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ciprofloxacin side effects

What are the ciprofloxacin side effects?

Posed on  November 25, 2020, edited by Jason, category  
ciprofloxacin side effects
ciprofloxacin side effects

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What is ciprofloxacin?

1. Definition

Ciprofloxacin is a synthetic third-generation quinolone with broad-spectrum antibacterial activity and good bactericidal effect. The antibacterial activity against almost all bacteria is 2 to 4 times stronger than norfloxacin and enoxacin. It has antibacterial effects against Enterobacter, Pseudomonas aeruginosa, Haemophilus influenzae, Neisseria gonorrhoeae, Streptococcus, Legionella, and Staphylococcus aureus. However, ciprofloxacin side effects come into notice.

2. Purpose

The new broad-spectrum antibacterial drug has strong permeability, high blood concentration and low toxicity, which is not easy to produce drug resistance and can be quickly distributed to other organs. This medicine is easily absorbed orally, and the effect of intramuscular injection is even better. The new quinolone broad-spectrum antibacterial drug has a strong effect on Gram-positive and negative bacteria.

The third-generation quinolone antibiotic has a broad antibacterial spectrum, and powerful bactericidal power. It has bactericidal effect on Gram-positive and negative bacteria including Pseudomonas aeruginosa, intestinal bacteria and Staphylococcus aureus. Its hydrochloride is often used clinically for the treatment of respiratory tract infections, urinary tract infections, intestinal infections, biliary system infections, intra-abdominal infections, gynecological disease infections, bone and joint infections and severe systemic infections

3. Pharmacology and Toxicology

It belongs to fluoroquinolones and has the same antibacterial spectrum as norfloxacin. Its antibacterial activity is the strongest among the widely used fluoroquinolones. In addition to its high antibacterial activity against gram-negative bacilli, it also has a good antibacterial effect against Staphylococcus, and its effect against Pneumococcus and Streptococcus is slightly worse than that of Staphylococcus.

This product also has inhibitory effects on some mycobacteria, Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis, etc. As a bactericide, it is generally believed that quinolones act on the A subunit of bacterial cell DNA helicase, inhibiting DNA synthesis and replication and leading to bacterial death.

4. Pharmacokinetics

Ciprofloxacin has a broad antibacterial spectrum and strong antibacterial ability. This product inhibits bacterial DNA helicase and prevents bacterial replication, so it quickly reduces bacterial reproduction.

It is a bactericidal drug. Ciprofloxacin has a special mode of action and is different from any other antibiotics except quinolones. Therefore, ciprofloxacin has higher antibacterial ability compared with penicillins, cephalosporins, aminoglycoside and tetracyclines resistant bacterial beads. In vitro experiments have proved that the combined application of ciprofloxacin, beta lactams, and aminoglycoside antibiotics can produce additive or harmless effect. In vivo experiments synergistic effects of drugs often appear, especially in animals with reduced leukocytes.

Healthy people take 0.25g or 0.5g of ciprofloxacin hydrochloride orally. After 1 to 2 hours, the Cmax is 1.5μg/ml and 2.5μg/ml respectively. The half-life is about 4 hours. The product is mainly distributed in bile, mucus, saliva, and bone, as well as in the prostate, but the concentration in the brain and spinal cord is lower. The product can be metabolized in the liver and excreted in the urine through the kidneys, maintaining a high drug concentration in the urine.

The drug is widely distributed in the body after absorption, and can reach effective drug levels in vesicular fluid, prostate, lung and urogenital tissues, and sputum. The elimination half-life of this product is 3.3 to 4.9 hours, 29% to 44% (oral) and 45% to 60% (intravenous infusion) of the drug is excreted in the urine as the original form of the drug, and part of it is excreted in the form of metabolites by urine. The concentration of the drug in the bile is much higher than that in the blood, and about 15% to 25% of the dose is excreted by the feces.

What is ciprofloxacin used for?

1. What does ciprofloxacin treat?

Ciprofloxacin has a wider clinical use than norfloxacin. In addition to urinary tract infections, intestinal infections, gonorrhea, etc., it can also be used to treat influenza bacilli, E. coli, pneumoniae, Proteus mirabilis, Proteus vulgaris, Bone and joint infections, skin and soft tissue infections, pneumonia, sepsis, etc. caused by Professionella, Morganella, Pseudomonas aeruginosa, Enterobacter cloacae, Citrobacter frautus, Staphylococcus (including methicillin-resistant strains), etc. The oral preparation of this product is compatible with norfloxacin; intravenous administration can be used for the treatment of heavier infections, such as enterobacteriaceae bacterial sepsis, pulmonary infection, abdominal cavity and biliary tract infections.

  • Respiratory tract infections: Ciprofloxacin can be used to Pneumonia Klebsiella, Enterobacter, Proteus, Pseudomonas, Haemophilus, Branhamella, Legionella and Staphylococcus. Ciprofloxacin is generally not used as the drug of choice for the treatment of encephalococcal encephalitis in outpatients.
  • Middle ear infection (otitis media), sinus infection (sinusitis), especially infections caused by Gram-negative bacteria including Pseudomonas or Staphylococcus.
  • Eye infection.
  • Kidney and/or urinary tract infection.
  • Gonadal organ infections: including appendicitis, gonorrhea and prostatitis.
  • Abdominal infection (intestinal infection, biliary tract infection, peritonitis).
  • Skin and soft tissue infections.
  • Bone and joint infections.
  • Sepsis, bacteremia.

2. Ciprofloxacin Dosage

  • The daily dosage for adults (based on ciprofloxacin, the same below) is 0.5 to 1.5 g, orally in 2 doses. Intravenous drip 0.2 ~ 0.6g per day, but the speed should not be too fast; divided into 2 drips, each time for about 1 hour.
  • Bone and joint infections, 1.0~1.5g a day, divided into 2~3 times, the course of treatment is 4~6 weeks or longer.
  • Pneumonia and skin and soft tissue infections are 1 to 1.5 g daily, divided into 2 times, and the course of treatment is 7 to 14 days.
  • Ciprofloxacin Lactate for Injection
  • Intestinal infection 1g daily, divided into 2 times, the course of treatment is 5-7 days. Typhoid fever is 1.5g daily, divided into 2 doses, and the course of treatment is 10 to 14 days. 5. For urinary tract infections, take 0.5~1g daily, divided into 2 times, the course of treatment is 7~14 days; the course of treatment for severe or complicated cases needs to be extended appropriately.
  • Gonorrhea 0.25~0.5g orally in a single dose.
  • In severe cases, it can be administered by intravenous drip, 0.4 ~ 0.6g per day, divided into 2 intravenous drips.
  • The product should be taken on an empty stomach. Although foods can delay its absorption, the total absorption (bioavailability) has not been reduced, so it can also be taken after a meal to reduce gastrointestinal reactions. It is advisable to drink 250ml of water at the same time.
  • Crystaluria may occur, especially when the patient's urine pH is above 7, so the alkalinizer should be avoided at the same time. The daily water intake must be sufficient to keep the daily urine output above 1200~1500ml.

3. Veterinary drug application

This product is a broad-spectrum bactericide. It has the strongest antibacterial activity against gram-negative bacteria among fluoroquinolones currently used in veterinary medicine; it also has a strong effect on gram-positive bacteria. In addition, it also has a strong antibacterial effect on mycoplasma anaerobes and Pseudomonas aeruginosa.

It is used to interfere with various systems of the whole body, and has good effects on the digestive tract, respiratory tract, urogenital tract, skin and soft tissue infections and mycoplasma infections.

Ciprofloxacin side effects

1. Side effects

Its side effects mainly include gastrointestinal reactions (3-4%), central nervous system symptoms (2%), allergic reactions (0.5-1.0%) and abnormal laboratory tests (3-4%), which can occasionally lead to epilepsy and even convulsions (Overdose tends to occur). The adverse reactions are mostly mild, so it rarely affects the continuation of treatment. Crystaluria, arthralgia or stiffness, light sensitivity, and visual disturbances can occasionally occur during the course of treatment. It can cause mild gastrointestinal irritation or discomfort, nausea, heartburn, loss of appetite. Mild nervous system reactions such as dizziness, drowsiness, headache, restlessness, symptoms will disappear (return to normal) after stopping the drug.

Allergic reactions, rashes, itching, flushing of the face or skin, and conjunctival congestion may occur. It can also cause transient aminotransferase elevation, fluid retention and so on. Liver damage can be seen in individual cases.

It can cause kidney damage, increased urea nitrogen, and renal insufficiency. There is also a decrease in white blood cells and platelets, an increase in eosinophils, and oral ulcers. Allergies can cause upper respiratory tract mucosal congestion, throat edema, suffocation, skin vasculitis, joint and muscle pain, and severe cases can be life-threatening. Gastrointestinal tract: nausea, diarrhea, vomiting, indigestion, abdominal pain, bloating, anorexia.

If you find severe long-term diarrhea during or after treatment, you must consult your doctor, because this may cause serious intestinal disease (pseudomembranous enteritis), which requires prompt treatment. Once this happens, you must stop using ciprofloxacin, and give appropriate treatment (vancomycin orally 4×250 mg/day), and prohibit intestinal motility drugs.

A. Nervous system:
Dizziness, headache, fatigue, agitation, tremor;

B. The rare ones are:
Insomnia, abnormal peripheral pain, sweating, unstable gait, convulsions, increased intracranial pressure, anxiety, night dreams, confusion, depression, and hallucinations also occur, and individual patients have mental reactions. In some patients, these adverse reactions may occur during the initial medication. At this time, you can stop taking badprofloxacin immediately and notify your doctor.

C. Sensory organs:
The side effects of sensory organs are rare, sometimes it can be seen that taste is impaired, visual disturbances (double vision, color vision), tinnitus and hearing are temporarily damaged, especially in high-frequency environments.

D. Highly allergic reaction:
In some cases, allergic reactions may occur during the initial administration. In this case, stop the medication and notify the doctor immediately.

E. Skin reaction:
Such as skin rash, itching, drug fever. The formation of blisters (peechiae) on the skin with bleeding (blood blisters) and crusted nodules (papules) indicates vasculitis.

F. Stevens Johnson and Lyell syndrome:
Interstitial nephritis, hepatitis, and liver necrosis rarely lead to life-threatening liver failure. In some patients, however, allergic reactions may occur at the first administration (e.g. facial, vascular and laryngeal edema; breathing difficulties, leading to life-threatening body G); once these conditions occur, the drug should be stopped immediately.

G. Cardiovascular system:
Tachycardia: Flushing, migraine, and syncope.

2. Precaution

  • This product should not be used for those allergic to quinolones.
  • This product is not suitable for children, pregnant women and breastfeeding women.
  • It is advisable to reduce the dose when renal function is impaired (the dose is halved when the creatinine clearance rate is less than 20ml/min). Those with impaired liver function must weigh the pros and cons.
  • People with a history of epilepsy or central nervous system disease should use it with caution. Patients with impaired renal function should be dosed according to the degree of renal impairment when using this product. The mechanism of action of fluoroquinolone drugs such as norfloxacin is to inhibit DNA synthesis. And it is comfirmed that fluoroquinolones can damage cartilage of young mice. Therefore, such drugs should not be used in children and pregnant women. Breastfeeding should be suspended when it is used as the drug can be secreted into breast milk.

Conclusion

Ciprofloxacin has a broad antibacterial spectrum, and its antibacterial activity is the strongest among quinolones. However, there are many possible ciprofloxacin side effects, which need to be paid attention to, especially for pregnant women and children.

ciprofloxacin-test
ciprofloxacin-test

BALLYA provides a quinolones erythromycin combo test kit to tell you if there are quinolones residues and erythromycin residues in dairy products you eat every day.

References

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