Ciprofloxacin tablets are indicated in adults and pediatric patients from birth to 17 years of age for inhalational anthrax (post-exposure) to reduce the incidence or progression of disease following exposure to aerosolized Bacillus anthracis.
Full Answer
When is ciprofloxacin not a first-line empirical therapy for respiratory tract infections?
For respiratory tract infections, ciprofloxacin should not be a first-line empirical therapy if penicillin-susceptible Streptococcus pneumoniaeis the primary pathogen. Ciprofloxacin is an appropriate treatment option in patients with mixed infections or patients with predisposing factors for Gram-negative infections.
What is ciprofloxacin used for?
Ciprofloxacin is an antibiotic agent in the fluoroquinolone class used to treat bacterial infections such as urinary tract infections and pneumonia.
What should be included in a patient education about ciprofloxacin?
Identify the mechanism of action of ciprofloxacin. Summarize the types of infections and bacterial coverage of ciprofloxacin, where it would be effective in a target population. Recognize the adverse events associated with ciprofloxacin therapy.
What is the indication of ciprofloxacin for inhalational anthrax?
Ciprofloxacin is indicated in adults and pediatric patients from birth to 17 years of age for inhalational anthrax (post-exposure) to reduce the incidence or progression of disease following exposure to aerosolized Bacillus anthracis.
What bacteria is ciprofloxacin used to treat?
Of the fluoroquinolone class, ciprofloxacin is the most potent against gram-negative bacilli bacteria (notably, the Enterobacteriaceae such as Escherichia coli, Salmonella spp., Shigella spp., and Neisseria). [3] Ciprofloxacin also has effectiveness against some gram-positive bacteria.
What is the indication for ciprofloxacin?
Hide table of contentsIndicationsInfections of the upper respiratory tractAcute exacerbation of chronic sinusitisChronic suppurative otitis mediaMalignant external otitisUrinary tract infections (see section 4.4)Uncomplicated cystitis21 more rows
What is the target of the drug ciprofloxacin?
Ciprofloxacin is a bactericidal antibiotic of the fluoroquinolone drug class. It inhibits DNA replication by inhibiting bacterial DNA topoisomerase and DNA-gyrase.
Can ciprofloxacin treat staphylococcus aureus?
Ciprofloxacin appears to be safe and effective for a wide variety of clinical infections. In-vitro and animal studies point to high cure rates for both methicillin-sensitive and methicillin-resistant Staphylococcus aureus infections.
Is Cipro effective against E coli?
Ciprofloxacin is still considered as a better choice against infections caused by E. coli, S. aureus, S.
Can ciprofloxacin be used to treat gonorrhea?
Even though WHO and the US Centers for Disease Control recommend a single-dose of 500 mg ciprofloxacin to treat uncomplicated gonorrhea, the findings of the international studies suggest that a single dose of 250 mg ciprofloxacin effectively treats uncomplicated gonorrhea, even extragenital sites of infection.
Does Cipro treat anaerobic bacteria?
The first generation of fluoroquinolones such as ciprofloxacin and ofloxacin are inactive against most anaerobic bacteria. However, some broad-spectrum quinolones, which have recently become clinically available or are under active development, have significant antianaerobic activity.
Does Cipro cover Gram positive bacteria?
Ciprofloxacin, a second generation broad spectrum fluoroquinolone, is active against both Gram-positive and Gram-negative bacteria.
What antibiotics treat Gram-negative bacilli?
Gram-negative bacteria can acquire resistance to one or more important classes of antibiotics, which usually prove effective against them such as: Ureidopenicillins (piperacillin) Third- or fourth-generation cephalosporins (cefotaxime, ceftazidime) Carbapenems (imipenem, meropenem)
Does ciprofloxacin cover streptococcus?
Ciprofloxacin, the first fluoroquinolone to be used to treat lower respiratory tract infections (LRTI), demonstrates poor potency against Streptococcus pneumoniae, and its use has been associated with the emergence of resistance.
Does Cipro treat staph epidermidis?
Ciprofloxacin has limited usefulness against MR Staphylococcus aureus but can be still used to treat Staphylococcus epidermidis infections.
Does Cipro treat Pseudomonas aeruginosa?
Ciprofloxacin was well tolerated. This new quinolone seems to be suitable for single drug treatment of Pseudomonas aeruginosa infections in patients with normal host defense mechanisms, while its therapeutic potential in compromised hosts requires further evaluation.
When to take Ciprofloxacin for inhalational anthrax?
Inhalational Anthrax (Post-Exposure) Ciprofloxacin tablets are indicated in adults and pediatric patients from birth to 17 years of age for inhalational anthrax (post-exposure) to reduce the incidence or progression of disease following exposure to aerosolized Bacillus anthracis.
What should be done before Ciprofloxacin treatment?
If anaerobic organisms are suspected of contributing to the infection, appropriate therapy should be administered. Appropriate culture and susceptibility tests should be performed before treatment in order to isolate and identify organisms causing infection and to determine their susceptibility to Ciprofloxacin.
How long does Ciprofloxacin last?
The duration of therapy was 10 to 21 days (mean duration of treatment was 11 days with a range of 1 to 88 days). The primary objective of the study was to assess musculoskeletal and neurological safety.
What is Ciprofloxacin used for?
Ciprofloxacin tablets are indicated in adult patients for treatment of complicated intra-abdominal infections (used in combination with metronidazole) caused by Escherichia coli, Pseudomonas aeruginosa, Proteus mirabilis, Klebsiella pneumoniae, or Bacteroides fragilis.
What is the mechanism of action of Ciprofloxacin?
Mechanism of Action#N#The bactericidal action of Ciprofloxacin results from inhibition of the enzymes topoisomerase II (DNA gyrase) and topoisomerase IV (both Type II topoisomerases), which are required for bacterial DNA replication, transcription, repair, and recombination. #N#Mechanism of Resistance#N#The mechanism of action of fluoroquinolones, including Ciprofloxacin, is different from that of penicillins, cephalosporins, aminoglycosides, macrolides, and tetracyclines; therefore, microorganisms resistant to these classes of drugs may be susceptible to Ciprofloxacin. Resistance to fluoroquinolones occurs primarily by either mutations in the DNA gyrases, decreased outer membrane permeability, or drug efflux. In vitro resistance to Ciprofloxacin develops slowly by multiple step mutations. Resistance to Ciprofloxacin due to spontaneous mutations occurs at a general frequency of between < 10 -9 to 1x10 -6 .#N#Cross Resistance#N#There is no known cross-resistance between Ciprofloxacin and other classes of antimicrobials.#N#Ciprofloxacin has been shown to be active against most isolates of the following bacteria, both in vitro and in clinical infections [see Indications and Usage (1) ].#N#Gram-positive bacteria#N#Bacillus anthracis#N#Enterococcus faecalis#N#Staphylococcus aureus (methicillin-susceptible isolates only)#N#Staphylococcus epidermidis (methicillin-susceptible isolates only)#N#Staphylococcus saprophyticus#N#Streptococcus pneumoniae#N#Streptococcus pyogenes#N#Gram-negative bacteria#N#Campylobacter jejuni#N#Citrobacter koseri#N#Citrobacter freundii#N#Enterobacter cloacae#N#Escherichia coli#N#Haemophilus influenzae#N#Haemophilus parainfluenzae#N#Klebsiella pneumoniae#N#Moraxella catarrhalis#N#Morganella morganii#N#Neisseria gonorrhoeae#N#Proteus mirabilis#N#Proteus vulgaris#N#Providencia rettgeri#N#Providencia stuartii#N#Pseudomonas aeruginosa#N#Salmonella typhi#N#Serratia marcescens#N#Shigella boydii#N#Shigella dysenteriae#N#Shigella flexneri#N#Shigella sonnei#N#Yersinia pestis#N#The following in vitro data are available, but their clinical significance is unknown. At least 90 percent of the following bacteria exhibit an in vitro minimum inhibitory concentration (MIC) less than or equal to the susceptible breakpoint for Ciprofloxacin (≤1 mcg/mL). However, the efficacy of Ciprofloxacin in treating clinical infections due to these bacteria has not been established in adequate and well-controlled clinical trials.#N#Gram-positive bacteria#N#Staphylococcus haemolyticus (methicillin-susceptible isolates only)
How much bioavailability is Ciprofloxacin?
Absorption#N#The absolute bioavailability of Ciprofloxacin when given as an oral tablet is approximately 70% with no substantial loss by first pass metabolism. Ciprofloxacin maximum serum concentrations (C max) and area under the curve (AUC) are shown in the chart for the 250 mg to 1000 mg dose range (Table 12).
Does Ciprofloxacin help with gonorrhea?
Ciprofloxacin has not been shown to be effective in the treatment of syphilis. Antimicrobial agents used in high dose for short periods of time to treat gonorrhea may mask or delay the symptoms of incuba ting syphilis . Perform a serologic test for syphilis in all patients with gonorrhea at the time of diagnosis. Perform follow-up serologic test for syphilis three months after Ciprofloxacin treatment.
Usual Adult Dose for Inhalation Bacillus anthracis
IV: 400 mg IV every 12 hours Oral: 500 mg orally every 12 hours Duration of Therapy: 60 days Comments: -Therapy should be started as soon as possible after suspected/confirmed exposure. -Indication based on efficacy studies in animals. Use: For treatment of inhalational anthrax (postexposure) to reduce incidence/progression of disease after exposure to aerosolized Bacillus anthracis US CDC Recommendations: -IV: 400 mg IV every 8 hours -Oral: 500 mg orally every 12 hours Duration of Therapy: Postexposure prophylaxis for B anthracis infection: 60 days Systemic anthrax: -With possible/confirmed meningitis: At least 2 to 3 weeks or until patient is clinically stable (whichever is longer) -When meningitis has been excluded: At least 2 weeks or until patient is clinically stable (whichever is longer) -Patients exposed to aerosolized spores will require prophylaxis to complete an antimicrobial regimen of 60 days from onset of illness. Cutaneous anthrax without systemic involvement: -Bioterrorism-related cases: 60 days -Naturally acquired cases: 7 to 10 days Comments: -The preferred drug for pregnant women -Recommended as a preferred oral drug for postexposure prophylaxis and for the treatment of cutaneous anthrax without systemic involvement -Recommended as the preferred IV drug for the treatment of systemic anthrax -Recommended for all strains (regardless of penicillin susceptibility or if susceptibility unknown) when used for postexposure prophylaxis, systemic anthrax when meningitis has been excluded, or cutaneous anthrax without systemic involvement -Recommended for use with a protein synthesis inhibitor when used for systemic anthrax; the addition of a bactericidal beta-lactam is recommended with possible/confirmed meningitis. -Systemic anthrax includes anthrax meningitis, inhalation anthrax, injection anthrax, gastrointestinal anthrax, and cutaneous anthrax with systemic involvement, extensive edema, or lesions of the head or neck. -Current guidelines should be consulted for additional information..
Usual Adult Dose for Cutaneous Bacillus anthracis
IV: 400 mg IV every 12 hours Oral: 500 mg orally every 12 hours Duration of Therapy: 60 days Comments: -Therapy should be started as soon as possible after suspected/confirmed exposure. -Indication based on efficacy studies in animals. Use: For treatment of inhalational anthrax (postexposure) to reduce incidence/progression of disease after exposure to aerosolized Bacillus anthracis US CDC Recommendations: -IV: 400 mg IV every 8 hours -Oral: 500 mg orally every 12 hours Duration of Therapy: Postexposure prophylaxis for B anthracis infection: 60 days Systemic anthrax: -With possible/confirmed meningitis: At least 2 to 3 weeks or until patient is clinically stable (whichever is longer) -When meningitis has been excluded: At least 2 weeks or until patient is clinically stable (whichever is longer) -Patients exposed to aerosolized spores will require prophylaxis to complete an antimicrobial regimen of 60 days from onset of illness. Cutaneous anthrax without systemic involvement: -Bioterrorism-related cases: 60 days -Naturally acquired cases: 7 to 10 days Comments: -The preferred drug for pregnant women -Recommended as a preferred oral drug for postexposure prophylaxis and for the treatment of cutaneous anthrax without systemic involvement -Recommended as the preferred IV drug for the treatment of systemic anthrax -Recommended for all strains (regardless of penicillin susceptibility or if susceptibility unknown) when used for postexposure prophylaxis, systemic anthrax when meningitis has been excluded, or cutaneous anthrax without systemic involvement -Recommended for use with a protein synthesis inhibitor when used for systemic anthrax; the addition of a bactericidal beta-lactam is recommended with possible/confirmed meningitis. -Systemic anthrax includes anthrax meningitis, inhalation anthrax, injection anthrax, gastrointestinal anthrax, and cutaneous anthrax with systemic involvement, extensive edema, or lesions of the head or neck. -Current guidelines should be consulted for additional information..
Usual Adult Dose for Anthrax Prophylaxis
IV: 400 mg IV every 12 hours Oral: 500 mg orally every 12 hours Duration of Therapy: 60 days Comments: -Therapy should be started as soon as possible after suspected/confirmed exposure. -Indication based on efficacy studies in animals. Use: For treatment of inhalational anthrax (postexposure) to reduce incidence/progression of disease after exposure to aerosolized Bacillus anthracis US CDC Recommendations: -IV: 400 mg IV every 8 hours -Oral: 500 mg orally every 12 hours Duration of Therapy: Postexposure prophylaxis for B anthracis infection: 60 days Systemic anthrax: -With possible/confirmed meningitis: At least 2 to 3 weeks or until patient is clinically stable (whichever is longer) -When meningitis has been excluded: At least 2 weeks or until patient is clinically stable (whichever is longer) -Patients exposed to aerosolized spores will require prophylaxis to complete an antimicrobial regimen of 60 days from onset of illness. Cutaneous anthrax without systemic involvement: -Bioterrorism-related cases: 60 days -Naturally acquired cases: 7 to 10 days Comments: -The preferred drug for pregnant women -Recommended as a preferred oral drug for postexposure prophylaxis and for the treatment of cutaneous anthrax without systemic involvement -Recommended as the preferred IV drug for the treatment of systemic anthrax -Recommended for all strains (regardless of penicillin susceptibility or if susceptibility unknown) when used for postexposure prophylaxis, systemic anthrax when meningitis has been excluded, or cutaneous anthrax without systemic involvement -Recommended for use with a protein synthesis inhibitor when used for systemic anthrax; the addition of a bactericidal beta-lactam is recommended with possible/confirmed meningitis. -Systemic anthrax includes anthrax meningitis, inhalation anthrax, injection anthrax, gastrointestinal anthrax, and cutaneous anthrax with systemic involvement, extensive edema, or lesions of the head or neck. -Current guidelines should be consulted for additional information..
Usual Adult Dose for Febrile Neutropenia
Empirical therapy: 400 mg IV every 8 hours for 7 to 14 days Comments: -Recommended for use with piperacillin (50 mg/kg IV every 4 hours) Use: In combination with piperacillin, for the treatment of febrile neutropenia
Usual Adult Dose for Intraabdominal Infection
IV: 400 mg IV every 12 hours Oral: 500 mg orally every 12 hours Duration of Therapy: 7 to 14 days Use: In combination with metronidazole, for treatment of complicated intraabdominal infections due to Escherichia coli, Pseudomonas aeruginosa, Proteus mirabilis, Klebsiella pneumoniae, or Bacteroides fragilis
Usual Adult Dose for Joint Infection
IV: 400 mg IV every 8 to 12 hours Oral: 500 to 750 mg orally every 12 hours Duration of Therapy: 4 to 8 weeks Uses: For treatment of bone and joint infections due to Enterobacter cloacae, Serratia marcescens, or P aeruginosa
Usual Adult Dose for Osteomyelitis
IV: 400 mg IV every 8 to 12 hours Oral: 500 to 750 mg orally every 12 hours Duration of Therapy: 4 to 8 weeks Uses: For treatment of bone and joint infections due to Enterobacter cloacae, Serratia marcescens, or P aeruginosa
Proper Use
Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.
Dosing
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
Missed Dose
If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
