Pharmacological properties
Synthetic antimicrobial drug with a broad spectrum of action. Has a bactericidal effect, which is due to the inhibition of the activity of bacterial DNA gyrase. Plasmid-mediated resistance does not occur to the drug. has high activity against gram-negative bacteria (enterobacteriaceae, including e. coli, salmonella, klebsiella, shigella, proteus mirabilus, proteus vulgaris, klebsiella oxytoca, yersinia enterocolitica, enterobacter, citrobacter, morgenella morganii, other gram-negative microorganisms, including pseudomonas aeruginosa, haemophilus influenzae, acinetobacter, campylobacter, brucella melitensis, pasteurella multocida, eikenella corrodenus, flavobacterium, moraxella, gardnerella vaginalis, legionella species, vibrio cholerae and vibrio parahemolyticus, neisseria meningitis and neisseria gonorrhoeae, including strains that produce β-lactamases), gram-positive bacteria (staphylococcus aureus, including β-lactamase-producing and methicillin-resistant strains, streptococcus pneumonia, β-hemolytic streptococci group a, streptococci group b and other streptococci, enterococci, including enterococcus faecalis, corynebacterium, listeria monocytogenes) and other microorganisms, including anaerobic bacteria and some strains of Bacteroides.
Ciprofloxacin is effective against microorganisms resistant to a number of antibiotics (aminoglycosides, penicillins, tetracycline), as well as to nalidixic acid.
Ciprofloxacin is rapidly absorbed from the gastrointestinal tract. Bioavailability after oral administration is 70%. Food intake moderately slows down its absorption, but does not change its bioavailability. Binding to plasma proteins is 20-40%. It is subject to the effect of first-pass effect through the liver. It is widely distributed in tissues and biological fluids of the body, which distinguishes it from aminoglycosides and β-lactam antibiotics, which have a small volume of distribution. It creates high concentrations in the prostate gland, lungs, bone tissue, bronchial secretions, bile. It penetrates the placenta, is excreted in breast milk. It is excreted in urine and bile, mainly unchanged. The half-life is 3-5 hours. In patients with impaired renal function, the concentration of the drug in the blood plasma increases and the half-life increases. Significant drug concentrations exceeding the MIC for most sensitive bacteria persist in urine and feces for several days after cessation of therapy.
Indication
Infectious-inflammatory diseases caused by microorganisms sensitive to the drug, respiratory, urinary tract, ENT organs, skin and soft tissues, bones and joints, abdominal organs, gynecological infections, gonorrhea, osteomyelitis, septicemia, preoperative prophylaxis and postoperative treatment of surgical infections. Ciprofloxacin is used for the prevention of infectious complications and the treatment of patients with immunodepression.
Application
Inside, regardless of meals. The dose is set individually depending on the severity of the infection, age, body weight and renal function of the patient. Recommended doses for adults:
- respiratory tract infections: 500-750 mg 2 times a day;
- infections of the skin and soft tissues, bones and joints: 500-750 mg 2 times a day;
- digestive tract infections: 250-500 mg 2 times a day;
- gonorrhea: 250 mg once;
- non-gonococcal urethritis: 750 mg 2 times a day;
- chancroid: 500 mg 2 times a day;
- other infections: 500-750 mg 2 times a day.
Patients should drink plenty of water during treatment.
The drug is not recommended for use in children. If the expected therapeutic effect outweighs the potential risk, the drug may be prescribed at a dose of 5-10 mg/kg body weight per day in 2 divided doses.
The duration of treatment for acute infections is 5-7 days. Therapy should be continued for another 3 days after the symptoms of infection have disappeared.
Contraindication
Hypersensitivity to ciprofloxacin or other quinolones, epilepsy, age under 18 years, pregnancy and breastfeeding.
Side effects
Possible diarrhea, vomiting, abdominal pain, headache, fainting, convulsions, anxiety, skin rashes, photodermatoses, rarely - arthralgia, increased activity of serum transaminases, palpitations, increased fever, chest pain, visual impairment, anaphylactic reactions, extremely rarely - acute renal failure and pseudomembranous colitis.
Special instructions
To avoid the development of crystalluria, it is unacceptable to exceed the recommended daily dose, it is necessary to drink sufficient fluids and maintain an acidic urine reaction.
During treatment, you should refrain from engaging in potentially hazardous activities that require increased attention and speed of mental and motor reactions.
If severe and prolonged diarrhea occurs during treatment, pseudomembranous colitis should be excluded, which requires immediate discontinuation of the drug and the appointment of appropriate treatment.
If tendon pain or the first signs of tendovaginitis appear, treatment should be discontinued. During the treatment period, contact with direct sunlight should be avoided.
Interactions
Ciprofloxacin may increase the serum concentration and increase the half-life of theophylline when used simultaneously. The drug may increase prothrombin time when administered simultaneously with indirect anticoagulants of the coumarin series. Antacids containing magnesium and/or aluminum hydroxide may interfere with the absorption of ciprofloxacin; the interval between taking antacids and ciprofloxacin should be 1-2 hours.
It is manifested by an increase in the severity of the side effects of the drug. It is necessary to carefully monitor the patient's condition, perform gastric lavage, carry out standard emergency measures, ensure sufficient fluid intake. A small (less than 10%) amount of the drug can be removed by hemodialysis or peritoneal dialysis.
Storage conditions
In a dry place, protected from light.
Translation of the instructions can be
