Antimicrobial Spectrum and Mechanism of Action
The drug demonstrates high efficacy against Gram-negative flora, destroying microorganisms in both the active division phase and the resting phase. Against Gram-positive flora, Ciprofloxacin acts moderately, and exclusively during the period of cell division. The drug is practically ineffective against anaerobes.
Target pathogens for the drug include:
- Enteric bacteria and Enterobacteriaceae (Escherichia coli, Salmonella, Shigella, Klebsiella, Proteus, Helicobacter);
- Specific pathogens (Neisseria meningitidis, Neisseria gonorrhoeae, Haemophilus influenzae);
- Nosocomial flora, including Pseudomonas aeruginosa and staphylococci;
- Intracellular pathogens (Chlamydia, Legionella, Brucella, and Mycobacterium tuberculosis).
Low susceptibility to the drug is exhibited by pneumococci, streptococci, enterococci, and mycoplasmas.
Pharmacokinetics and Dosage Forms
Upon oral administration, the bioavailability of Ciprofloxacin reaches 60–80%. Food intake can delay the absorption of the active substance, but overall bioavailability is not reduced. The drug distributes well into organs and tissues, crossing the blood-brain barrier (BBB).
The treatment regimen involves administering the drug at 12-hour intervals. The pharmaceutical industry produces the drug in various dosage forms:
- Oral forms;
- Parenteral (intravenous);
- Topical (eye and ear drops, and eye ointment).
Clinical Application
Its broad spectrum allows Ciprofloxacin to be prescribed for inflammatory processes of various localizations:
- ENT organs: sinusitis, otitis media, tonsillitis, and pharyngitis;
- Lower respiratory tract: bronchitis and pneumonia;
- Urinary system and pelvis: cystitis, pyelonephritis, prostatitis, and endometritis;
- Musculoskeletal system: arthritis and osteomyelitis;
- Skin: infected burns, ulcers, wounds, and abscesses;
- Abdominal cavity: intestinal bacterial infections, as well as surgical perioperative prophylaxis;
- Ophthalmology: conjunctivitis, keratitis, and blepharitis;
- Phthisiology: combination therapy for tuberculosis.
Additionally, the drug has specific indications: anthrax prophylaxis and treatment of tularemia.
Safety and Drug Interactions
When using Ciprofloxacin, potential gastrointestinal side effects must be considered. A specific complication of therapy is pseudomembranous colitis associated with Clostridium difficile activity.
Among drug interactions, the effect on the metabolism of theophylline is of key importance. The antibiotic inhibits its breakdown, leading to an increase in blood theophylline concentrations and an enhancement of its toxic effects.