Ciprofloxacin

KEY POINTS

Ciprofloxacin (Cipro) is a fluoroquinolone antibiotic that interferes with bacterial DNA synthesis in susceptible organisms by inhbiting DNA gyrase (topoisomerase II) and topoisomerase IV
Possesses activity versus a variety of Gram negative bacilli, including Pseudomonas aeruginosa
- One of the few oral antibiotics with activity versus Pseudomonas sp.
Ciprofloxacin is NOT Considered a “respiratory fluoroquinolone” because of its limited activity versus Streptococcus pneuamoniae as compared to other fluoroquinolones
- Note that ciprofloxacin achieves decent concentrations in the lungs
Should generally be avoided for Enterococcus sp. or Staphylococcus sp. due to resistance issues
Possesses activity versus atypical organisms such as Legionella sp. and Mycoplasma sp.
Available in oral and injectable formulations
- Oral formulation will bind to cations (e.g., calcium) so do not administer concomitantly with milk, calcium carbonate or other things that may bind to levofloxacin and prevent its absorption
Adjust dose for renal impairment
- 80% bioavailable
When possible, avoid ciprofloxacin for uncomplicated UTI, acute sinusitis or acute bronchitis
A common drug to consider for the treatment of prostatitis due to it’s ability to penetrate the prostate (and activity versus E. coli)
Beware QTC prolongation, tendonitis/ tendon rupture, peripheral neuropathy, photosensitivitity

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