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Ciprofloxacin

CIPROFLOXACIN

Manufacturer: Sagent Pharmaceuticals

Score: 141.0

Quick Summary

Ciprofloxacin is a fluoroquinolone antibacterial indicated for various infections, including skin and skin structure infections, bone and joint infections, and urinary tract infections. It is essential to consider the potential risks, such as tendonitis and tendon rupture, particularly in elderly patients and those with renal impairment. The drug should be used with caution in patients with known history of myasthenia gravis and in pediatric patients due to the increased incidence of adverse reactions. Dosage adjustments are necessary for patients with renal impairment, and the drug should be administered at least 2 hours before or 6 hours after multivalent cations.

Key Clinical Findings and Indications

  • Skin and skin structure infections
  • Bone and joint infections
  • Complicated intra-abdominal infections
  • Infectious diarrhea
  • Typhoid fever
  • Uncomplicated cervical and urethral gonorrhea
  • Inhalational anthrax (post-exposure)
  • Plague
  • Chronic bacterial prostatitis
  • Lower respiratory tract infections
  • Urinary tract infections
  • Acute sinusitis

Important Safety Information

Warning

Fluoroquinolones, including ciprofloxacin, have been associated with disabling and potentially irreversible serious adverse reactions, such as tendinitis and tendon rupture, peripheral neuropathy, and central nervous system effects.

Contraindications

  • Hypersensitivity to ciprofloxacin or other quinolones
  • Concomitant administration with tizanidine

Adverse Reactions

  • Nausea
  • Diarrhea
  • Liver function tests abnormal
  • Vomiting
  • Rash
  • Tendinitis and tendon rupture
  • Peripheral neuropathy
  • Central nervous system effects

Dosing Recommendations

General Guidance

Dosage adjustments are necessary for patients with renal impairment.

Skin and skin structure infections

Adult Dose

500-750 mg every 12 hours

Pediatric Dose

10-20 mg/kg every 12 hours

Bone and joint infections

Adult Dose

500-750 mg every 12 hours

Pediatric Dose

Not recommended

Special Population Considerations

Pregnancy

  • Ciprofloxacin should not be used during pregnancy unless the potential benefit justifies the potential risk to both fetus and mother.

Nursing Mothers

  • Ciprofloxacin is excreted in human milk, and a decision should be made whether to discontinue nursing or to discontinue the drug.

Pediatric Use

  • Ciprofloxacin is indicated for the treatment of complicated urinary tract infections and pyelonephritis in pediatric patients 1 to 17 years of age.
  • Ciprofloxacin is not a drug of first choice in the pediatric population due to an increased incidence of adverse reactions.

Geriatric Use

  • Geriatric patients are at increased risk for developing severe tendon disorders, including tendon rupture, when being treated with ciprofloxacin.
  • Caution should be used when prescribing ciprofloxacin to elderly patients, especially those on corticosteroids.

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