Ciprofloxacin
Description
Ciprofloxacin is a synthetic quinolone anti-infective agent. Ciprofloxacin has broad spectrum of activity. It is active against most gram-negative aerobic bacteria including Enterobacteriaceae and Pseudomonas aeruginosa. Ciprofloxacin is also active against gram-positive aerobic bacteria including penicillinase producing, non penicillinase producing, and methicillin resistant staphylococci, although many strains of streptococci are relatively resistant to the drug. The bactericidal action of ciprofloxacin results from interference with the enzyme DNA gyrase needed for the synthesis of bacterial DNA.
Following oral administration it is rapidly and well absorbed from the G.I. tract. It is widely distributed into the body tissues and fluids. The half life is about 3.5 hours. About 30% to 50% of an oral dose of ciprofloxacin is excreted in the urine within 24 hours as unchanged drug and biologically active metabolites.
Indications
Ciprofloxacin is indicated for the treatment of single infection or mixed infections caused by two or more susceptible organisms. It can also be used for infections caused by organisms resistant to other antibiotics including Aminoglycosides, Penicillins and Cephalosporins.
As antibacterial concentrations of ciprofloxacin are obtained in serum and body tissues as well as in the urine following administration by mouth, Ciprofloxacin has been suggested for use in the treatment of a wide range of infections caused by susceptible organisms including infections of the urinary, respiratory and gastrointestinal tracts, gonorrhoea and septicaemia. The extensive tissue penetration of ciprofloxacin combined with its enhanced antibacterial activity (including antipseudomonal activity), enables Ciprofloxacin to be used alone (pending sensitivity results) or in combination with an Aminoglycoside or with beta lactam antibiotics for instance when severe neutropenia is present or with an antibiotic active against anaerobes where the presence of bacteroides fragilis is suspected. Rocipro® is indicated for the treatment of the following infections caused by sensitive bacteria:
Severe systemic infections: e.g. septicaemia, bacteraemia, peritonitis, infections in immunosuppressed patients with haematological or solid tumors and in patients in intensive care unit with specific problems such as infected burns.
Respiratory tract infections: Lobar and bronchopneumonia, acute and chronic bronchitis, acute exacerbation of cystic fibrosis, bronchiectasis, empyema.
Dosage & Administration
Adult Dose (Oral):
Urinary Tract infection:
- Acute uncomplicated: 250 mg twice daily for 3 days; Mild/Moderate: 250 mg twice daily for 7 to 14 days;
- Severe/Complicated: 500 mg twice daily for 7 to 14 days;
Chronic Bacterial Prostitis: 500 mg twice daily for 28 days;
Lower Respiratory Tract infection:
- Mild/Moderate: 500 mg twice daily for 7 to 14 days,
- Severe/Complicated: 750 mg twice daily for 7 to 14 days;
Acute Sinusitis: 500 mg twice daily for 10 days;
Skin and Skin Structure infection:
- Mild/Moderate: 500 mg twice daily for 7 to 14 days,
- Severe/Complicated: 750 mg twice daily for 7 to 14 days,
Bone and joint infection:
- Mild/Moderate: 500 mg twice daily for 4 to 6 weeks,
- Severe/Complicated: 750 mg twice daily for 4 to 6 weeks,
Intra Abdominal Infection: 500 mg twice daily for 7 to 14 days,
Infectious Diarrhea: Mild/Moderate/Severe: 500 mg twice daily for 5 to 7 days,
Typhoid Fever: 500 mg twice daily for 10 days,
Urethral & Cervical Gonococcal Infections: Uncomplicated: 250 mg Single dose.
For IV infusion:
Urinary Tract Infection:
- Mild to Moderate: 200 mg 12 hourly for 7-14 days;
- Severe or Complicated: 400 mg 12 hourly for 7-14 days;
Lower Respiratory Tract infection:
- Mild to Moderate: 400 mg 12 hourly for 7-14 days;
- Severe or Complicated: 400 mg 8 hourly for 7-14 days;
Nosocomial Pneumonia: Mild/Moderate/Severe: 400 mg 8 hourly for 10-14 days;
Skin and Skin Structure:
- Mild to Moderate: 400 mg 12 hourly for 7-14 days;
- Severe or Complicated: 400 mg 8 hourly for 7-14 days;
Bone and Joint Infection:
- Mild to Moderate: 400 mg 12 hourly for more than 4-6 weeks;
- Severe/Comlicated: 400 mg 8 hourly for more than 4-6weeks;
Intra abdominal (Acute abdomen): Complicated: 400 mg 12 hourly for 7-14 days;
Acute Sinusitis: Mild/Moderate: 400 mg 12 hourly for 10 days:
Chronic Bacterial Prostatitis: Mild/Moderate: 400 mg 12 hourly for 28 Days.
Children and adolescents:
RTI & GI infections:
- Neonate:Â 15 mg/kg twice daily,
- Child (1 month -18 years):Â 20 mg/kg (max 750 mg) twice daily;
UTI:
- Neonate:Â 10 mg/kg twice daily,
- Child (1 month -18 years):Â 10 mg/kg (max 750 mg) twice daily
Pseudomonal lower respiratory tract infection in cystic fibrosis:
- Child (1 month -18 years):Â 20 mg/kg (max 750 mg) twice daily;
Anthrax (treatment & post exposure prophylaxis):
- Child (1 month-18 years):Â 20 mg/kg (max 750 mg) twice daily.
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