Ciprofloxacin

How it works

     * Ciprofloxacin is an antibiotic used to treat a wide range of
       infections. Ciprofloxacin converts two bacterial enzymes,
       topoisomerase IV and DNA gyrase, into toxic enzymes that inhibit
       the manufacture and repair of DNA and other DNA processes.
     * Ciprofloxacin belongs to a group of medicines known as
       fluoroquinolones (also called quinolones).

Upsides

     * Ciprofloxacin may be used to treat a wide range of infections such
       as those occurring in the urinary tract, prostate, respiratory
       tract, sinuses, bones and joints, abdomen, and genital area.
       However, it is usually only used in the treatment of urinary tract
       infections, chronic bronchitis, and sinusitis when other
       alternative treatment options have failed or cannot be used.
     * May be used for the treatment of plague or uncomplicated gonorrhea,
       in addition to other infections.
     * May be given as a preventive measure when people have been exposed
       to anthrax.
     * Effective against susceptible strains of a number of different
       gram-positive and gram-negative bacteria, for example:
       Staphylococcus aureus (methicillin-susceptible strains only), S.
       epidermidis (methicillin-susceptible isolates), S. pyogenes,
       Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa.
       Also effective against Enterobacter cloacae, Proteus mirabilis,
       Proteus vulgaris, Providencia stuartii, Morganella morganii and
       Citrobacter freundii.
     * Available as oral tablets, extended-release tablets, oral solution,
       eye drops and in an injectable form.
     * Generic ciprofloxacin is available.

Downsides

   If you are between the ages of 18 and 60, take no other medication or
   have no other medical conditions, side effects you are more likely to
   experience include:
     * Diarrhea, nausea, abnormal liver function tests, vomiting, and
       rash.
     * Tendonitis and tendon rupture, peripheral neuropathy (nerve pain in
       fingers and toes) and central nervous system effects (side effects
       that affect the brain including psychosis, convulsions,
       hallucinations) have been associated with ciprofloxacin and other
       fluoroquinolones. These side effects may be irreversible and can
       all occur together in some patients. May occur at any time after
       starting ciprofloxacin and in any patient. If any of these very
       severe side effects happen, ciprofloxacin should be discontinued
       immediately and all fluoroquinolones avoided in the future. The
       risk of tendonitis and tendon rupture is increased in people over
       the age of 60, in those taking corticosteroids, or with a history
       of organ transplant. Previous tendon disorders or strenuous
       activity may also increase risk.
     * May also cause anxiety, insomnia, psychotic reactions, nerve pain
       or a loss of feeling, ECG abnormalities, increase sensitivity to
       light and other effects.
     * Should not be given to children under the age of 18 years unless
       they have certain serious infections that cannot be treated with
       other antibiotics. Children are more susceptible to the adverse
       effects of ciprofloxacin.
     * May exacerbate muscle weakness in people with myasthenia gravis.
     * Serious, sometimes life-threatening, adverse reactions such as
       liver damage and allergic reactions have been occasionally
       reported.
     * May trigger seizures or increase the risk of having a seizure.
     * May disturb blood glucose levels in people with diabetes; careful
       monitoring of blood glucose is required.
     * May cause photosensitivity reactions and severe sunburn on exposed
       areas of skin.
     * Not suitable for people with myasthenia gravis, certain heart
       rhythm disturbances, or pediatric patients (unless being given to
       prevent inhalation anthrax or plague). Dosage may need the reducing
       in people with poor kidney function. May cause liver damage or
       heart rhythm disturbances.
     * May interact with some medications including antacids or
       preparations containing iron or zinc. Administer at least two hours
       before or two hours after these preparations.

   Notes: In general, seniors or children, people with certain medical
   conditions (such as liver or kidney problems, heart disease, diabetes,
   seizures) or people who take other medications are more at risk of
   developing a wider range of side effects. For a complete list of all
   side effects, [84]click here.

Bottom Line

   Ciprofloxacin is an effective antibiotic that treats a wide variety of
   infections; however, its use is restricted in children and it carries a
   risk of tendinitis or tendon rupture.

Tips

     * Oral ciprofloxacin tablets may be taken with or without food. Take
       exactly as directed and for the time period indicated to reduce the
       risk of resistant bacteria developing, unless side effects force
       early discontinuation.
     * Only use when prescribed by a doctor to treat infections caused by
       susceptible bacteria as improper use increases the chance of
       resistant bacteria developing.
     * Do not take ciprofloxacin within two hours of
       magnesium/aluminum-containing antacids or other products containing
       calcium, iron or zinc. Other products may also affect absorption
       (check product information).
     * Avoid administration of ciprofloxacin with dairy products (eg, milk
       or yogurt) or calcium-fortified juices alone; however,
       ciprofloxacin may be taken with meals that contain calcium.
     * Protect yourself from sunlight and avoid excessive exposure to the
       sun when taking ciprofloxacin. Wear sunblock when outdoors.
     * Keep well hydrated when taking ciprofloxacin to avoid the formation
       of highly concentrated urine and crystal formation.
     * Discontinue ciprofloxacin immediately if you experience tendon
       pain, swelling, inflammation or rupture and contact your healthcare
       provider.
     * Seek medical advice if chronic diarrhea develops during or
       following ciprofloxacin.
     * Discontinue ciprofloxacin immediately and contact your healthcare
       provider if you experience pain, tingling, or numbness in your
       fingers and toes; or any central nervous system effects (such as
       paranoia, depression, hallucinations); a severe rash; jaundice
       (skin yellowing); a change in your heartbeat; or any sign of an
       allergic reaction.
     * Do not drive or operate machinery if ciprofloxacin makes you feel
       dizzy or tired. Avoid alcohol.

Response and Effectiveness

     * Peak concentrations of ciprofloxacin are reached one to two hours
       after dosing; however, it may take up to 48 hours before
       infection-related symptoms start to abate.

References