Ципрофлоксацин

Описание

Ciprofloxacin is a quinolone antibacterial related to recently marketed norfloxacin (10), ofloxacin (2), pefloxacin (2) and enoxacin. It has a broad spectrum of activity against gram-positive and gram-negative bacteria, and is useful in the treatment of urinary and upper respiratory tract infections.

Химические свойства

White Powder

Использование

Ciprofloxacin is used in the treatment of infections from a wide range of aerobic gram-positive and aerobic gramnegative microorganisms. It has been shown to be effective against inhalational anthrax and reduce the incidence or progression of disease following exposure to aerosolized Bacillus anthracis. It is also used in select respiratory infections, urinary tract infections, typhoid fever, some sexually transmitted diseases, and septicemia. Infectious diarrhea may be caused by organisms found in food or water and transferred by person-to-person contact. This may have a devastating effect, globally, especially in immunocompromised individuals. Ciprofloxacin is effective against those organisms that may contribute to infectious diarrhea, such as Escherichia coli (enterotoxigenic strains), Campylobacter jejuni, and select strains of Shigella; and is utilized when antibacterial therapy is medically indicated. Ciprofloxacin has also been utilized as a secondary agent in the treatment of tuberculosis.

Определение

ChEBI: A quinolone that is quinolin-4(1H)-one bearing cyclopropyl, carboxylic acid, fluoro and piperazin-1-yl substituents at positions 1, 3, 6 and 7, respectively.

Антимикробная активность

It exhibits potent activity against most Enterobacteriaceae, as well as against Acinetobacter spp. (MIC 0.25–1 mg/L), fastidious Gram-negative bacilli such as Mor. catarrhalis (MIC 0.06–0.25 mg/L) and Campylobacter jejuni(MIC 0.12 mg/L). In common with other quinolones, it is active against Bacillus anthracis. Ciprofloxacin is the most active quinolone against Ps. aeruginosa and exhibits good activity in vitro against other non-fermenting Gram-negative bacilli. In-vitro activity against Staph. aureus coagulase-negative staphylococci, Str. pyogenes, Str. pneumoniae and Enterococcus spp. (MIC c. 0.5–2 mg/L) is moderate. Most methicillin-resistant strains of staphylococci are resistant. It has poor activity against anaerobes, but is active against M. tuberculosis, Mycoplasma spp. and intracellular pathogens such as Chlamydia, Chlamydophila and Legionella.

Фармацевтические приложения

A 6-fluoro, 7-piperazinyl quinolone formulated as the hydrochloride for oral administration and as the lactate for intravenous use.

Побочные эффекты

Untoward reactions are uncommon, those encountered being typical of the group. Reactions severe enough to require withdrawal of treatment have occurred in <2% of patients. The most common reactions, gastrointestinal tract disturbances, have been seen in 5% of patients and rashes in about 1%. CNS disturbances typical of quinolones have been reported in 1–2% of patients. Tendinitis and tendon rupture (especially of the Achilles tendon) may occur in a small number of patients and ciprofloxacin should be avoided in patients at risk for these conditions. Potentiation of the action of theophylline and other drugs metabolized by microsomal enzymes may occur. Crystalluria and transient arthralgia have been reported.
In volunteers, dosages of up to 750 mg produced no change in the numbers of fecal streptococci and anaerobes, but did produce a 2.5 × log10 decline in the numbers of enterobacteria, which lasted 1 week. There was no change in the susceptibility of the affected organisms and no overgrowth by resistant strains. As with other quinolones, ciprofloxacin is not recommended for use in children or in pregnant or lactating women.
The drug should be avoided in suspected or confirmed infections caused by Str. pneumoniae. It is inferior to conventional agents and some other fluoroquinolones in the treatment of genital tract infections caused by C. trachomatis.
Ciprofloxacin has also been shown to be effective in the treatment of patients with malignant otitis externa, catscratch disease, prevention of infection in patients undergoing biliary tract surgery, and treatment of biliary tract infections. A topical preparation for use in the treatment of ocular infections is available, but is neither more effective nor safer than established topical agents; it may be indicated for superficial eye infections caused by pathogens resistant to conventional drugs or in patients unable to tolerate standard therapeutic agents.

Экологическая судьба

The antimicrobial action of the drug is due to inhibition of the enzymes required for bacterial DNA function. Topoisomerase II (DNA gyrase) and topoisomerase IV are necessary for bacterial DNA replication, transcription, strand repair, and recombination. Thus, ciprofloxacin cytotoxicity may be caused by the loss of mtDNA encoded functions.