General
Description & Use
Ciprofloxacin
is a synthetic antibiotic, originally manufactured and sold by
Bayer. Generic versions are now available (Ciplox, Cifran, Lucipro,
Ciproxin by Lupin, Ranbaxy and Cipla) but Bayer continues sale
under the brand names Cipro, Ciproxin and Ciprobay belonging to
a group called fluoroquinolones. Ciprofloxacin is bactericidal.
Its mode of action depends upon blocking bacterial DNA replication
by binding itself to an enzyme called DNA gyrase, thereby inhibiting
the unwinding of bacterial chromosomal DNA during and after the
replication.
Ciprofloxacin is available for oral, parenteral and topical use.
It has a variety of indications, including lower respiratory tract
infections (such as pneumonia and acute bronchitis), urinary tract
infections, several STDs, skin and soft tissue infections, septicemia,
legionellosis, and anthrax.
Uses
Ciprofloxacin is a broad-spectrum antibiotic that is active against
both Gram-positive and Gram-negative bacteria. It is used to treat
certain infections caused by bacteria, such as pneumonia; gonorrhea;
infectious diarrhea; typhoid fever; anthrax; and bone, joint,
skin, and urinary tract infections. It functions by inhibiting
DNA gyrase, a type II topoisomerase, which is an enzyme necessary
to separate replicated DNA, thereby inhibiting cell division.
It is effective against:
Enterobacteriaceae, Vibrio, Haemophilus influenzae, Haemophilus
ducreyi, Neisseria gonorrhoeae (widespread resistance to ciprofloxacin
limits its usefulness in treating N. gonorrhea infections), Neisseria
meningitidis, Moraxella catarrhalis, Brucella, Campylobacter,
Mycobacterium intracellulare, Legionella sp., Pseudomonas aeruginosa,
Bacillus anthracis, Escherichia coli, Staphylococcus aureus (MRSA).
Weak activity against:
Streptococcus pneumoniae, Chlamydia trachomatis, Chlamydia pneumoniae
No activity against:
Bacteroides, Burkholderia cepacia, Enterococcus faecium, Ureaplasma
urealyticum, Streptococcus pyogenes and others.
Ciprofloxacin
ophthalmic solution is used to treat bacterial infections of the
eye including conjunctivitis (pinkeye; infection of the membrane
that covers the outside of the eyeball and the inside of the eyelid)
and corneal ulcers (infection and loss of tissue in the clear
front part of the eye).
Use
against chlamydia and mycoplasma infections is now contraindicated;
ciprofloxacin appears to be ineffective against these organisms,
merely stopping their growth (and allowing them to resume growth
after the antibiotic is withdrawn) rather than killing them.
Adverse
effects
Manufacturer-funded studies report that approximately 9% of patients
taking the medication experience side effects ranging from mild
to moderate, with the vast majority of those relating to metabolic-nutritional
problems and the central nervous system. Compared to other fluoroquinolones
the incidence and severity of side effects from ciprofloxacin
is low; the major adverse effect most often seen with its use
is gastrointestinal irritation, as is common with many antibiotics.
Because of its general safety, potency and broad spectrum of activity,
ciprofloxacin was initially reserved as a drug of last resort
for use against difficult-to-treat and antibiotic-resistant infections.
As with any antibiotic, however, increasing time and use has led
to an increase in ciprofloxacin-resistant infections, mainly in
the hospital setting. Also implicated in the rise of resistant
bacteria is the use of lower-cost, less potent fluoroquinolones,
and the widespread addition of ciprofloxacin and other antibiotics
to the feed of farm animals, which leads to greater and more rapid
weight gain for unclear reasons.
Ciprofloxacin can cause photosensitivity reactions and can elevate
plasma theophylline levels to toxic values. It can also cause
constipation and sensitivity to caffeine. Ciprofloxacin is also
known to cause swelling of joints and cartilage, and cause tendon
rupture and chronic pain.
