;
  • complicated cystitis, uncomplicated pyelonephritis: 500 mg x2 times/day – 7 days;
  • prostatitis: 500–750 mg x2 times/day – 2–4 weeks (with exacerbation), 4–6 weeks (with a chronic course);
  • genital infections: fungal urethritis, cervicitis – 500 mg once;
  • orchiepididymitis, inflammatory processes of the pelvic organs: 500–750 mg x2 times/day – at least 14 days;
  • intestinal infections, intra-abdominal infection: 500 mg x2 times/day – 1 day;
  • diarrhea caused by Shigella dysenteriae type I – 500 mg x2 times/day – 5 days;
  • diarrhea caused by Vibrio cholera – 500 mg x2 times/day – 3 days;
  • typhoid fever – 500 mg x2 times/day – 7 days;
  • intra-abdominal infection caused by Gy — microorganisms — 500–750 mg x2 times/day — 5–14 days;
  • infections of soft tissues, skin: 500–750 mg x2 times/day – 7–14 days;
  • infections of the joints, bones: 500–750 mg x2 times/day – maximum 3 months;
  • prevention/treatment of infections in patients with neutropenia: 500–750 mg x2 times/day – until neutropenia stops;
  • prevention of invasive infections caused by Neisseria meningitides: 500 mg once;
  • prophylaxis after contact with a sick person, as well as treatment of anthrax: 500 mg x2 times/day – 60 days from the moment of confirmation of infection.

Contraindications

Do not use this antibiotic if you have any of the following diseases/conditions:

  • hypersensitivity to ciprofloxacin, other quinolones or any of the excipients of the drug;
  • deficiency of glucose-6-phosphate dehydrogenase;
  • epilepsy;
  • age up to 18 years (except for children aged 15-17 years with bronchopulmonary infections in cystic fibrosis caused by Pseudomonas aeruginosa);
  • pregnancy, breastfeeding;
  • simultaneous use with tizanidine.

Side effects

Cipro can cause the following adverse reactions: loose stools, nausea, eosinophilia, fungal superinfection, lack of appetite, agitation, hyperactivity, headaches, taste disturbances, dizziness, sleep disorders, vomiting, flatulence, pain in the stomach / intestines, increased activity of liver enzymes, itching, increased bilirubin, musculoskeletal pain, statutory pain, rash, urticaria, impaired kidney function, fever, fatigue, changes in the number of leukocytes, anemia (anemia), inflammation of the colon, decrease in platelets, increased sugar levels, allergic reactions, confusion, depression with the appearance of suicidal thoughts, pathological dreams, changes in sensitivity, dizziness, tremors, convulsions, impaired vision, decreased blood pressure, hearing disorders, tachycardia, syncope, abnormalities in the liver, suffocation, jaundice, hepatitis, muscle pain, photosensitivity, inflammation of joints, muscle cramps, increased muscle tone, kidney failure, nephritis, blood / crystals in the urine, increased activity amylase, hemolytic anemia, bone marrow suppression, anaphylactic shock, migraine, mental reactions with suicidal attempts, unstable gait, lack of coordination, odor perception disorder, changes in color perception, vasculitis, increased intracranial pressure, pancreatitis, petechiae, erythema, necrosis of the liver, syndrome Stevens-Johnson, muscle weakness, toxic epidermal necrolysis, inflammation / tendon rupture (often Achilles), increased sweating, edema, an increase in prothrombin time, periphery eskaya neuropathy, arrhythmia, ventricular tachycardia, pustular rash.

Pregnancy and breastfeeding

The use of Cipro during pregnancy and lactation (breastfeeding) is possible only in the case when the intended benefit to the mother outweighs the potential risk to the fetus and child. The active substance is excreted into breast milk.

Interactions

Do not combine this antibiotic with the following drugs and substances:

  • alcohol;
  • pain and fever medications as Advil, Aleve, and Motrin;
  • theophylline (Elixophyllin, Uniphyl, Theo-24);
  • some antidepressants, such as clozapine (Clozaril, FazaClo);
  • glyburide (DiaBeta, Glucovance, Micronase);
  • some non-steroidal anti-inflammatory drugs, such as ibuprofen(Advil, Motrin) and naproxen (Aleve, Naprosyn);
  • medications that contain caffeine, including Excedrin, NoDoz, and Vivarin;
  • cyclosporine (Gengraf, Neoral, Sandimmune);
  • tizanidine (Zanaflex);
  • diuretics;
  • antacids, vitamins, and supplements that contain magnesium, calcium, aluminum, iron, or zinc;
  • amiodarone (Cordarone);
  • disopyramide (Norpace);
  • procainamide (Procanbid);
  • warfarin (Coumadin, Jantoven);
  • phenytoin (Dilantin, Phenytek);
  • methotrexate (Rheumatrex, Trexall);
  • metoclopramide (Reglan)

Safety precautions

To avoid crystalluria, it is unacceptable to exceed the recommended daily dose.

During treatment, patients should consume an adequate amount of fluid.

Overdose symptoms include headache, fatigue, confusion, dizziness, convulsions, hallucinations, abdominal discomfort, crystals/blood in the urine, impaired kidney/liver function. As a first aid, it is recommended to wash the stomach, take antacids.

In patients with impaired renal function, a dosage regimen is required. The antibiotic is used with caution in elderly patients, patients with atherosclerosis of cerebral vessels, disorders of cerebral circulation, epilepsy, convulsive syndrome of unknown etiology.

In case of persistent diarrhea, the medication should be discontinued.

In the process of treatment, it is necessary to control the concentration of urea, creatinine, and hepatic transaminases in the blood.

During the treatment period, a decrease in reactivity is possible (especially when used simultaneously with alcohol).

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