Ciprofloxacin Antibiotic

CIPROFLOXACIN
“Success In Life Is A Result Of Decision. Failure In
Life Is A Result Of Decision”
Group: WinnerzKlub Inc.
Year: 2019

What are Fluoroquinolones?
 The fluoroquinolones are synthetic, broad-
spectrum agents with bactericidal activity.
 Examples include: ciprofloxacin,
moxifloxacin, & norfloxacin & ofloxacin.
 The newer oral quinolones provide an
alternative to β-lactams in the treatment of
community acquired lower respiratory
infections.
 Related structurally to Nalidixic acid.

(cont’d):
 Inhibitors of bacterial DNA synthesis-
quinolones
◦ Inhibits cytochrome P450 (CYP₁A₂)
 Unfortunately, bacterial resistance to
quinolones is increasing world-wide, &
appropriate use is needed to extend
their clinical use.

Bacterial resistance:
Year Resistance
1987 Ciprofloxacin-resistant Escherichia coli (30-40%)
2007/2008 Ciprofloxacin-resistant Neisseria meningitidis reported in
USA
•Enterobacteria
•Salmonella spp
•Staphylococcus aureus
•Vibrio cholerae

Ciprofloxacin:
 Is an example of a fluoroquinolone.
 Is not ototoxic.
 Ciprofloxacin & moxifloxacin are the
only quinolones available for
parenteral use.
 Used in ocular infections.
 Metabolized in liver and highly
dependent on kidneys for excretion.

Mechanism of action:
 Interfere with bacterial topoisomerase
II (DNA gyrase) & topoisomerase IV.
◦ the enzymes involved in the supercoiling
of DNA that is necessary for the
duplication, transcription & repair of
bacterial DNA.

PARAMETERS:
 Oral bioavailability is 50-70%.
 Half-life: 4hours
 May be used for lower UTIs.
 Usually administered in dosage of
500ml twice daily.
 NB: Avoid in childhood and pregnancy
& in pts. taking corticosteroids.
◦ Should not be used in pts. with tendonitis.

ACTIONS:
 Ciprofloxacin ear drops (0.3%) & eye
drops for severe conjunctivitis & bacterial
keratitis.
 Useful in gram (-)ve septicaemia, skin &
bone infections, urinary & respiratory
tract infections, some sexually
transmitted diseases such as gonorrhea
& in severe cases of travelers' diarrhea.
 As alternative (single dose) in
meningococcal meningitis

DRUG INTERACTIONS:
DRUG POSSIBLE EFFECTS & MANAGEMENT
Antacids,
ferrous sulfate
or sucralfate
May decrease absorption of ciprofloxacin, reducing
drug effectiveness. Administer quinolone at least 2hrs
before these medications.
Theophylline &
other xanthines
Ciprofloxacin & norfloxacin may inhibit the
theophylline metabolism, resulting in increased
theophylline plasma concentration & toxicity. Monitor
theophylline plasma concentration closely, as dosage
adjustments may be required.
Thyroxine Decreases absorption of thyroxine from GIT. A 4hrs
interval with administration of thyroxine.
Iron Forms complexes with iron, reducing overall
bioavailability

Side Effects:
 Gastric disturbances
 Photosensitive rashes
 Occasional neurotoxicity

Sa Oji:
 Sources:
◦ Pharmacology for Health Professionals,
4th Ed., B.Bryant & K.Knights.
◦ Clinical Medicine, 8th Ed., Kumar and
Clarks.

Ciprofloxacin Antibiotic

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Ciprofloxacin Antibiotic