Cipro (also ciprofloxacin) represents an antimicrobial broad-spectrum antibiotic of fluoroquinolone type. The drug inhibits DNA gyrase enzyme bacteria disrupted resulting DNA replication and synthesis of cellular proteins of bacteria.
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Cipro acts as proliferating microorganisms, and the rest are in phase. By Cipro susceptible Gram-negative aerobic bacteria: enterobacteria (E.coli, Salmonellaspp., Shigellaspp., Citrobacterspp., Klebsiellaspp., Edwardsiellatarda, Enterobacterspp., Proteusmirabilis, Proteusvulgaris, Serratiamarcescens, Hafniaalvei, Providenciaspp., Morganellamorganii, Vibriospp., Yersiniaspp.), other Gram-negative bacteria (Haemophilusspp., Pseudomonasaeruginosa, Pseudomonasshigelloides, Campilobacterjeiuni, Neisseria, spp.); some intracellular pathogens: Legionellapneumophila, Brucellaspp., Chlamydiatrachomatis, Listeriamonocytogenes, Mycobacteriumtuberculosis, Mycobacteriumkansasii, Mycobacteriumaviumintracellulare. Also sensitive to Cipro gram positive aerobic bacteria: Staphylococcusspp. (S.aureus, S.hominis, S.saprophyticus), Streptococcusspp. (St. pyogenes, St.agalactiae), Streptococcus pneumoniae, Enterococcus faeclis moderate, Corinebacterium spp., Bacteroides fragilis, Pseudomonas maltophilia, Ureaplasma urealyticum, Clostridium difcile, Nocardia asteroids.
If ingestion, especially on an empty stomach, Cipro is well absorbed from the gastrointestinal tract. Peak concentrations in plasma is 1-2 hours after ingestion.
The volume of distribution in the body is 2-3.5 l / kg. In cerebrospinal fluid the drug in a small quantity, where its concentration is 6-10 % of that of the serum.
High drug concentrations observed in bile, lungs, kidneys, liver, gall bladder, uterus, seminal fluid, prostatic tissue, tonsils, endometrium, fallopian tubes and ovaries. The concentration of drug in these tissues than in the serum. Cipro is also well into the bone, ocular fluid, bronchial secretions, saliva, skin, muscle, pleura ,peritoneum, lymph.
Developmental Cipro concentration in blood neutrophils 2-7 times higher than in serum.
The degree of binding of Cipro to plasma proteins is 30%. The half – about 4 hours Patients with renal function unchanged half-life increases. The main way of Cipro excretion from the body – the kidneys. The urine output of 50-70 %. From 15 to 30 % is excreted in the feces. Patients with severe renal insufficiency (creatinine clearance below 20 ml/min/1 73 m2) should be administered half of the daily dose.
Used in infections caused by organisms susceptible to the drug:
respiratory tract infections (pneumonia, but pneumococcal, acute and chronic bronchitis, bronchiectasis, exacerbations in patients with cystic fibrosis);
ENT (otitis media, sinusitis, mastoiditis, tonsillitis, pharyngitis)
pelvic infections (cystitis, pyelonephritis, adnexitis, endometritis, oophoritis, tubular abscess, pelvic peritonitis, prostate);
abdominal and hepatobiliary infections (peritonitis, intra-abdominal abscesses, cholecystitis, cholangitis);
bones and joints (osteomyelitis, septic arthritis);
skin and soft tissue (infected ulcers, wounds, burns, abscesses, cellulitis, an infection of the external auditory meatus);
STD (gonorrhea, chancroid, chlamydia);
severe systemic infections (sepsis, infections in neutropenic patients);
infectious diarrhea (pathogens are strains of E. coli and Campylobacter jejuni);
prevention of infection in surgical interventions (in urology, gastroenterology, orthopedics).
The drug is indicated for the treatment of infections in cancer patients.
Tablets are taken on an empty stomach with plenty of water.
Cipro dose depends on the severity of the disease, the type of infection, body condition, age, weight and kidney function in the patient.
In severe infections, complicated, and depending on the pathogen (for example, when the infection caused by P. Aeruginosa), the daily dose may be increased up to 750 mg three times.
In acute gonorrhea enough single oral administration of 250-500 mg.
Urinary system: crystalluria, glomerulonephritis, dysuria, polyuria, albuminuria, hematuria, transient increase in serum creatinine.
Hematopoietic system: eosinophilia, leukopenia, neutropenia.
Allergic reactions: itching, urticaria, angioedema, Stevens-Johnson syndrome, arthralgia.
From the laboratory parameters: increase in liver transaminases, alkaline phosphatase, bilirubin, increasing concentrations of urea, creatinine.
childhood and adolescence to 18 years;
Hypersensitivity to Cipro or other drugs of fluoroquinolones.
Patients receiving Cipro should be careful when driving and other activities potentially hazardous activities that require attention.
The specific antidote is unknown. Must carefully monitor the condition of the patient, gastric lavage, make routine emergency measures, to ensure adequate fluid intake. With hemo-and peritoneal dialysis can be derived only minor (less than 10 %) amount of the drug.