Ciprofloxacin

Question 1

Drug class?

Answer 1

Quinolones

Question 2

How does it work?

Answer 2

• Broad spectrum bactericidal Abx

- Bacteriacidal, inhibits DNA gyrase.

Question 3

Indications?

Answer 3

Spectrum – staph aureus, haemophilus influenza, e.coli, klebsiella, pseudomonas aeruginosa, Moraxella catarrhalis, mycoplasma pneumoniae, chlaymida, salmonella, shigella, campylobacter. Has some activity against Neisseria meningitides and gonorrhoeae.

LRTIs due to gram –ve bacteria, chronic suppurative otitis media, acute exacerbation of chronic sinusitis, UTIs, genital tract infections, infections of GI tract (e.g. traveller’s diarrhoea), intra-abdominal infections, infections of skin and soft tissue, malignant external otitis, infections of bone and joints.

Question 4

Contra-indications?

Answer 4

Pregnancy, children, epilepsy (lowers seizure threshold), exacerbates myasthenia gravis, can precipitate attack in G6PD deficiency, can cause tendon rupture so avoid in sportspeople and those with history of damage.

Question 5

Side-effects?

Answer 5

Common: nausea, vomiting, abdo pain, diarrhoea.
Rarely: insomnia, confusion, convulsions.

Question 6

Possible interactions?

Answer 6

P450 INHIBITOR

• Cyclosporin:  risk nephrotoxicity
• Theophylline:  risk of convulsions
• Warfarin:  anticoagulant effects