Treatmentof bacterial infections in many different parts of the body{ciprofloxacin}

Ciprofloxacin  is a broad-spectrum synthetic quinolone antibacterial agent. h is active against most of the gram-negative aerobic barteria like Enterobacteriaceas & Pseudomonas aeruginosa and gram positive aerobic bacteria including penicillinase producing, penicillinase non-producing and Methicillin-resistant Staphylococci. The bactericidal action of Ciprofloxacin results from interfering with the enzyme DNA gyrase.

Indications

Ciprofloxacin is indicated for the management of single or mixed infections caused by two or more susceptible mirooraganisms. It can also be used against infections caused by organisms resistant to other antibiotics. Ciprofloxacin is indicated for the treatment of the following infections.

Gastrointestinal tract infection: Typhoid fever and infected diarrhoea. Urinary tract infection:

Complicated and uncomplicated urethritis, cystitis, pyelonephritis, prostatitis and epididymitis.

Respiratory tract infection: Pneumonia, acute and chronic bronchitis, cystic fibrosis, bronchiectasis and empyema. Skin and soft tissue infection: Wound infection, abscess, infected ulcer, cellulitis, infected burn, erysipelas and otitis externa. Severe systemic infection: Septicemia, bacteremia, infection in immunosuppressive patient with hematological or solid tumors. Biliary tract infection: Cholangitis, cholecystitis, empyema of the gall bladder. Eye, ear, nose and throat infection: Otitis media, sinusitis, mastoiditis and tonsillitis. Bone and joint infection: Osteomylitis and arthritis. Pelvic infection: Salpingitis, endometritis and pelvic inflammatory diseases. Abdominal infection: Peritonitis & infra-abdominal abscess. Gonorrhea: Urethral, rectal and pharyngeal gonorrhea caused by beta-lactate producing

organisms or organisms moderately sensitive to penicillin.

Dosage and administration

Adult: The usual adult dose is 250-750 mg 12 hourly. Usual dosage schedule Typhoid Fever: 500 mg 12 hourly 7-14 days

Infected Diarrhea: 500 mg 12 hourly 5-7 days

Chronic Salmonella Carriers: 500-750 mg 12 hourly 28 days Complicated UTI:

500 mg 12 hourly 3-5 days

Uncomplicated UTI: 250 mg 12 hourly 3-5 days

Respiratory Tract Infection: 500-750 mg 12 hourly 7-14 days Skin and Soft Tissue Infection: 500-750 mg

12 hourly 7-14 days Uncomplicated Gonorrhea: 250 mg single dose

Uncomplicated Gonorrhea: 250 mg single dose

Wound Infection: 500 mg 12 hourly 7-14 days

Bone and Joint Infection: 500-750 mg 12 hourly 7-14 days

Other Infection: 500.750 mg 12 hourly 7-14 days

Adolescent and Children: Generally not recommended but where the benefit is more than potential risk, the dose should be 10-30 mg/kg/day depending upon the severity of Infection, administered in two divided doses.

Side effects

Ciprofloxacin is generally well tolerated. Gastrointestinal disturbances like nausea, vomiting, diarrhea, dyspepsia and abdominal pain; CNS disturbances e.g. dizziness, drowsiness, headache, tiredness, confusion. convulsion, skin rashes, prurient and possible systemic reactions may occur. It has also been reported that joint pain, mild photo sensitivity may occur and liver enzyme, serum bilirubin, creation levels may increase slightly

after administration.

Precautions

Ciprofloxacin should be used with great caution it patient with a known history of epilepsy or other factors, which predispose to seizure and convulsion. Patients should be advised to take Clprofloxacin two hours after meal. Patients should be advised not to take Antacid containing aluminum or magnesium concomitantly or within two hours after dosing and also requested to drink plenty of water.

Pregnancy and lactation

Ciprofloxacin has been shown to cause arthropathy it immature annals and therefore its use during pregnancy is not yet recommended. It has been reported that Ciprofloxacin is secreted in milk during administration to nursing mother and is thus not also recommended yet.

Drug interactions

Concurrent administration of Ciprofloxacin with Theophyline and Caffeine may potentiate the adverse effects of theophyline and caffeine. Antacid containing aluminum or magnesium may decrease the bioavailablllty of Clprofloxacin. Quinolones, including Ciprofloxacin, have been reported to enhance the effects of the oral anticoagulant Warfarin or its derivatives.