Antibiotic Ciprofloxacin: which group of antibiotics belongs to, instructions for use, release forms, analogues

In 1983, the German pharmaceutical company Bayer introduced Ciprofloxacin, a synthetic antibiotic. The drug showed high activity against organisms that are immune to most antimicrobial agents. Despite its effectiveness, it requires a detailed study before use.

Composition and forms of antibiotic release

In pharmacies, Ciprofloxacin can be found as a concentrate or solution for infusion, a tool for instillation into the eyes and ears, and tablets.

The first form is a glass vial, which contains 100 mg of ciprofloxacin as an active substance, or an ampoule with a concentrate for further dilution with other compatible solutions. Additional components: injection water, lactic acid, edetate disodium, hydrochloric acid. It looks like a completely transparent or slightly cloudy liquid with a yellowish tint.

The second form is eye drops, ear drops. They have a high concentration of antibiotic - 3 mg / ml of solution. Appearance is similar.

The third form is large tablets with a volume of the main component of 250 mg, 500 mg and 750 mg. The main substance is the antibiotic ciprofloxacin.Auxiliary components: cellulose, croscarmellose, potato starch, hypromellose, polysorbate, titanium dioxide, silicon dioxide, magnesium stearate.

Less commonly used is an eye ointment based on this substance, intended for laying under the lower eyelid.

Which group of antibiotics belongs

According to the pharmacological index, ciprofloxacin is a representative of the group of quinolones or fluoroquinolones. The substance is actually close to antibiotics due to its synthetic origin (other antibacterial drugs are created from plant materials). Used since the 1960s to destroy bacteria that are resistant to most drugs.

Quinolones are classified into four generations. Substances of the first group (oxolinic, pipemidic, nalidixic acid) neutralize a small list of gram-negative bacteria. Second generation fluoroquinolones are effective in killing gram-negative microbes. The bactericidal properties of this group allowed the development of the drug Ciprofloxacin - eye and ear drops. The third and fourth generation are substances effective in eliminating diseases caused by anaerobic bacteria, intracellular pathogens, pneumococci, and gram-positive organisms.

Pharmacological properties and indications for use

The bactericidal effect of ciprofloxacin disrupts the production of DNA, the microbial cell loses its ability to multiply and soon dies. Foreign organisms do not develop immunity to the drug, therefore it is effective against bacteria resistant to penicillin, tetracycline, cephalosporin.

The most common bacteria vulnerable to ciprofloxacin:

• Escherichia coli or E. coli;
• Salmonella - the causative agent of salmonellosis, paratyphoid fever, typhoid fever;
• Klebsiella - a bacterium that causes pneumonia, meningitis, conjunctivitis, acute infections of the gastrointestinal tract and genitourinary system;
• Legionella pneumophila, manifested as legionellosis;
• Chlamydia trachomatis - causative agent of urogenital chlamydia;
• Mycobactérium tuberculósis or Koch's bacillus - the cause of tuberculosis;
• Mycobactérium kansasii, causing mycobacteriosis;
• Corynebacterium diphtheriae - cause of diphtheria;
• Staphylococcus - a genus of staphylococcus microbes, manifested as inflammation and suppuration in different tissues of a person;
• other enterobacteria and gram-negative organisms.

An antibiotic is indicated for such disorders in adults:

• microbial infection of the respiratory tract;
• pneumonia;
• inflammatory and purulent diseases of the joints, ligaments, bones, skin and muscle tissue;
• anthrax in pulmonary form;
• otitis media or complications of a similar disease of the outer ear;
• infectious diseases of the genitals, excretory systems;
• an exacerbation period with chronic sinusitis;
• gastrointestinal infections;
• inflammation and ulceration of the cornea of ​​the eyes.

It is used in the treatment of people under the age of 18 with a diagnosis of:

• bronchopulmonary diseases provoked by Pseudomonas aeruginosa - Pseudomonas aeruginosa;
• pyelonephritis, complications of infection of the excretory system;
• anthrax (during therapy and recovery period).

In other severe bacterial diseases in children, the doctor prescribes ciprofloxacin only if there is no alternative.

Instructions for use ciprofloxacin for children and adults

Ciprofloxacin is an antibiotic of synthetic origin, which, when illiterate combined with various drugs and an incorrectly defined dosage, negatively affects the body, up to poisoning or the manifestation of negative effects. The norm of the main substance is determined by the sensitivity of the pathogen bacteria to the drug, the form and severity of the disease, and the health of the kidneys. If the patient has not reached the age of 18, body weight affects the amount of medication taken.

In severe diseases or complications, a dose above the standard, but only as directed by a doctor, may be prescribed.Ciprofloxacin is also administered under the supervision of a doctor.

Ciprofloxacin in ampoules for injections

 

The drug is presented as a concentrate for dilution with other infusion solutions:

• ringer's solution (5%);
• sodium chloride (0.9%);
• fructose (10%);
• dextrose (10%);
• a combination of dextrose and sodium chloride solutions (5% and 0.225% or 0.45%, respectively).

Before use, it is necessary to pour the antibiotic concentrate to the drug indicated above to obtain a solution containing 2 mg of ciprofloxacin per 1 ml of liquid.

The resulting substance is administered intravenously for 30-60 minutes. The solution must be used immediately after preparation - the components are sensitive to light and may lose sterility. Do not pull the ampoule out of the box, do not mix under direct sunlight.

Single dose	Frequency of admission (number of procedures per day)	Indications
200 mg	2 times	uncomplicated diseases of the excretory system.
400 mg or 10 mg / kg body weight (for the treatment of childhood diseases)	2 times	• anthrax with lung damage; • diarrhea with microbial lesions of the digestive tract.
400 mg	2-3 times	• damage to the respiratory system; • severe forms of bacterial urogenital diseases.
400 mg or 10 mg per 1 kg of body weight (for children and adolescents)	3 times	Life-threatening diseases provoked by staphylococci, streptococci, pseudomonads (Pseudomonas aeruginosa): • lesions of the skin, bone and muscle tissue; •pneumonia; •septicemia; • Infectious relapses against cystic fibrosis.

You can not take more than 1200 mg of ciprofloxacin for adults, children - more than 800 mg.

Do not use ciprofloxacin solution with drugs incompatible with the antibiotic.

Manifestations of this may be the appearance of a precipitate, staining of the liquid in a different color, turbidity.

Ciprofloxacin injections are not done intramuscularly.

In pills

The dosage and duration of treatment is determined by the type of disease and pathogen.

Single dose (standard - 500 mg ciprofloxacin tablet)	The number of receptions per day	Indications
0.5-1 tablet	2 times	• uncomplicated form of cystitis.
1 tablet	1 time	• prevention of diseases provoked by meningococci; • cervicitis.
1 tablet	2 times	• complicated cystitis; • pyelonephritis; • digestive tract disorders caused by infection by bacteria; • preventive measures after contact with the anthrax carrier or direct treatment of the disease.
1-1.5 tablets	2 times	• severe pyelonephritis; •prostatitis; • chronic sinusitis and otitis media; • bacterial diseases of the skin, bones, muscles.
20 mg per 1 kg of body weight	2 times	• cystic fibrosis.
10-20 mg / kg	2 times	• pyelonephritis and other diseases of the urinary tract.

The maximum single dose is 1500 mg of ciprofloxacin.

Elderly patients are prescribed ciprofloxacin based on the severity of the disease and the condition of the excretory organs.

Tablets are recommended to be taken on an empty stomach for rapid absorption of the substance, but in general the use of the drug is not tied to food. The tool is washed down with 1-2 glasses of pure water.

Within 30-90 minutes after ingestion, dairy products, concentrated juices, water with the addition of minerals should not be consumed.

Eye and ear drops Ciprofloxacin

Ciprofloxacin eye drops, like ear drops, have a specific dosage regimen designed for specific diseases.

When expressing on the surface of the cornea, adhere to the following procedure:

• 1 day: the first 6 hours of therapy - 2 drops in the conjunctival sac every 15 minutes, the rest of the day - every 30 minutes;
• 2 day: 2 drops of solution every hour;
• 3 day and until the end of the course: 2 drops every 4 hours.

Standard treatment with Ciprofloxacin lasts 14 days, but the value varies, depending on the neglect of the disease.

With superficial eye lesions, the norm is 1-2 drops with an interval of 4 hours, with complex forms of these diseases - every 2 hours.

To reduce systemic absorption after instillation of the drug and to reduce the risk of side effects, it is recommended to close your eyes tightly for targeted exposure to the drug.

The dose for such diseases in children is the norm for adults. The antibiotic is used to treat conjunctivitis in infants up to 1 month (course - 4 days, apply three times a day).

For ear diseases, the standard norm for adults is 4 drops of the substance. The drug is instilled into a ear canal cleaned with a cotton swab or swab twice a day.

The duration of therapy is 5-10 days.

The dosage for children is 3 drops at the same intervals indicated above.

Before using the drug, it is necessary to lie on the side opposite to the affected ear. It is not recommended to move after instillation for 5-10 minutes.

Do not allow contamination of the dropper tip - do not touch the affected areas of the eye or auricle, other surfaces, tighten the cap tightly.

Infusion solution

The dosage of the solution is similar to the standards for ciprofloxacin in ampoules. The difference is that there is no need to breed an antibiotic. The standard concentration (2 mg / ml) is contained in the liquid in the vial.

A dropper is placed for 30-60 minutes, depending on the calculated dose (200 mg or 400 mg, respectively).

Ciprofloxacin during pregnancy and lactation

The effect of the antibiotic on the body of pregnant women and women who are breastfeeding is not well understood. Animal experiments demonstrate a negative effect on the joints of the fetus, so the use of the drug during these periods is prohibited.

Can I drink alcohol while taking the drug

Ethanol contained in alcoholic beverages reduces the effectiveness of the drug, loads the liver. Nausea, vomiting, weakness, decreased reaction rate, dull perception can be observed.

Ciprofloxacin cannot be combined with alcohol, especially for patients who drive a car or carry out activities that require a long concentration of attention.

Drug Interactions with Other Drugs

The combination of an antibiotic with some drugs leads to unpredictable consequences, but the reaction of Ciprofloxacin to such compounds has been practically established:

• vitamin K antagonists (decreased thrombin activity);
• phenytoin (the concentration of this substance in the blood increases or decreases with a parallel intake, the likelihood of an overdose of the drug increases);
• theophylline (dizziness, irritability, headaches, insomnia, cramps);
• probenecid (filtering function of the kidneys worsens, ciprofloxacin is more slowly excreted);
• cyclosporine (increased creatinine in plasma);
• hypoglycemic agents (enhancing their effect);
• tizanidine (possible lethargy, lowering blood pressure);
• ropinirole (theoretically - mental disorders, nervous disorders);
• methotrexate (increased amount of active substance in the body);
• lidocaine (reduced excretion rate of the substance, possibly enhancing the negative effects of ciprofloxacin).

When taking the indicated drugs, it is important to control the blood composition, the general condition of the patient. Reactions to the combined use of ciprofloxacin with other drugs have not been studied.

Contraindications, side effects and overdose

The drug should not be taken if you are hypersensitive to the active substance, other representatives of the fluoroquinolone group, or are allergic to auxiliary components.

Most often, patients complain of nausea, upset stools, rashes on the skin, but in medical practice, such effects have been recorded that affect other organs:

• nervous system - dizziness, headache, irritability;
• mental health - anxiety, excitability;
• musculoskeletal system - “breaking” in muscles, bones, joints;
• excretory system - impaired renal function;
• metabolic function of the body - anorexia;
• blood formation and activity of lymphocytes - eosinophilia.

Less often, the temperature rises, lethargy, weakness, and fatigue are felt.

When using 12 g of ciprofloxacin, symptoms characteristic of moderate poisoning were observed. When taking 16 g of an antibiotic, kidney failure develops.

Common symptoms of an overdose: fatigue, headaches, disorientation, tremors (involuntary tremors), negative abdominal effects, hallucinations, crystalluria (accumulation of salts in the urine), hematuria (the amount of blood in the urine is above normal).

When taking Ciprofloxacin, constant monitoring of the functioning of the patient's kidneys, condition of bones and joints (especially in the treatment of children) is necessary.

Analogs of the antibiotic ciprofloxacin

Preparations containing the main substance are automatically analogues.

Ciprofloxacin is present in such drugs:

• Procipro
• Ififpro;
• Ecofitsole;
• Cyprodox;
• Tseprov;
• Basigenes.

Means that have the second generation of fluoroquinolones in their composition work similarly.

These include:

• Ivacin;
• Oflocid;
• Abactal;
• Zanocin.
• Levofloxacin;
• Nolicin;
• Levotek;
• Gastipan;

Ciprofloxacin is a highly active drug effective for the treatment of complex infectious diseases. Like other antibiotics, it has side effects and requires special care, a clear dosage and prior familiarization with the features of the application. Do not self-medicate with this drug.