Cipro, Aug.7

Information about the antibiotic prescribed for urinary tract infections, prostatitis, cystitis, bacterial infections, and infectious diarrhea.

19 years ago, Bayer Pharmaceuticals introduced the first broad spectrum oral fluoroquinolone, Ciprofloxacin (Cipro®, Ciproxin®). The intravenous formulation of Cipro was introduced in 1991. Cipro is available in more than 100 countries and has been approved for the treatment of 14 types of infections, especially urinary tract infections (UTIs) such as acute uncomplicated cystitis, pyelonephritis, and chronic bacterial prostatitis.

Cipro is considered the "gold standard" therapy for many types of Gram Negative infections, including Pseudomonas aeruginosa, and has maintained a high level of activity against Escherichia coli compared to other agents used for UTIs.Cipro's 19 year history includes:

Extensively studied and documented in over 37,000 publications
More than 100,000 patients enrolled in double blind trials around the world
Prescribed for more than 340 million patients worldwide

Extensive and unprecedented safety profile

The major adverse effect seen with use is gastrointestinal irritation, common with many antibiotics. Because of its general safety, potency and broad spectrum activity, ciprofloxacin was initially reserved as a drug of last resort for use on difficult and antibiotic-resistant infections. As with any antibiotic, however, increasing time and usage has led to an increase in ciprofloxacin-resistant infections, mainly in the hospital setting. Also implicated in the rise of resistant bacteria is the use of lower-cost, less potent fluoroquinolones, and the widespread addition of ciprofloxacin and other antibiotics to the feed of farm animals, which leads to greater and more rapid weight gain, for reasons which are not clear.
In cell culture it is used to treat infection with mycoplasma.


It is used in lower respiratory infections (pneumonias), urinary tract infections, STDs, septicemias, Legionellosis and atypical Mycobacterioses. Dosage in respiratory infections is 500-1500 mg a day in 2 doses.
It is contraindicated in children, pregnancy, and in patients with epilepsy. Dose adjustment or avoidance may be necessary with liver or renal failure.
Ciprofloxacin can cause photosensitivity reactions and can elevate plasma theophylline levels to toxic values. It can also cause constipation and sensitivity to caffeine. Ciprofloxacin is also known to cause swelling of certain joints and cartilage.

Quercetin, a flavonoid occasionally used as a dietary supplement may interact with fluoroquinolones, as quercetin competitively binds to bacterial DNA gyrase. Some foods such as garlic and apples contain high levels of quercetin. Whether this inhibits or enhances the effect of fluoroquinolones is not entirely clear.


Metal cations such as aluminium, magnesium, calcium, ferrous sulphate, and zinc are thought to form chelation complexes with fluoroquinolone antibiotics and prevent the drugs from being absorbed. Because of this, avoid taking ciprofloxacin with antacids which contain aluminium, magnesium or calcium. Sucralfate, which has a high aluminium content, also reduces the bioavailability of ciprofloxacin to approximately 4%Ciprofloxacin may be taken with meals or on an empty stomach. Ciprofloxacin should not be taken with dairy products or calcium-fortified juices alone, but may be taken with a meal that contains these products.

Heavy exercise is discouraged, as achilles tendon rupture has been reported in patients taking ciprofloxacin. Achilles tendon rupture due to ciprofloxacin use is typically associated with renal failure.