Antibiotic cifloproxacin instructions

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Ciprofloxacin

Ciprofloxacin is an antibiotic that is used to treat bacterial infections. Ciprofloxacin stops the growth of bacteria by inhibiting reproduction and altering their genetics. The FDA approved ciprofloxacin in October 1987.

Ciprofloxacin belongs to the fluoroquinolone class, which includes levofloxacin (Levaquin), ofloxacin (Floxin), gatifloxacin (Tequin), norfloxacin (Noroxin), moxifloxacin (Avelox), trovafloxacin (Trovan), and others.

Ciprofloxacin: instructions for use

Spelling errors - cicroproxotin.

Release forms and composition

Film-coated tablets

1 film-coated tablet contains:

Active ingredient: ciprofloxacin hydrochloride (in terms of ciprofloxacin) - 250, 500 or 750 mg.

Auxiliary components: starch 1500 (potato starch) or corn starch, lactose (milk sugar), magnesium stearate, crospovidone, MCC (microcrystalline cellulose), talc, hypromellose, croscarmellose sodium, colloidal anhydrous silicon dioxide, macrogol 6000, additive E171 (titanium dioxide ), polysorbate 80.

Shell: the content and number of components depend on the manufacturer.

Packaging: 10, 20, 30, 40, 50, 60 or 100 tablets.

Ear and eye drops 0.3%

Active ingredient: ciprofloxacin hydrochloride (in terms of ciprofloxacin) at a concentration of 3 mg per 1 ml of solution

Excipients: Trilon B, benzalkonium chloride, sodium chloride, purified water.

Bottles of 3 or 5 ml.

The ophthalmic ointment contains the active substance at a concentration of 3 mg/ml.

Solution for infusion

The active ingredient is ciprofloxacin hydrochloride (in terms of ciprofloxacin) - 2 mg per 1 ml of solution.

Excipients: sodium chloride, disodium edetate, lactic acid, diluted hydrochloric acid, water for injection.

Bottles of 100 ml.

Indications for use

Respiratory tract infections.

The use of ciprofloxacin is indicated for so-called difficult pathogens (for example, Klebsiella, Enterobacter, Proteus, Pseudomonas, Legionella, Staphylococcus, Escherichia coli).

Infections of the middle ear and paranasal sinuses, especially if they are caused by gram-negative pathogens, including Pseudomonas, or Staphylococcus.

Infections of the eyes, kidneys and (or) urinary tract, genital organs, including inflammation of the appendages, gonorrhea, prostatitis; infections of the abdominal cavity (for example, bacterial infections of the gastrointestinal tract, biliary tract, peritonitis), skin and soft tissues, bones and joints (for example, osteomyelitis), sepsis.

Treatment and prevention of threatening infections in patients with weakened protective functions of the body, for example, during treatment with immunosuppressive drugs or in patients with neutropenia.

Selective intestinal decontamination in patients receiving treatment with immunosuppressive drugs.

  • Balanoposthitis
  • Skin abscess, boil and carbuncle
  • Retropharyngeal and parapharyngeal abscess
  • Peritonsillar abscess
  • Local infection of the skin and subcutaneous tissue
  • Bronchitis
  • Arthritis and polyarthritis
  • Monoarthritis
  • Bartholin gland diseases
  • Eyeball diseases
  • Otitis media
  • Otitis externa
  • Inflammation and blockage of the auditory (Eustachian) tube
  • Purulent endophthalmitis
  • Gonococcal infection
  • Acute and gonococcal pharyngitis
  • Inflammatory diseases of the uterus, cervix, prostate gland, male genital organs
  • Posterior cyclitis
  • Iridocyclitis
  • Intestinal infections
  • Impetigo
  • Keratitis
  • Mastoiditis and related conditions
  • Orchitis and epididymitis
  • Postpartum sepsis
  • Bronchiolitis
  • Laryngitis and tracheitis, acute and chronic
  • Acute obstructive laryngitis [croup] and epiglottitis
  • Prostatitis
  • Myringitis
  • Salpingitis and oophoritis
  • Sinusitis
  • Acute tonsillitis [tonsillitis], chronic tonsillitis
  • Tubulointerstitial nephritis
  • Osteomyelitis
  • Peritonitis
  • Chronic diseases of the tonsils and adenoids
  • Urethritis and urethral syndrome
  • Chlamydial conjunctivitis
  • Typhoid and paratyphoid
  • Phlegmon
  • Chorioretinal inflammation
  • Cholangitis
  • Cholecystitis
  • Episcleritis
  • Diarrhea and gastroenteritis of suspected infectious origin
  • Disseminated chorioretinal inflammation
  • Cholelithiasis
  • Cystitis
  • Shigellosis

Pharmacodynamics

Ciprofloxacin, a synthetic derivative of 4-fluoroquinolone, inhibits bacterial DNA gyrase, which despirals sections of chromosomal DNA molecules, which is necessary for reading genetic information. The low toxicity of the drug for the cells of the macroorganism is explained by the absence of gyrases in them.

Ciprofloxacin is a broad-spectrum bactericidal antibacterial drug (primarily against gram-negative flora, in this regard it is close to aminoglycosides). On gram-positive microorganisms, ciprofloxacin has a bactericidal effect only during the division period, on gram-negative organisms - and during the dormant period, since it affects not only DNA gyrase, but also causes lysis of the cell wall.

Prevents the transcription of bacterial genetic material necessary for their normal metabolism. This leads to a rapid decrease in the ability of bacteria to divide. As a result of its action, there is no parallel development of resistance to other antibiotics that do not belong to the group of gyrase inhibitors, which makes it highly effective against bacteria that are resistant, for example, to aminoglycosides, penicillins, cephalosporins, tetracyclines and many other antibiotics.

The following pathogenic microorganisms are highly sensitive to ciprofloxacin: E. coli, Shigella, Salmonella, Citrobacter, Klebsiella, Enterobacter, Serratia, Hafnia, Edwardsiella, Proteus (indole-positive and indole-negative), Providencia, Morganella, Yersinia; Vibrio, Aeromonas, Plesiomonas, Pasteurella, Haemophilus, Campylobacter, Pseudomonas, Legionella, Neisseria, Moraxella, Acinobacter, Brucella; Staphylococcus, Listeria, Corynebacterium, Chlamydia. The following microorganisms are moderately susceptible to ciprofloxacin: Gardnerella, Flavobacterium, Alcaligenes, Streptococcus agalactiae, Enterococcus faecalis, Streptococcus pyogenes, Streptococcus pneumoniae, Viridans group of streptococci, Mycoplasma hominis, Mycobacterium tuberculosis and Mycobacterium fortuitum.

The following microorganisms are considered usually sensitive to ciprofloxacin: Enterococcus faecium, Ureaplasma urealyticum, Nocardia asteroides. With some exceptions, anaerobic microorganisms are moderately sensitive (eg, Peptococcus, Peptostreptococcus) or resistant (eg, Bacteroides) to ciprofloxacin. Ciprofloxacin is not effective against Treponema pallidum.

Resistance develops extremely slowly, since on the one hand, after its action there are practically no persistent microorganisms left, and on the other hand, bacterial cells do not have enzymes that inactivate it. No cross-resistance to other antimicrobial drugs was observed.

Pharmacokinetics

It is quickly absorbed after oral administration, well distributed in body tissues (excluding fat-rich tissue, such as nervous tissue), its volume of distribution is 2-3 l/kg, which is greatly facilitated by its low connection with blood plasma proteins (20-30 %) and the fact that at physiological blood pH values ​​it is in a non-ionized state.

Intracellular concentrations are quite high, which makes it more effective against intracellular bacteria (for example, Legionella). The drug is well absorbed (mainly in the small intestine), the percentage of its absorption reaches 70-80%.

The maximum concentration in blood plasma is created after a minute; the content of ciprofloxacin in tissues is 2-12 times higher than in plasma. The serum concentration of ciprofloxacin has a linear relationship with the dose taken.

The drug is practically not inactivated during the first passage through the liver and the degree of its bioavailability practically does not differ from the percentage of its absorption. The concentrations of ciprofloxacin detected in blood plasma exceed the MIC values ​​even for such multidrug-resistant bacteria as enterobacteria, Staphylococcus aureus and bacilli of blue-green pus.

When using ciprofloxacin, therapeutic concentrations are achieved in saliva, bile, intestines, abdominal and pelvic organs, kidneys and urinary organs, lung tissue, bronchial secretions, bone tissue, muscles, synovial fluid and articular cartilage, peritoneal fluid, skin. In cerebrospinal and intraocular fluids it is found in 10% concentration compared to plasma. Activity decreases slightly at acidic pH values. T1/2 - about 4 hours, from 50 to 70% is excreted unchanged by the kidneys (tubular filtration and tubular secretion), the rest - in the form of metabolites and through the intestinal wall.

In case of renal failure, the percentage of ciprofloxacin excreted through the kidneys decreases, but its accumulation in the body does not occur when creatinine clearance is above 20 ml/min, since in parallel with this there is an increase in the metabolism of ciprofloxacin and excretion in feces. With parenteral administration of ciprofloxacin, the percentage of it excreted unchanged by the kidneys is greater than after oral administration.

Dosage regimen

As a rule, treatment should be continued for at least 3 more days after the fever has subsided or clinical symptoms have disappeared.

Average duration of treatment:

  • 1 day for acute uncomplicated gonorrhea and cystitis,
  • up to 7 days for infections of the kidneys, urinary tract and abdominal cavity,
  • during the entire period of the neutropenic phase in patients with weakened body defenses,
  • no more than 2 months for osteomyelitis
  • 7-14 days for all other infections.
  • For streptococcal infections, due to the risk of late complications, as well as chlamydial infections, treatment should continue for at least 10 days.

For urinary tract infections

Prescribe 0.25-0.5 g 2 times/day; course of treatment days.

For uncomplicated gonorrhea

Prescribed in a dose of 0.25-0.6 g once; when a gonococcal infection is combined with chlamydial and mycoplasma, a dose of 0.75 g every 12 hours is indicated for 7-10 days.

0.5 g 2 times/day for several days.

For uncomplicated urinary tract and gastrointestinal infections

You can give a single daily dose of up to 0.6 g (orally).

With meningococcal carriage in the nasopharynx

Prescribed once in a dose of 0.5 or 0.75 g.

For chronic carriage of salmonella

Prescribed orally at 0.25 g 4 times or intravenously at 0.2 g 2 times a day; course of treatment - up to 4 weeks. If necessary, the dosage can be increased to 0.5 g 3 times a day.

For pneumonia and osteomyelitis

Prescribe 0.75 g orally or 0.2 g intravenously 2 times a day. The duration of treatment for osteomyelitis can be up to 2 months.

For gastrointestinal infections caused by Staphylococcus aureus

Prescribe 0.75 g every 12 hours for 7-28 days.

For severe infections (especially those caused by multidrug-resistant pathogens)

The drug should be administered intravenously in a single dose of 0.1-0.2 g; frequency of administration - 2 times/day. If intravenous treatment is necessary, for particularly severe, life-threatening or recurrent infections caused by Pseudomonas, staphylococci or Streptococcus pneumoniae, the dose can be increased to 0.4 g with a frequency of administration up to 3 times a day. If the glomerular filtration rate (GFR) is from 31 to 60 ml/min/1.73 sq.cm or the serum creatinine concentration is from 1.4 to 1.9 mg/100 ml, the maximum daily dose should be 1 g/day when administered orally and 0.8 g/day when administered intravenously. /in the introduction. When the glomerular filtration rate is below 30 ml/min/1.73 sq.cm or the serum creatinine concentration is above 2.0 mg/100 ml, the maximum daily dose should be 0.5 g/day for oral administration and 0.4 g/day for intravenous administration. If the patient is undergoing hemodialysis or peritoneal dialysis, the dose of the drug should be 0.25-0.5 g/day orally, but the drug should be taken after the hemodialysis session. For elderly patients, the dose should be reduced (usually by 1/3). For peritonitis, it is permissible to use intraperitoneal administration of ciprofloxacin infusion solutions.

For particularly dangerous infections

For example, for recurrent attacks of infection in patients with cystic fibrosis, infections of the abdominal cavity, bones and joints caused by Pseudomonas or staphylococci, acute pneumonia caused by Streptococcus pneumoniae, and chlamydial genitourinary infections, the dose should be increased to 0.75 g (orally) every 12 hours After IV use, you can continue treatment orally. The tablets should be swallowed whole with a small amount of liquid. They can be consumed regardless of meal time. If the tablets are taken on an empty stomach, the active substance is absorbed more quickly. IV use: infusion duration is 30 minutes at a dose of 0.2 g and 60 minutes at a dose of 0.4 g. Eye drops: for mild to moderately severe infection, 1-2 drops into the affected eye (or both eyes) every 4 hours; for severe infection - 2 drops every hour. If necessary, as directed by your doctor, a different dosage may be chosen. Infusion solutions are ready for use; if necessary, they can be combined with the following infusion solutions: physiological sodium chloride solution, Ringer's solution and lactated Ringer's solution, 5% and 10% glucose solution, 10% fructose solution, and 5% glucose solution containing 0.225 % NaCl or 0.45% NaCl.

Side effects

Long-term or repeated use of ciprofloxacin may lead to superinfection with resistant bacteria or yeasts.

Gastrointestinal Tract

Nausea, diarrhea, vomiting, dyspepsia, abdominal pain, flatulence, loss of appetite.

Central nervous system

Dizziness, headache, fatigue, anxiety, trembling; very rare: insomnia, peripheral paralgesia (anomaly in the perception of pain), sweating, increased intracranial pressure, anxiety, nightmares, confusion, depression, hallucinations, psychotic reactions (occasionally even progressing to states in which the patient may harm himself) , thrombosis of cerebral vessels.

Impaired taste and smell, visual disturbances (for example, diplopia or double vision, changes in color vision), tinnitus, temporary hearing impairment.

The cardiovascular system

Tachycardia; flushing, migraine, fainting.

Blood and blood components

Eosinophilia, leukocytopenia, granulocytopenia, anemia, thrombocytopenia; leukocytosis, thrombocytosis, hemolytic anemia, changes in prothrombin levels. Under the influence of the drug, a temporary increase in the level of transaminases, alkaline phosphatase, or cholestatic jaundice may occur, especially in patients with previous liver diseases; temporary increase in urinary creatinine or serum bilirubin; hyperglycemia, crystalluria or hematuria.

Organs of the urinary system

Crystalluria (primarily with alkaline urine and low diuresis), glomerulonephritis, dysuria, polyuria, urinary retention, albuminuria, urethral bleeding, transient renal failure, interstitial nephritis.

Itching, drug fever.

When using eye drops

There may be a hypersensitivity reaction to the drug in the form of itching, burning, injection of the sclera; pinpoint skin hemorrhages (petechiae), blistering accompanied by bleeding, and small nodules that form scabs, as well as vasculitis; erythema nodosum, exudative erythema multiforme; Stevens-Johnson syndrome (malignant exudative erythema), Lyell's syndrome, hepatitis, liver necrosis. Anaphylactic and anaphylactoid reactions, for example, swelling of the face, blood vessels or larynx; dyspnea; joint pain, arthritis; general feeling of weakness, muscle pain, tendovaginitis, increased photosensitivity.

Contraindications

Individual intolerance to quinolones, patients with uncontrolled epilepsy, children under 15 years of age (incomplete process of skeletal formation; pregnancy, lactation, viral keratitis.

Pregnancy and lactation

Contraindicated during pregnancy and lactation.

Ciprofloxacin penetrates the placental barrier and is excreted in breast milk. Experimental studies have shown that it causes arthropathy.

Interaction

When administered together, ciprofloxacin increases the concentration of theophylline (and other xanthines, for example, caffeine), oral hypoglycemic drugs in the blood plasma and prolongs their T1/2 due to a slight decrease in the activity of microsomal oxidation processes in hepatocytes (the severity of this effect is weaker than that of cimetidine). For the same reason, the simultaneous administration of indirect anticoagulants and ciprofloxacin can increase the severity of the decrease in the prothrombin index.

The combination of very high doses of ciprofloxacin and some non-steroidal anti-inflammatory drugs (excluding acetylsalicylic acid) can cause seizures.

Oral administration together with iron-containing drugs, sucralfate and antacid drugs containing magnesium, aluminum and calcium ions leads to a decrease in its absorption, so ciprofloxacin should be given either 1-2 hours before or at least 4 hours after taking antacids.

Food also slows down the rate of absorption of ciprofloxacin, however, does not change its completeness, so that its peak concentration is observed approximately 30 minutes later than when taken on an empty stomach.

Metoclopramide accelerates the absorption of ciprofloxacin, which leads to a decrease in the time until its maximum plasma concentration is reached.

Co-administration of uricosuric drugs leads to a slower elimination of ciprofloxacin (up to 50%) and an increase in its plasma concentration.

When combined with other antimicrobial drugs, synergistic interactions are usually observed (beta-lactams, aminoglycosides, clindamycin, metronidazole): ciprofloxacin can be successfully used in combination with azlocillin and ceftazidime for infections caused by Pseudomas; with mezlocillin, azlocillin and other beta-lactam antibiotics - for streptococcal infections; with isoxazolepenicillins and vancomycin - for staphylococcal infections; with metronidazole and clindamycin - for anaerobic infections.

With the simultaneous use of ciprofloxacin and cyclosporine, an increase in serum creatinine is observed, so in such patients it is necessary to monitor this indicator 2 times a week.

When taken simultaneously with warfarin, an increase in the effect of warfarin is observed.

Ciprofloxacin infusion solution is incompatible with all infusion solutions and drugs that are physicochemically unstable at acidic pH (ciprofloxacin infusion solution pH 3.9-4.5). Do not mix the solution for intravenous administration with solutions having a pH greater than 7.

special instructions

The drug may affect reaction speed and reduce the ability to drive a car or operate complex machines (especially when ciprofloxacin and alcohol are used simultaneously).

Use with caution in patients with cerebral atherosclerosis, cerebrovascular accident, convulsive syndrome, due to the threat of adverse reactions from the central nervous system.

With simultaneous intravenous administration of ciprofloxacin and anesthetics from the group of barbituric acid derivatives, constant monitoring of heart rate, blood pressure, and ECG is necessary.

To avoid the development of crystalluria, it is unacceptable to exceed the recommended daily dose; sufficient fluid intake and maintaining an acidic urine reaction are necessary.

Eye drops cannot be used as injections.

Best before date

Film-coated tablets 250 mg - 5 years.

Film-coated tablets 500 mg - 5 years.

Film-coated tablets 750 mg - 5 years.

Film-coated tablets 250 mg - 2 years.

Eye drops 0.3% - 2 years. After opening - 1 month.

Solution for infusion 2 mg/ml - 2 years.

Analogs

  • Aquacipro
  • Alcipro
  • Arflox
  • Afenoxin
  • Vero-Ciprofloxacin
  • Zindolin
  • Ificipro OD
  • Ificipro
  • Quintor
  • Quipro
  • Lyproquin
  • Liproquin
  • Medociprin
  • Microflox
  • Neofloxin
  • Proxacin
  • Procipro
  • Recipro
  • Syphlox
  • Tacip
  • Tseprova
  • Tsefobak
  • Ciloxane
  • Ciplox
  • Tsiprinol
  • Tsiprobay
  • Ciprobid
  • Cyprobrine
  • Tsiprova
  • Ciprovin 250
  • Tsiprodar
  • Ciprodox
  • Ciproquin
  • Ciproxin
  • Ciprolacare
  • Tsiprolet
  • Ciprolone
  • Tsipromed
  • Cypronate
  • Cypropane
  • Tsiprosan
  • Tsiprosin
  • Ciprosol
  • Ciprofloxacin hydrochloride
  • Ciprocinal
  • Citeral
  • Cyflozin
  • Cifloxinal
  • Tsiflosin
  • Ciflocin
  • Tsifran OD
  • Tsifran

Reviews

I was prescribed Ciprofloxacin by my doctor for 5 days twice a day (every 12 hours). I didn't have any side effects, but it did make me feel worse.

This is my first time using ciprofloxacin. There were no side effects for the first 3 days. About 99% of UTIs went away and I experienced immediate relief within the first 24 hours. No problems with discomfort, only when urinating the color of the urine changed, no odor. I was hesitant to use it because of the side effects, but I'm glad I didn't experience any.

I had symptoms frequently - blood in my urine, pressure on my bladder, needing to pee every 10 seconds. After taking ciprofloxacin 500 mg twice, almost all the symptoms disappeared, but the side effects were terrible. I had nausea, headache, diarrhea, drowsiness and chest pain. The size of the tablet is kind of huge, so one day it got stuck in my throat.

This medicine is amazing. Ciprofloxacin solved three different urinary tract infections and cured them in one day, seriously.

I initially took amoxicillin for my UTI, but after 3 days I still had a fever, cloudy urine and general malaise. The doctor then prescribed ciprofloxacin. Wow. in less than 24 hours, the fever was gone and the urine was normal in color. My head cleared. The list of side effects is a little scary, but so far, no problems.

I'm on day 4 of 5 treatment so I can't say that the ciprofloxacin has eliminated the bacteria causing my infection, but I no longer have any symptoms of a urinary tract infection. Before I started taking it I had painful and frequent urination, fever and chills and these started to subside after the second pill, the fever and chills went away completely on the first day. I take 500 mg tablets twice a day. Luckily, I never experienced any side effects. I had a bad dream last night, but I wouldn't call it a nightmare.

I was prescribed 500 mg of ciprofloxacin twice a day for five days for my urinary tract infection. After one day (two doses), I honestly felt about 85% better. I was initially afraid to take it after reading horror stories about some of the possible side effects, but I'm glad I tried it. I have an allergy (anaphylaxis reaction) to penicillin, as this drug is (dare I say) a miracle cure for those who are allergic to penicillin.

It was a parade of stomach pains, but after taking it that day I felt much better.

I took ciprofloxacin (500 mg 2 times a day) to treat a bladder infection and the only side effect I got was drowsiness. After a few days of taking it, I made the mistake of reading reviews about the medicine and I was sure that it was slowly killing me. Well, I don't know, maybe some other side effects will come out in the future, but I can assure you that it really went away without any serious side effects. Conclusion - there are either a ton of people with their own psychomatics or I’m the only anomalous one.

I often suffer from urinary tract infections and since childhood, the only antibiotic that saved me was ciprofloxacin. I have never had any side effects.

Pregnancy progresses differently for each woman and each child, but being prepared for unpleasant sensations is half the battle won.

Table of contents:

Chronic cholecystitis is an inflammatory disease of the gallbladder. Treatment is prescribed by a gastroenterologist. It is advisable to follow a non-strict diet.

Otitis is called inflammation of the ear. To treat purulent otitis, the latest generation of antibiotics from a number of macrolides and fluoroquinolones are used.

Treatment of cystitis is not only to relieve inflammation, but also to direct therapeutic therapy to destroy the pathogen. Taking antibiotics is the basis for treating cystitis.

Apitherapy treats diseases in the following areas: neurology, rheumatology, dermatology, endocrinology, surgery, eye diseases, urology, gynecology, cardiology, otolaryngology.

If antibiotics for bronchitis are prescribed without sputum culture, then, as a rule, drugs from a group of broad-spectrum antibiotics are prescribed. In this case, it is a group of penicillin or protected penicillin.

Acute bronchitis is an acute inflammation of the tracheobronchial tree. Based on the dysfunction of external respiration, bronchitis is divided into obstructive and non-obstructive bronchitis. Symptoms of acute bronchitis are harsh breathing, scattered dry wheezing.

Conjunctivitis is a disease that causes inflammation of the lining of the eye. When a child's eyes fester, this is the first sign of such a disease.

In children, peritonitis has a number of specific features due to the structural features of internal organs and their functionality.

Chronic cholecystitis is an inflammatory disease lasting more than 6 months, affecting the walls of the gallbladder mainly in the cervical area, usually occurring with impaired bile circulation.

All materials presented on the site are for informational and informational purposes only and cannot be considered a guide to treatment or the choice of certain treatments.

Do not self-medicate. At the first signs of a disease, consult a doctor; only a doctor has the competence to diagnose the disease and the right to prescribe medications.

The site administration and the authors of the articles are not responsible for any losses and consequences that may arise when using the site materials.

Source: http://site-zdorovie.ru/lekarstvennie-sredstva/ciprofloksacin-instrukciya-po-primeneniyu.htm

Ciprofloxacin

Release forms

Sale: by prescription

Storage: 15-25C (room temperature)

Shelf life: 36 months.

Sale: by prescription

Storage: 15-25C (room temperature)

Shelf life: 36 months.

Sale: by prescription

Storage: 15-25C (room temperature)

Shelf life: 24 months.

Sale: by prescription

Storage: 15-25C (room temperature)

Shelf life: 36 months.

Sale: by prescription

Storage: 15-25C (room temperature)

Shelf life: 36 months.

Sale: by prescription

Storage: 15-25C (room temperature)

Shelf life: 24 months.

Ciprofloxacin instructions

Ciprofloxacin is an antibiotic that has a bactericidal effect against a wide range of pathogenic microorganisms. It does not slow down or stop the development and reproduction of microscopic objects, as bacteriostatic drugs do, but completely destroys bacteria, causing their death and subsequent removal from the body. The mechanism of action of this antibiotic is based on the inhibition of bacterial DNA gyrase, an enzyme responsible for DNA duplication, without which the process of protein synthesis is unthinkable.

Among the bacteria that are affected by ciprofloxacin, there are both gram-negative and gram-positive specimens. Bacteria of the genus Staphylococcus, Streptococcus, Enterobacteriaceae, Escherichia coli and Haemophilus influenzae, Klebsiella, Morganella, Neisseria, Salmonella, Shigella, Legionella, Providence, Yersinia, Chlamydia, Mycobacteria and many others are sensitive to it.

Taking ciprofloxacin is associated with a number of restrictions. So, while undergoing treatment with this drug, it is necessary to refrain from excessive exposure to the open sun. An important condition for the effective operation of the drug is the consumption of a sufficient volume of fluid to maintain diuresis at a normal level (otherwise hemato- and crystalluria may occur).

The method of administration and dose of ciprofloxacin are determined individually depending on the severity and localization of the infection in the body, the age and body weight of the patient, his general health in general and the functional state of the urinary system in particular.

The recommended single dose for tablets is 250 mg for uncomplicated and 500 mg for complex infections when taken twice daily. The drug is taken on an empty stomach along with plenty of liquid. The average course of treatment with ciprofloxacin is 7 to 10 days. For severe infections, the drug can be used in the form of intravenous infusions of 400 mg twice a day (a detailed list of antibiotic doses depending on the disease is given in the package insert). In ophthalmological and ENT practice, ciprofloxacin is used topically in the form of eye and ear drops. For mild and moderate eye infections, it is enough to instill 2 drops of the drug into the conjunctival sac every 4 hours, for severe ones - every hour. Eye ointment, as a dosage form of ciprofloxacin, is currently not widely used and is produced by only one plant - the Russian OJSC Tatkhimfarmpreparaty. In otolaryngology, the recommended dose of ciprofloxacin is 3-4 drops instilled into the external auditory canal 2-4 times a day.

Reviews from doctors about ciprofloxacin

One of my most frequently prescribed antibiotics. This drug has a wide spectrum of action and is also effective. It has different dosage forms (tablets, eye drops and ear drops). Side effects are rarely observed. I personally use it for myself too. The big “+” is the price/quality ratio: because The drug is inexpensive, so patients always buy it if you prescribe it (greater patient adherence to the prescribed treatment).

Ciprofloxacin is a broad-spectrum antibiotic with high efficiency. Convenient application regimen (twice a day). It is used for 7-10 days, I usually prescribe seven days. Affordable price for everyone. The official annotation indicates a large list of side effects. I have never encountered any side effects, but if they write about it, it means we need to take this into account. I would like to note that during the period of taking the drug it is necessary to avoid excessive insolation (sun exposure), and it is also necessary to drink a sufficient amount of fluid.

Age limit, not recommended under 18 years old.

Produced by our industry.

First-line antibacterial drug in urology. Efficiency is high.

Frequent and uncontrolled use causes a decrease in effectiveness, as an antibiotic predisposes to dysbacteriosis and stomatitis. May cause allergies. Taking the drug for more than 5 days requires monitoring of blood tests.

Affordable, effective. Not acceptable for self-medication.

An excellent drug in its group. Particularly pleasing is its effectiveness against soft tissue infections. Repeatedly tested on myself and patients.

Side effects are the same as with all antibiotics. May cause dysbacteriosis; allergic reactions have rarely been observed.

I recommend the drug for the treatment and prevention of soft tissue infections.

The drug has its own advantages and disadvantages, there are problems with increasing antibacterial resistance after the use of ciprofloxacin, currently it should be used only as a reserve drug in the absence of effect from other antibiotics. Convenient form of application twice a day, few direct allergic reactions. It cannot be used in children under 18 years of age, which limits its use in general.

The origin and quality of the drug is often unclear, since it is produced by many large and small pharmaceutical companies.

One of the best broad-spectrum antibacterial drugs, especially effective for respiratory tract and genitourinary infections. It has minimal impact on normal intestinal flora, which allows it to be used without fear of dysbacteriosis.

According to personal impressions, a number of patients experience moderate hematological toxicity in the form of a decrease in platelet counts.

The drug of choice for the treatment of pneumonia, bronchitis, cystitis, pyelonephritis, prostatitis.

An excellent antimicrobial drug with a broad spectrum of bactericidal action from the group of fluoroquinolones. Works well in the treatment of infectious and inflammatory diseases. Inexpensive drug, available in pharmacy chains.

Long-term use may cause dysbacteriosis.

I use this drug in urological practice.

An excellent antibacterial drug with a strong antimicrobial effect. Copes well with various infections and inflammations. A relatively inexpensive antibiotic that comes in many forms.

It has side effects typical of antibacterial drugs. With long-term therapy, it can cause dysbacteriosis and stomatitis.

Effective in urology in the treatment of cystitis, cystourethritis.

In gynecology, in the treatment of cervicitis, the effectiveness is about 50%, even taking into account typing to antibiotics and proven sensitivity to ciprofloxacin. This is partly due to low bioavailability - drugs pass into the cervical canal quite poorly, but, to a greater extent, these are cheap generics. Patients really like to take ciprofloxacin for 27 rubles instead of at least Ciprolet (not to mention Ciprobay). The effectiveness of such a drug tends to zero.

Ciproflosacin is one of the most frequently prescribed antibacterial drugs, since it has a wide spectrum of action, is quite well tolerated, and has several dosages, which makes it easier to prescribe the drug in different age groups. In gastroenterology, it is effective in exacerbation of cholecystitis, postcholecytectomy disorders, enterocolitis, and in the syndrome of bacterial overgrowth in the intestines.

It rarely produces side effects in the form of bitterness and nausea, which resolve on their own.

One of the main broad-spectrum antibiotics for empirical antibacterial therapy. Available in parenteral and oral forms, which is convenient for starting treatment and subsequent long-term use.

There are many generics, some of which are significantly less effective. In hospitals, resistant forms of microorganisms are often found.

For me, this drug is the best antibiotic in gastroenterology. Quickly and efficiently copes with infections and inflammatory processes. I often prescribe IV to severe patients in a hospital setting. The drug was well tolerated, no side effects were noticed. The price of the drug is low, every patient can afford it.

Patient reviews of ciprofloxacin

I always try to treat colds using traditional methods. Raspberries, cans, milk and soda, etc. But sometimes you develop a sore. Nowadays, being sick is expensive, and you don’t want to miss work. We have to use antibiotics. “Ciprofloxacin” suits me personally quite well. I take it 2 times a day on an empty stomach with water. Dosage per dose is 500 mg. Within one or two weeks the condition returns to normal. The medicine is generally inexpensive and accessible. In our pharmacy (Evpatoria) it costs from 25 to 40 rubles. The disadvantage for me personally is that it has a bad effect on the stomach, sometimes even leading to vomiting. But in principle, it’s a completely normal budget medicine.

Ciprofloxacin is the best antibiotic you can find. I've been using it for three years now. Basically, I find use for this drug when I have flu and colds. When I have the flu, I take these pills, and after 2-3 days I completely recover. The drug perfectly reduces fever and improves well-being. But the main thing is to watch the doses correctly. Personally, I buy a drug in which 1 tablet contains 500 mg of ciprofloxacin. It's more effective. I take the whole tablet half an hour after eating, or divide it into two (250 mg each morning and evening). And most importantly, you should not take it on an empty stomach, just like any other medicine. I have never observed any side effects. But, in addition to colds and flu, this drug is also effective against other infectious diseases.

My husband was prescribed this antibiotic for chronic prostatitis, and it helped very well. The only thing is that they supplemented the treatment with Smartprost to enhance the effect, because the disease is already quite advanced. And in the acute stage, he probably would have managed on his own.

An excellent drug for inflammation, I had laryngitis, I took 2 pieces for 5 days, now I feel good, I heard that there is also powder for injection, but this is for serious diseases. The downside is that by the 4th day it created a problem with the intestinal microflora, I had to buy biological products to restore the microflora. But I didn’t notice any serious disadvantages. The main thing is that the doctor prescribes it.

I have known Ciprofloxacin for quite some time. A very good antibiotic and, in principle, cheap. Price has absolutely no fundamental significance when choosing medications. I first felt the need to take Ciprofloxacin during an exacerbation of chronic dental periodontitis, when pus had already appeared. The most important thing is to drink the whole course from 5, and according to new standards, sometimes up to 7 days, so that antibiotic resistance does not appear. I did not have any side effects, the acute period of the disease passed within 2 days of starting to take the medicine. I took the course and forgot about the toothache.

The doctor prescribed me ciprofloxacin to treat bladder inflammation. Course 10 days, 2 tablets. The drug helped me; repeated tests revealed no inflammation. While taking ciprofloxacin on the third day, I experienced a side effect in the form of abdominal pain and indigestion. But then these symptoms disappeared. As I understand it, ciprofloxacin is a new generation antibiotic, quite effective and reliable.

There was acute bronchitis when ciprofloxacin was prescribed. I’m happy, it helped quickly and the price is reasonable. I took flemoxin before, but it didn’t help at all, although it’s a bit expensive.

My treatment for acute bronchitis began with a macrolide antibiotic, which not only did not improve my condition, but on the third day of use caused an allergy in the form of angioedema. As a replacement, the doctor prescribed the drug ciprofloxacin tablets. By the evening of the second day, my condition improved - the whistling sounds disappeared, my breathing became less harsh, and my cough became more moist. Another day later, the doctor stated that the wheezing had disappeared. In combination with an expectorant, the five-day course of taking the antibiotic was completed. Ciprofloxacin coped with bronchitis, and, most wonderfully, the side effects no longer bothered me.

Last summer, during the air conditioning season, my husband came home from work with a fever and signs of acute respiratory infections. He went to the family doctor, prescribed him some kind of children's treatment (syrups, lozenges) and sent him home. The temperature did not drop, and his health did not improve, and he again went to the clinic and insisted on additional examinations. Pneumonia was discovered! He was urgently admitted to the hospital and the first point of treatment was the antibiotic Ciprofloxacin. On the same day the temperature dropped, and the next day it dropped to normal. My husband is on the mend, and we finally breathe a sigh of relief. True, this antibiotic had a strange side effect - in the first days of the IV drips, my husband’s scalp was very flaky, peeling off in whole flakes, like dandruff, only in larger sizes.

I have been suffering from chronic pyelonephritis since childhood, and in the acute stage of the disease I cannot do without an antibiotic. Back in 2005, the doctor prescribed Ciprofloxacin for the first time - it helped literally within a week of taking it, and this is very fast - previously I treated an exacerbation of the disease for 3-4 weeks. Since then I have been treated with it constantly, and it always helps as if for the first time. In May, my son fell ill with an intestinal infection, the pediatrician prescribed ciprofloxacin intravenously - and then it helped a lot, after 3 days the child’s tests became an order of magnitude better than they were before taking it. Another significant advantage of this drug is its low price and the fact that it can be found in any pharmacy.

I used ciprofloxacion in the treatment of meibomitis (hordeolum) in my daughter on the recommendation of an ophthalmologist. The medicine really helped - on the 2nd day the purulent contents began to drain away. The only drawback is that when ciprofloxacin gets on the skin, itching and red rashes appear, so you need to use it with caution (wash your face after instillation, if necessary, give an antiallergic drug).

Patient Questions

In addition, it is not indicated in what concentration it was detected, and this is important. And lastly, Ciprofloxacin currently has a weak effect, since E. coli has developed immunity to it. Therefore, Immunomax is unlikely to improve the situation.

Instructions for use of ciprofloxacin

pharmachologic effect

Broad-spectrum antimicrobial agent of the fluoroquinolone group. Has a bactericidal effect. Suppresses DNA gyrase and inhibits bacterial DNA synthesis.

Highly active against most gram-negative bacteria: Pseudomonas aeruginosa, Haemophilus influenzae, Escherichia coli, Shigella spp., Salmonella spp., Neisseria meningitidis, Neisseria gonorrhoeae.

Active against Staphylococcus spp. (including strains that produce and do not produce penicillinase, methicillin-resistant strains), some strains of Enterococcus spp., Campylobacter spp., Legionella spp., Mycoplasma spp., Chlamydia spp., Mycobacterium spp.

Ciprofloxacin is active against bacteria that produce beta-lactamases.

Ureaplasma urealyticum, Clostridium difficile, and Nocardia asteroides are resistant to ciprofloxacin. The effect against Treponema pallidum has not been sufficiently studied.

Pharmacokinetics

Release form, composition and packaging

100 ml - polyethylene bottles (1) - cardboard packs.

100 ml - polyethylene bottles (50) - cardboard boxes.

Dosage regimen

Individual. Inside - pomg 2 times a day. The duration of treatment is from 7-10 days to 4 weeks.

For intravenous administration, a single dose is mg, the frequency of administration is 2 times a day; Duration of treatment: a week, or more if necessary. It can be administered intravenously as a stream, but drip administration over 30 minutes is more preferable.

When applied topically, instill 1-2 drops into the lower conjunctival sac of the affected eye every 1-4 hours. After the condition improves, the intervals between instillations can be increased.

The maximum daily dose for adults when taken orally is 1.5 g.

Drug interactions

With simultaneous use of ciprofloxacin with didanosine, the absorption of ciprofloxacin is reduced due to the formation of ciprofloxacin complexes with aluminum and magnesium buffers contained in didanosine.

When used simultaneously with warfarin, the risk of bleeding increases.

With the simultaneous use of ciprofloxacin and theophylline, it is possible to increase the concentration of theophylline in the blood plasma, increase T1 /2 of theophylline, which leads to an increased risk of developing toxic effects associated with theophylline.

Simultaneous use of antacids, as well as drugs containing aluminum, zinc, iron or magnesium ions, can cause a decrease in the absorption of ciprofloxacin, so the interval between the administration of these drugs should be at least 4 hours.

Side effect

From the digestive system: nausea, vomiting, diarrhea, abdominal pain, increased activity of liver transaminases, alkaline phosphatase, LDH, bilirubin, pseudomembranous colitis.

From the side of the central nervous system: headache, dizziness, feeling of fatigue, sleep disorders, nightmares, hallucinations, fainting, visual disturbances.

From the urinary system: crystalluria, glomerulonephritis, dysuria, polyuria, albuminuria, hematuria, transient increase in serum creatinine.

From the hematopoietic system: eosinophilia, leukopenia, neutropenia, change in platelet count.

From the cardiovascular system: tachycardia, heart rhythm disturbances, arterial hypotension.

Allergic reactions: skin itching, urticaria, Quincke's edema, Stevens-Johnson syndrome, arthralgia.

Adverse reactions associated with chemotherapy: candidiasis.

Local reactions: pain, phlebitis (with intravenous administration). When using eye drops, in some cases, mild soreness and hyperemia of the conjunctiva are possible.

Indications

Infectious and inflammatory diseases caused by microorganisms sensitive to ciprofloxacin, incl. diseases of the respiratory tract, abdominal cavity and pelvic organs, bones, joints, skin; septicemia; severe infections of the ENT organs. Treatment of postoperative infections. Prevention and treatment of infections in patients with reduced immunity.

For local use: acute and subacute conjunctivitis, blepharoconjunctivitis, blepharitis, bacterial corneal ulcers, keratitis, keratoconjunctivitis, chronic dacryocystitis, meibomitis. Infectious eye lesions after injury or foreign bodies. Preoperative prophylaxis in ophthalmic surgery.

Contraindications for use

Use during pregnancy and breastfeeding

Contraindicated during pregnancy and lactation.

Ciprofloxacin penetrates the placental barrier and is excreted in breast milk.

Experimental studies have shown that it causes arthropathy.

Use for renal impairment

Use in children

Contraindicated in children and adolescents under 15 years of age.

special instructions

In patients with impaired renal function, dosage regimen adjustment is required. Use with caution in elderly patients, with atherosclerosis of cerebral vessels, cerebrovascular accidents, epilepsy, and convulsive syndrome of unknown etiology.

During treatment, patients should receive sufficient fluids.

In case of persistent diarrhea, ciprofloxacin should be discontinued.

With simultaneous intravenous administration of ciprofloxacin and barbiturates, monitoring of heart rate, blood pressure, and ECG is necessary. During treatment, it is necessary to control the concentration of urea, creatinine, and liver transaminases in the blood.

During treatment, a decrease in reactivity is possible (especially when used simultaneously with alcohol).

Ciprofloxacin should not be administered subconjunctivally or directly into the anterior chamber of the eye.

Source: http://protabletky.ru/ciprofloxacin/

Ciprofloxacin

Ciprofloxacin: instructions for use and reviews

Latin name: Ciprofloxacinum

ATX code: S03AA07

Active ingredient: Ciprofloxacin (Ciprofloxacinum)

Manufacturer: PJSC "Farmak", PJSC "Tekhnolog", JSC "Kievmedpreparat" (Ukraine), LLC "Ozon", JSC "Veropharm", JSC "Sintez" (Russia), CO Rompharm Company SRL (Romania)

Update of description and photo: 05.11.2017

Prices in pharmacies: from 15 rubles.

Ciprofloxacin is an antimicrobial drug with a broad spectrum of bactericidal action from the group of fluoroquinolones.

Release form and composition

  • film-coated tablets (the appearance of the tablets and the shape of the packaging depend on the manufacturer and dose of the active substance);
  • solution for infusion: clear, colorless or slightly colored liquid (100 ml bottles; the number of bottles per package depends on the manufacturer);
  • concentrate for preparing a solution for infusion: transparent, colorless or slightly greenish-yellow liquid without mechanical inclusions (10 ml bottles, 5 bottles in a cardboard box);
  • eye drops 0.3%: clear liquid, yellowish-greenish or slightly yellow (1 ml, 1.5 ml, 2 ml, 5 ml or 10 ml in bottles or polyethylene dropper tubes with a polyethylene valve/screw neck, according to 1 bottle, 1 or 5 dropper tubes in a cardboard box);
  • eye and ear drops 0.3%: transparent, colorless or slightly yellowish liquid (5 ml in polymer dropper bottles, 1 bottle in a cardboard pack).

Composition of 1 film-coated tablet:

  • active ingredient: ciprofloxacin – 250, 500 or 750 mg;
  • auxiliary components: starch 1500 or corn starch, lactose (milk sugar), magnesium stearate, crospovidone, MCC (microcrystalline cellulose), talc;
  • shell: the content and number of components depend on the manufacturer.

Composition of 1 ml solution for infusion:

  • active ingredient: ciprofloxacin (in the form of monohydrate hydrochloride) – 2 mg (2.33 mg);
  • auxiliary components: lactic acid, sodium chloride, 1M sodium hydroxide solution, disodium ethylenediaminetetraacetic acid, water for injection.

Composition of 1 ml of concentrate for the preparation of solution for infusion:

  • active ingredient: ciprofloxacin (in the form of hydrochloride) – 100 mg (111 mg);
  • auxiliary components: disodium edetate dihydrate, lactic acid, hydrochloric acid, sodium hydroxide, water for injection.

Composition of 1 ml eye drops 0.3%:

  • active ingredient: ciprofloxacin (in the form of hydrochloride monohydrate) – 3 mg;
  • auxiliary components: mannitol, disodium edetate, sodium acetate, benzalkonium chloride, acetic acid, water for injection.

Composition of 1 ml eye and ear drops 0.3%:

  • active ingredient: ciprofloxacin (in the form of hydrochloride monohydrate) – 3 mg;
  • auxiliary components: mannitol, sodium acetate trihydrate, disodium edetate dihydrate, benzalkonium chloride, glacial acetic acid, purified water.

Pharmacological properties

Pharmacodynamics

Ciprofloxacin is a broad-spectrum antimicrobial drug. This quinolone derivative inhibits bacterial DNA gyrase (topoisomerases II and IV, responsible for the process of supercoiling of chromosomal DNA around RNA nuclei, which ensures the reading of the necessary genetic information), disrupts DNA production, inhibits the growth and reproduction of bacteria, leads to pronounced changes in morphological nature (in including cell membranes and walls) and immediate death of bacterial cells.

The substance has a bactericidal effect against gram-negative microorganisms during the period of division and dormancy (since it affects not only DNA gyrase, but also provokes lysis of cell walls). Ciprofloxacin affects gram-positive microorganisms only during the division period.

Low toxicity to the cells of the macroorganism is due to the absence of DNA gyrase in them. During treatment with ciprofloxacin, parallel resistance to other antibiotics not included in the group of DNA gyrase inhibitors does not develop. This increases the effectiveness of the drug against bacteria resistant to tetracyclines, aminoglycosides, cephalosporins, and penicillins.

Hypersensitivity to ciprofloxacin is characterized by:

  • gram-negative aerobic bacteria: enterobacteria (Yersinia spp., Escherichia coli, Vibrio spp., Salmonella spp., Morganella morganii, Shigella spp., Providencia spp., Citrobacter spp., Edwardsiella tarda, Klebsiella spp., Hafnia alvei, Proteus vulgaris, Proteus mirabilis, Serratia marcescens), some intracellular pathogens (Mycobacterium kansasii, Mycobacterium tuberculosis, Legionella pneumophila, Listeria monocytogenes, Brucella spp.);
  • gram-positive aerobic bacteria: Streptococcus spp. (Streptococcus agalactiae, Streptococcus pyogenes), Staphylococcus spp. (Staphylococcus saprophyticus, Staphylococcus aureus, Staphylococcus hominis, Staphylococcus haemolyticus).

Ciprofloxacin is active against Bacillus anthracis. Most staphylococci that are resistant to methicillin also exhibit similar resistance to ciprofloxacin. The sensitivity of Mycobacterium avium, Enterococcus faecalis, Streptococcus pneumoniae (localized intracellularly) is moderate: high concentrations of the drug are required to suppress the vital activity of these microorganisms.

The drug has no effect on Nocardia asteroids, Bacteroides fragilis, Clostridium difficile, Ureaplasma urealyticum, Pseudomonas maltophilia, Pseudomonas cepacia. It is also not effective enough against Treponema pallidum.

Resistance develops quite slowly, since ciprofloxacin almost completely destroys persistent microorganisms, and bacterial cells lack enzymes that inactivate it.

Pharmacokinetics

When taken orally, ciprofloxacin tablets are almost completely and rapidly absorbed from the gastrointestinal tract (mainly in the jejunum and duodenum). Eating inhibits absorption but does not affect bioavailability and maximum concentration. Bioavailability is 50–85%, and the volume of distribution is 2–3.5 l/kg. Ciprofloxacin is approximately 20-40% bound to plasma proteins. The maximum level of the substance in the body when taken orally is reached in approximately minutes. The maximum concentration is related to the dose taken by a linear dependence and is 5.4, 4.3, 2.4 and 1.2 μg/ml at doses of 1000, 750, 500 and 250 mg, respectively. 12 hours after oral administration of 750, 500 and 250 mg, the content of ciprofloxacin in plasma decreases to 0.4, 0.2 and 0.1 μg/ml, respectively.

The substance is well distributed in body tissues (excluding tissues enriched in fats, for example, nervous tissue). Its content in tissues is 2–12 times higher than in blood plasma. Therapeutic concentrations are found in the skin, saliva, peritoneal fluid, tonsils, articular cartilage and synovial fluid, bone and muscle tissue, intestines, liver, bile, gallbladder, kidneys and urinary system, abdominal and pelvic organs (uterus, ovaries and fallopian tubes, endometrium), prostate tissue, seminal fluid, bronchial secretions, lung tissue.

Ciprofloxacin penetrates into the cerebrospinal fluid in small concentrations, where its content in the absence of an inflammatory process in the meninges is 6–10% of that in the blood serum, and in the presence of inflammatory foci – 14–37%.

Ciprofloxacin also penetrates well into the lymph, pleura, ocular fluid, peritoneum and through the placenta. Its concentration in blood neutrophils is 2–7 times higher than in blood serum. The compound is metabolized in the liver by approximately 15-30%, forming low-active metabolites (formylciprofloxacin, diethylciprofloxacin, oxociprofloxacin, sulfocyprofloxacin).

The half-life of ciprofloxacin is about 4 hours, increasing to 12 hours in chronic renal failure. It is excreted mainly through the kidneys through tubular secretion and tubular filtration in unchanged form (40–50%) and in the form of metabolites (15%), the rest is excreted through the gastrointestinal tract. A small amount of ciprofloxacin is excreted in breast milk. Renal clearance is 3–5 ml/min/kg, and total clearance is 8–10 ml/min/kg.

In chronic renal failure (creatinine clearance more than 20 ml/min), the degree of excretion of ciprofloxacin through the kidneys is reduced, but it does not accumulate in the body due to a compensatory increase in the metabolism of this substance and its excretion through the gastrointestinal tract.

When carrying out an intravenous infusion of the drug at a dose of 200 mg, the maximum concentration of ciprofloxacin, amounting to 2.1 mcg/ml, is achieved after 60 minutes. After intravenous administration, the content of ciprofloxacin in the urine during the first 2 hours after infusion is almost 100 times higher than in the blood plasma, which significantly exceeds the minimum inhibitory concentration for most pathogens of urinary tract infections.

When applied topically, ciprofloxacin penetrates well into the tissues of the eye: the anterior chamber and the cornea, especially if the epithelial cover of the cornea is damaged. When it is damaged, the substance accumulates in it in concentrations capable of destroying most pathogens of corneal infections.

After a single instillation, the content of ciprofloxacin in the aqueous humor of the anterior chamber of the eye is determined after 10 minutes and is 100 mcg/ml. The maximum concentration of the compound in the moisture of the anterior chamber is reached after 1 hour and is equal to 190 μg/ml. After 2 hours, the concentration of ciprofloxacin begins to decrease, however, its antibacterial effect in the tissues of the cornea is prolonged and persists for 6 hours, in the moisture of the anterior chamber - up to 4 hours.

After instillation, systemic absorption of ciprofloxacin may be observed. When used in the form of eye drops 4 times a day in both eyes for 7 days, the average concentration of the substance in the blood plasma does not exceed 2–2.5 ng/ml, and the maximum concentration is less than 5 ng/ml.

Indications for use

Systemic use (tablets, solution for infusion, concentrate for solution for infusion)

In adult patients, Ciprofloxacin is used for the treatment and prevention of infectious and inflammatory diseases caused by sensitive microorganisms:

  • bronchitis (chronic in the acute stage and acute), bronchiectasis, pneumonia, cystic fibrosis and other respiratory tract infections;
  • frontal sinusitis, sinusitis, pharyngitis, otitis media, sinusitis, tonsillitis, mastoiditis and other infections of the ENT organs;
  • pyelonephritis, cystitis and other kidney and urinary tract infections;
  • adnexitis, gonorrhea, prostatitis, chlamydia and other infections of the pelvic and genital organs;
  • bacterial lesions of the gastrointestinal tract (gastrointestinal tract), bile ducts, intraperitoneal abscess and other infections of the abdominal organs;
  • ulcerative infections, burns, abscesses, wounds, phlegmon and other infections of the skin and soft tissues;
  • septic arthritis, osteomyelitis and other infections of bones and joints;
  • surgical operations (to prevent infection);
  • pulmonary anthrax (for prevention and therapy);
  • infections due to immunodeficiency resulting from therapy with immunosuppressive drugs or neutropenia.

For children aged 5 to 17 years, systemic Ciprofloxacin is prescribed for cystic fibrosis of the lungs for the treatment of complications caused by Pseudomonas aeruginosa, as well as for the prevention and treatment of pulmonary anthrax (Bacillus anthracis).

The solution for infusion and the concentrate for preparing the solution for infusion are also used for eye infections and severe general infection of the body - sepsis.

The tablets are prescribed for SDC (selective intestinal decontamination) in patients with reduced immunity.

Topical application (eye drops, eye drops and ear drops)

Ciprofloxacin drops are used for the treatment and prevention of the following infectious inflammations caused by microorganisms sensitive to ciprofloxacin:

  • ophthalmology (eye drops, eye and ear drops): blepharitis, subacute and acute conjunctivitis, blepharoconjunctivitis, keratitis, keratoconjunctivitis, meibomitis (styre), chronic dacryocystitis, bacterial corneal ulcer, bacterial eye lesions due to trauma or foreign bodies, perioperative prevention of infection in ophthalmic surgery;
  • otorhinolaryngology (eye and ear drops): otitis externa, treatment of infectious complications in the postoperative period.

Contraindications

Systemic application

  • co-administration with tizanidine [due to the high likelihood of a pronounced decrease in blood pressure (blood pressure) and drowsiness];
  • pseudomembranous colitis;
  • pregnancy and breastfeeding;
  • childhood and adolescence up to 18 years of age, except for cases of treatment and prevention of pulmonary anthrax (Bacillus anthracis), as well as treatment of complications caused by Pseudomonas aeruginosa in children with cystic fibrosis of the lungs aged 5 to 17 years;
  • lactase deficiency, lactose intolerance, glucose-galactose malabsorption (for tablets);
  • increased individual sensitivity to Ciprofloxacin, other fluoroquinolones and auxiliary ingredients of the drug.

Relative: systemically Ciprofloxacin is used with caution in cases of severe cerebral atherosclerosis, cerebrovascular accidents, mental illness, epilepsy, severe renal/liver failure, in old age, in the presence of a history of tendon lesions during fluoroquinolone therapy. Solution for infusion (optional) is used with caution in cases of increased risk of prolongation of the QT interval/development of arrhythmia such as torsades de pointes, including heart failure, bradycardia, myocardial infarction, congenital long QT interval syndrome and electrolyte imbalance (hypokalemia, hypomagnesemia).

Local application

Absolute contraindications to topical use of ciprofloxacin:

  • ophthalmic mycosis and viral eye infections;
  • pregnancy and breastfeeding (for ophthalmic instillations);
  • age up to 1 year (for ophthalmic instillations);
  • increased individual sensitivity to components.

The use of the drug in otorhinolaryngology (eye and ear drops) during pregnancy and during breastfeeding is permissible only if the possible benefit of therapy for the mother justifies the potential risk to the fetus or child.

Instructions for use of Ciprofloxacin: method and dosage

After the disappearance of clinical symptoms of the disease and normalization of body temperature, Ciprofloxacin therapy is continued for at least another 3 days.

Film-coated tablets

Ciprofloxacin tablets are taken orally after meals, swallowed whole with a small amount of liquid. Taking tablets on an empty stomach accelerates the absorption of the active substance.

Recommended dosage: 250 mg 2-3 times a day, for severe infections - 500-750 mg 2 times a day (once every 12 hours).

Dosage depending on the disease/condition:

  • urinary tract infections: twice a day, 250–500 mg for a course of 7 to 10 days;
  • chronic prostatitis: twice a day, 500 mg for a course of 28 days;
  • uncomplicated gonorrhea: 250–500 mg once;
  • gonococcal infection in combination with chlamydia and mycoplasmosis: twice a day (once every 12 hours) 750 mg for a course of 7 to 10 days;
  • chancroid: 500 mg twice a day for several days;
  • meningococcal carriage in the nasopharynx: 500–750 mg once;
  • chronic carriage of salmonella: 500 mg twice a day (if necessary, increase to 750 mg) for up to 28 days;
  • severe infections (recurrent cystic fibrosis, infections of the abdominal cavity, bones, joints) caused by pseudomonas or staphylococci, acute pneumonia caused by streptococci, chlamydial infections of the genitourinary tract: twice a day (once every 12 hours) at a dose of 750 mg (course of therapy for osteomyelitis can last up to 60 days);
  • infections of the gastrointestinal tract caused by Staphylococcus aureus: twice a day (once every 12 hours) at a dose of 750 mg for a course of 7 to 28 days;
  • complications caused by Pseudomonas aeruginosa in children 5–17 years old with cystic fibrosis of the lungs: twice a day, 20 mg/kg (maximum daily dose – 1500 mg) for a course of 10 to 14 days;
  • pulmonary form of anthrax (treatment and prevention): twice a day for children 15 mg/kg, adults - 500 mg (maximum doses: single - 500 mg, daily - 1000 mg), course of treatment - up to 60 days, start taking the drug follows immediately after infection (suspected or confirmed).

Maximum daily dose of Ciprofloxacin for renal failure:

  • creatinine clearance (CC) 31–60 ml/min/1.73 m2 or serum creatinine concentration 1.4–1.9 mg/100 ml – 1000 mg;
  • CC < 30 ml/min/1.73 m 2 or serum creatinine concentration > 2 mg/100 ml – 500 mg.

Patients on hemo- or peritoneal dialysis should take the tablets after the dialysis session.

Elderly patients require a dose reduction of 30%.

Solution for infusion, concentrate for the preparation of solution for infusion

The drug is administered intravenously, slowly, into a large vein, this reduces the risk of complications at the injection site. When administering 200 mg of ciprofloxacin, the infusion lasts 30 minutes, 400 mg – 60 minutes.

The concentrate for preparing a solution for infusion must be diluted before use to a minimum volume of 50 ml in the following infusion solutions: 0.9% sodium chloride solution, Ringer's solution, 5% or 10% dextrose solution, 10% fructose solution, 5% dextrose solution with 0.225 –0.45% sodium chloride solution.

The solution for infusion is administered alone or together with compatible solutions for infusion: 0.9% sodium chloride solution, Ringer's solution and Ringer's Lactate, 5% or 10% dextrose solution, 10% fructose solution, 5% dextrose solution with 0.225–0.45 % sodium chloride solution. The solution obtained after mixing should be used as quickly as possible in order to maintain its sterility.

If compatibility with another solution/medicinal substance is not confirmed, the Ciprofloxacin infusion solution is administered separately. Visible signs of incompatibility are precipitation, turbidity or discoloration of the liquid. The pH value of the Ciprofloxacin infusion solution is 3.5–4.6, therefore it is incompatible with all solutions/preparations that are physically or chemically unstable at such pH values ​​(heparin solution, penicillins), especially with agents that change pH values to the alkaline side. Due to storage of the solution at low temperatures, the formation of a precipitate that is soluble at room temperature is possible. It is not recommended to store the infusion solution in the refrigerator or freeze it, since only a clean and clear solution is suitable for use.

Recommended dosage regimen of Ciprofloxacin for adult patients:

  • respiratory tract infections: depending on the patient’s condition and the severity of the infection - 2 or 3 times a day, 400 mg;
  • infections of the genitourinary system: acute, uncomplicated - 2 times a day from 200 to 400 mg, complicated - 2 or 3 times a day 400 mg;
  • adnexitis, chronic bacterial prostatitis, orchitis, epididymitis: 2 or 3 times a day, 400 mg;
  • diarrhea: 2 times a day, 400 mg;
  • other infections listed in the “Indications for use” section: 2 times a day, 400 mg;
  • severe life-threatening infections, especially those caused by Staphylococcus spp., Pseudomonas spp., Streptococcus spp., including pneumonia caused by Streptococcus spp., peritonitis, bone and joint infections, septicemia, recurrent infections in cystic fibrosis: 3 times a day, 400 mg ;
  • pulmonary (inhalation) form of anthrax: 2 times a day, 400 mg for a course of 60 days (for therapy and prevention).

The dose of ciprofloxacin in elderly patients is adjusted downwards depending on the severity of the disease and the QC indicator.

For the treatment of complications in pulmonary cystic fibrosis caused by Pseudomonas aeruginosa in children aged 5–17 years, a dose of 10 mg/kg (maximum daily dose of 1200 mg) is recommended 3 times a day for a course of 10–14 days. For the treatment and prevention of pulmonary anthrax, 2 infusions per day of 10 mg/kg of ciprofloxacin are recommended (maximum single - 400 mg, daily - 800 mg), course - 60 days.

Maximum daily dose of ciprofloxacin for renal failure:

  • creatinine clearance (CC) 31–60 ml/min/1.73 m2 or serum creatinine concentration 1.4–1.9 mg/100 ml – 800 mg;
  • CC < 30 ml/min/1.73 m2 or serum creatinine concentration > 2 mg/100 ml - 400 mg.

For hemodialysis patients, ciprofloxacin is administered immediately after the session.

Average duration of therapy:

  • acute uncomplicated gonorrhea – 1 day;
  • infections of the kidneys, urinary tract and abdominal cavity – up to 7 days;
  • osteomyelitis – no more than 60 days;
  • streptococcal infections (due to the risk of late complications) – at least 10 days;
  • infections against the background of immunodeficiency resulting from therapy with immunosuppressive drugs - during the entire period of neutropenia;
  • other infections – 7–14 days.

Eye drops, eye and ear drops

In ophthalmological practice, Ciprofloxacin drops (eye, ophthalmic and ear) are instilled into the conjunctival sac.

Instillation regimen depending on the type of infection and severity of the inflammatory process:

  • acute bacterial conjunctivitis, blepharitis (simple, scaly and ulcerative), meibomitis: 1-2 drops 4-8 times a day for a course of 5-14 days;
  • keratitis: 1 drop 6 times a day for 14–28 days;
  • bacterial corneal ulcer: day 1 – 1 drop every 15 minutes for the first 6 hours of treatment, then during waking hours, 1 drop every 30 minutes; Day 2 – during waking hours, 1 drop every hour; Days 3–14 – during waking hours, 1 drop every 4 hours. If epithelization has not occurred after 14 days of therapy, treatment can be continued for another 7 days;
  • acute dacryocystitis: 1 drop 6–12 times a day for a course of no more than 14 days;
  • eye injuries, including ingestion of foreign bodies (prevention of infectious complications): 1 drop 4–8 times a day for a course of 7–14 days;
  • preoperative preparation: 1 drop 4 times a day for 2 days before surgery, 1 drop 5 times with an interval of 10 minutes immediately before surgery;
  • postoperative period (prevention of infectious complications): 1 drop 4–6 times a day for the entire period, usually from 5 to 30 days.

In otorhinolaryngology, the drug (eye and ear drops) is instilled into the external auditory canal, after carefully cleaning it.

Recommended dosage regimen: 2-4 times a day (or more often, as needed) 3-4 drops. The duration of therapy should not exceed 5–10 days, except in cases where the local flora is sensitive, then an extension of the course is allowed.

For the procedure, it is recommended to bring the solution to room temperature or body temperature to avoid vestibular stimulation. The patient should lie on the side opposite the affected ear and remain in this position for 5–10 minutes after instillation.

Sometimes, after local cleansing of the external auditory canal, it is allowed to place a cotton swab moistened with a solution of Ciprofloxacin in the ear and keep it there until the next instillation.

Side effects

Systemic application

  • digestive system: nausea/vomiting, diarrhea, flatulence, abdominal pain, loss of appetite and decreased volume of food eaten, cholestatic jaundice (especially in patients with a history of liver disease), hepatitis, hepatonecrosis;
  • nervous system: headache, dizziness, migraine, anxiety, fatigue, tremor, severe dreams (nightmares), insomnia, peripheral paraalgesia, hyperhidrosis, cerebral artery thrombosis, increased intracranial pressure, fainting, depression, confusion, hallucinations, other manifestations psychotic reactions, rarely progressing to states in which the patient is capable of harming himself;
  • sense organs: disturbances of smell and taste, visual disturbances (changes in color perception, diplopia), noise and ringing in the ears, hearing impairment up to its loss;
  • cardiovascular system: heart rhythm disturbances, tachycardia, decreased blood pressure; for the solution additionally – vasodilation, benign intracranial hypertension, cardiovascular collapse;
  • hematopoietic system: anemia, leukopenia, thrombocytopenia, granulocytopenia, leukocytosis, hemolytic anemia, thrombocytosis, inhibition of bone marrow hematopoiesis, pancytopenia;
  • laboratory parameters: increased activity of liver enzymes, hyperglycemia, hypoglycemia, hypoprothrombinemia, hyperbilirubinemia, hypercreatininemia;
  • urinary system: crystalluria, hematuria, glomerulonephritis, urinary retention, dysuria, polyuria, albuminuria, urethral bleeding, interstitial nephritis, decreased nitrogen excretory function of the kidneys;
  • musculoskeletal system: arthritis, arthralgia, tendovaginitis, myalgia, tendon ruptures;
  • hypersensitivity reactions: shortness of breath, urticaria, itching, increased photosensitivity, angioedema, blisters (accompanied by bleeding), small nodules (forming scabs), petechiae (point hemorrhages on the skin), drug fever, swelling of the face/larynx, eosinophilia, vasculitis, nodular erythema, exudative erythema multiforme (including Stevens-Johnson syndrome), Lyell's syndrome (toxic epidermal necrolysis);
  • other reactions: superinfections (including candidiasis), asthenia, flushing of the face;
  • local reactions (for solution): swelling, pain and phlebitis at the injection site.

If the above worsens or any other adverse reactions not listed in the instructions occur, you should consult a doctor.

Local application

  • hypersensitivity reactions: burning and itching, hyperemia and slight soreness of the conjunctiva (when instilled into the eyes) or in the area of ​​the outer ear and eardrum (when instilled into the ear), the development of superinfection;
  • other reactions (when instilled into the eyes): nausea, unpleasant taste in the mouth immediately after instillation, photophobia, swelling of the eyelids, lacrimation, sensation of a foreign body in the eye, decreased visual acuity, white crystalline precipitate (formed in patients with corneal ulcers), keratopathy , keratitis, formation of corneal spots/infiltration of the cornea.

Overdose

Symptoms of an overdose of Ciprofloxacin when taken orally or intravenously are nausea, vomiting, mental agitation, and clouded consciousness.

A specific antidote is unknown. When taking the drug orally, it is recommended to perform gastric lavage. You should also carefully monitor the patient’s condition, if necessary, resort to emergency measures and ensure that a large amount of fluid enters the body. Only a small (less than 10%) amount of Ciprofloxacin is excreted through hemo- or peritoneal dialysis.

Cases of overdose of Ciprofloxacin when applied topically have not been reported. If the drug is accidentally taken orally, the occurrence of overdose symptoms is unlikely, since the content of ciprofloxacin in 1 bottle of drops is negligible and is only 15 mg with a maximum daily dose of 1000 mg for adult patients and 500 mg for children. However, if the drug is ingested unintentionally, you should consult your doctor.

special instructions

Systemic application

For the treatment of suspected/established pneumonia caused by the pneumococcus Streptococcus pneumoniae, Ciprofloxacin is not the drug of choice.

Exceeding the recommended daily doses is unacceptable; to avoid the development of crystalluria, it is also necessary to consume a sufficient amount of fluid and maintain an acidic urine reaction.

If prolonged severe diarrhea occurs during or after therapy, the presence of pseudomembranous colitis should be excluded, which requires immediate discontinuation of the drug and appropriate treatment.

Pain that appears in the tendons or the first signs of tenosynovitis require immediate discontinuation of therapy; there is some evidence of inflammation and even tendon rupture during the use of fluoroquinolones.

During therapy with Ciprofloxacin, it is recommended to avoid intense artificial ultraviolet irradiation and direct sunlight, and in case of photosensitivity reaction (burn-like skin rashes) to stop taking the drug.

With long-term therapy, regular monitoring of general blood counts and renal/liver function is required.

Ciprofloxacin solution and concentrate contain sodium chloride, which should be taken into account in patients limiting sodium intake (with heart and kidney failure, nephrotic syndrome).

During treatment, due to the possibility of developing undesirable effects from the nervous system, such as dizziness, convulsions, drowsiness, caution must be observed when driving vehicles and complex mechanisms and engaging in other potentially hazardous activities.

Local application

Eye and ear drops (eye drops) are not intended for intraocular injection.

When using Ciprofloxacin drops simultaneously with other ophthalmic drugs, the interval between administrations should be at least 5 minutes.

If any symptoms of hypersensitivity occur, use of the drops should be discontinued.

If conjunctival hyperemia occurs over a long period of time or increases as a result of Ciprofloxacin therapy, you should stop using the drops and consult a doctor.

The use of soft contact lenses in conjunction with the use of Ciprofloxacin drops is not recommended. When wearing hard contact lenses, they should be removed before instillation and reinserted 15–20 minutes after instillation.

Due to possible blurred visual perception as a result of instillation of the drug, it is recommended to start working with complex mechanisms and driving vehicles 15 minutes after the procedure.

Use during pregnancy and lactation

According to the instructions, Ciprofloxacin is contraindicated during pregnancy and lactation, since it penetrates the placental barrier and into breast milk. Studies have confirmed that the drug can provoke the development of arthropathy.

Drug interactions

Due to the high pharmacological activity of Ciprofloxacin and the risk of adverse consequences of drug interactions, the decision on possible co-administration with other drugs/substances is made by the attending physician.

Analogs

Analogs of Ciprofloxacin in tablet form: Quintor, Procipro, Tseprova, Tsiprinol, Tsiprobay, Tsiprobid, Tsiprodox, Tsiprolet, Tsipropan, Tsifran, etc.

Analogues of solution for infusion and concentrate for the preparation of solution for infusion of Ciprofloxacin: Basijen, Ificipro, Quintor, Procipro, Tseprova, Tsiprinol, Ciprobid, etc.

Analogs of Ciprofloxacin eye drops/eye drops and ear drops: Betaciprol, Rocip, Tsiprolet, Ciprolon, Tsipromed, Ciprofloxacin-AKOS.

Terms and conditions of storage

Store in a dry, dark place at temperatures up to 25 °C, solution for infusion, concentrate and drops - do not freeze. Keep away from children.

The shelf life of tablets is from 2 to 5 years (depending on the manufacturer), solution and concentrate – 2 years, eye drops/eye and ear drops – 3 years.

Store eye and ear drops after opening the bottle for no more than 28 days, eye drops for no more than 14 days.

Conditions for dispensing from pharmacies

Ciprofloxacin in any form of release is available with a prescription.

Reviews of Ciprofloxacin

Reviews of Ciprofloxacin in tablet form are quite mixed. Some patients speak enthusiastically about its effectiveness, while others did not notice any changes in their condition during treatment. Almost all patients note the presence of adverse reactions, expressed to one degree or another.

According to those who have used drops for topical use, they have no drawbacks and successfully and quickly cope with infectious diseases.

According to experts, the advantages of Ciprofloxacin are increased bactericidal activity, good tolerability, and a wide range of antibacterial effects (the drug acts on gram-positive and gram-negative microorganisms, mycobacteria, chlamydia, mycoplasma). The substance is also capable of penetrating into the cells and tissues of the body, accumulating in them in concentrations close to or exceeding those in the serum.

Ciprofloxacin can be used for severe infectious diseases (in a hospital setting) as empirical antibacterial therapy. Its effectiveness has been proven in the treatment of hospital- and community-acquired infections of almost any location (infections of the skin, bones, UTIs, tonsillitis, etc.). The drug has a long half-life and is characterized by a post-antibiotic effect: taking just 2 times a day will be sufficient.

Price for Ciprofloxacin in pharmacies

The price of Ciprofloxacin tablets depends on their dosage and is approximately 12–20 rubles (dosage 250 mg, package includes 10 tablets) or 33–40 rubles (dosage 500 mg, package includes 10 tablets). The solution for infusion will cost 24–30 rubles (for 1 bottle of 100 ml). Eye drops 0.3% cost approximately 38–42 rubles (per 10 ml bottle). Eye and ear drops 0.3% can be purchased for approximately 22–28 rubles (per 10 ml bottle).

Ciprofloxacin tab. p.o 250 mg n10

Ciprofloxacin tablets 250 mg 10 pcs.

Ciprofloxacin 250 mg N10 tab

Ciprofloxacin drops hl. 0.3% 5ml n1

Ciprofloxacin 250 mg No. 10 tablets /Ozone/

Ciprofloxacin drops 0.3% 5 ml

Ciprofloxacin 250 mg No. 10 tablets

Education: First Moscow State Medical University named after I.M. Sechenov, specialty "General Medicine".

Information about the drug is generalized, provided for informational purposes and does not replace official instructions. Self-medication is dangerous to health!

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