Cipro Information (frequently asked questions)

How does Cipro work?

Ciprofloxin has in Vitro activity against a wide range of gram positive and gram negative organisms. Ciprofloxacin, a 4-quinolone, is one of the newer compounds of the fluoroquinolone class of antibiotics. It is rapidly absorbed after oral administration and shows excellent penetration into extra-vascular tissues and other body compartments. It is a synthetic bactericidal antibiotic that inhibits bacterial nuclear DNA synthesis, so that bacteria rapidly die. The target is the enzyme DNA gyrase (topoisomerase II), which is responsible for the supercoiling and uncoiling of the DNA . Supercoiling of the DNA allows the long DNA molecule to fit into the cell. Uncoiling of the structure is the initiative step for replication, transcription and repair of the DNA. Thus, prolonged inhibition will eventually lead to the death of the cell.

Bayer developed the first fluoroquinolone to be on the market, called ciprofloxacin (Cipro®). In 1987 Cipro® was approved by the FDA (Food and Drug Administration) in the United States as the first oral broad-spectrum antibiotic of this class. An intravenous formulation followed in 1991. Cipro® has been extensively studied and its safety profile is well documented in more than 32,000 publications. More than 250 million patients have been treated world-wide.

Cipro has shown to be active against most strains of the following microorganisms:

Bacillus Anthracis                      Enterococcus  Faecalis

Staphylococcus aureus             Staphylococcus epidermis

Staphylococcus saprophyticus Streptococcus pneumonia

Streptococcus pyogenes           Pseudomonas aeruginosa

Cambylobacter jejuni                 Citrobacter freundii

Citrobacter diversus                  Enterobacter cloacae

Escherichia coli                         Haemophilus influenza

Haemophilus parainfluenza        Shigela dysenteriae

Shigela flexneri                          Shigela sonnei

Neisseria gonorrhoeae              Moraxella catarrhalis

Klebsiella pneumonia                 Serratia marcescens

Providencia rettgeri                   Bacteroides fragilis

Escherichia coli                         Serratia marcescens

Neisseria gonorrhoeae              etc.

More Specifically:

Inhalational Anthrax – to reduce the incidence or progression of disease following exposure to aerosolized Bacillus anthracis

Acute Sinusitis – caused by Haemophilus influenza, Streptococcus pneumonia, Moraxella catarrhalis

Lower respiratory Infections – caused by Escherichia coli, Klebsiella pneumonia, Proteus mirabilis, Providencia rettgeri, Staphylococcus saprophyticus, Enterococcus  Faecalis, etc.

Please note: although effective against Klebsiella pneumonia Cipro is not the first choice medication for the treatment of this bacteria.

Urinary Tract Infections – caused by Escherichia coli, Klebsiella pneumonia, Pseudomonas aeruginosa, Staphylococcus saprophyticus, Staphylococcus epidermis, Enterococcus  Faecalis, etc.

Acute Uncomplicated Cystitis in females – caused by Escherichia coli

 or Staphylococcus saprophyticus

Complicated Intra-Abdominal Infections – (used in combination with metronidazole) caused by Escherichia coli, Pseudomonas aeruginosa, Pseudomonas aeruginosa, Klebsiella pneumonia, Bacteroides fragilis

Chronic Bacterial Prostitis – cause by Escherichia coli or Proteus mirabilis

Skin and Skin Structure Infections – caused by Escherichia coli, Klebsiella pneumonia, Proteus mirabilis, Staphylococcus epidermis, Streptococcus pyogenes, etc.

Bone and Joint Infections – caused by Enterobacter cloacae, Serratia marcescens, or Pseudomonas aeruginosa.

Infectious Diarrhea – caused by Escherichia coli, Cambylobacter jejuni, Shigella boydii, Shigella dysenteria, Shigella flexeri, Shigella sonnei.

Typhoid Fever (enteric fever) – caused by Salmonella typhi (note: the eradication of the chronic typhoid carrier has not been demonstrated).

Uncomplicated Cervical and Urethral Gonnorhea – due to Neisseria gonorrhoeae

How effective is Cipro in treating inhalation Anthrax?

Clinical studies have shown that individuals who begin treatment with Cipro within hours after exposure of the Anthrax spores and continue treatment for at least 30 days have a significant decrease in morbidity. Some studies have shown a reduced rate from 90% to 10%.

What is the recommended dose of Cipro?

The recommended adult dose of Cipro for post-exposure inhalational anthrax is 500 milligrams given orally twice a day.

How long should Individuals take the medication?

Individuals should remain on the medication for at least 30 days and possible up to 60 days. If there has been a verifiable exposure in a defined area it generally recommended to continue treatment for an additional 30 days.

Is there any severe contraindications to taking Cipro?

Serious and fatal reactions have been reported in patients receiving concurrent administration of ciprofloxacin and theophylline.  These reactions includecardiac arrest, seizure, status epililepticus and respiratory failure.

In addition, Pseudomembranous colitis has been reported with nearly all antibacterial agents, including Cipro, and may range in severity from mild to life-threatening. Therefore, it is important to consider this reaction if an individuals should have diarrhea subsequent to the administration of the Cipro.

Is Cipro safe for pregnant individuals or those younger than 18 years old?

The safety and effectiveness of ciprofloxacin in children and adolescents less than 18 years of age, except for inhalational anthrax (post-exposure), pregnant women and lactating women have not been established.

Is there any hypersensitivity issues associated with Cipro?

Ciprofloxacin is contraindicated in persons with a history of hypersensitivity to ciprofloxacin or any member of the quinolone class of antimicrobial agents. Ciprofloxacin should be discontinued at the first sign of an allergic reaction.

What are the most common side effects associated with Cipro?

Cipro Tablets and Oral Suspension: nausea, diarrhea, vomiting, abdominal pain/discomfort, headache, rash, restlessness.

Cipro I.V.: nausea, diarrhea, CNS disturbance, local I.V. site reactions, abnormailties of hepatic enzymes, eosinophilia, headache, rash, restlessness.

Is there any contraindication to taking Cipro with antacids?

Antacids containing magnesium, aluminum or calcium, or other products containing metal cations should be taken 2 hours after or 6 hours before oral administration of Cipro.

What is the shelf life of Cipro?

Cipro has a shelf life of approximately 36 months.However, materiel has been and is currently being tested through the DOD/FDA Shelf Life Extension Program (SLEP) and has received extensions up to 7 1/2 years from original expiration date and some lots have received up to 9 years from original expiration date. Materiel shows no signs of deteriorating based on yearly test.

What should be done in the event of an overdose?

In the event of an overdose call 911 and seek immediate medical attention.