CIPROFLOXACIN

Most potent first generation FQ
Broad spectrum
Spectrum: Highly susceptible bacteria are E.coli, K. pneumonae, Enterobacter, S. typhi, Shigella, proteus, N. gonorrhoea, N. meningitidis, H. influenzae, H.ducreyi, C. jejuni, Y. enterocolitica, V. cholerae
Moderately susceptible are P. aeruginosa, S. aureus, S. epidermidis, Legionella, Brucella, Listeria, B. anthracis & M. tuberculosis
Remarkable microbiological feature of FQ are:
Rapidly bactericidal activity & high potency
Long postantibiotic effect
Low chances of resistance
Protective intestinal streptococci & anaerobes are spared
Active against many beta lactam & aminoglycoside resistant bacteria
Less active at acidic pH
PK: absorbed orally, high tissue penetration is most important feature, conc. In lung, sputum, muscle, bone, prostate & phagocyte exceed that in plasma but CSF levels are lower, excreted in urine, urinary & biliary conc. Are higher than plasma
ADR:

TGI upset tendonitis & Tendon rupture: few cases have been reported. FQ caused cartilage damage in immature pups. FQ are C/I in children & during pregnancy
CNS: seizures occur at high dose d/t GABA antagonistic action
Hypersensitivity Rx:
INTERACTIONS:
Ciprofloxacin is cytochrome enzyme inhibitor, so plasma conc. of theofylline, warfarin are increased
NSAIDS may cause seizures CNS toxicity
USES:
UTI
Typhoid
Bone, soft tissue, gynecological & wound infection
Respiratory infections
Gonorrhea
Chancroid
Bacterial gastroenteritis
Gram negative septicemias
Meningitis
Tuberculosis
Prophylaxis
Conjunctivitis