Ciprofloxacin - Medical Uses

Medical Uses

Ciprofloxacin is used to treat a number of infections including: infections of bones and joints, endocarditis, gastroenteritis, malignant otitis externa, respiratory tract infections, cellulitis, urinary tract infections, prostatitis, anthrax, chancroid, among others.

• Urinary tract infections (recommended as a first-line antibiotic)
• Acute uncomplicated cystitis in females
• Chronic bacterial prostatitis (recommended as a first-line antibiotic choice)
• Lower respiratory tract infections (not recommended as a first-line antibiotic choice)
• Acute sinusitis (not recommended as a first-line antibiotic choice)
• Skin and skin structure infections
• Bone and joint infections
• Infectious diarrhea
• Typhoid fever (enteric fever) caused by Salmonella typhi
• Uncomplicated cervical and urethra gonorrhea (due to N. gonorrhoeae) – however, this indication is no longer effective in some areas (for example, Asian countries, United States (including Hawaii), Canada, and Scotland) due to bacterial resistance. Fluoroquinolones are no longer recommended in the USA for this indication.

Ciprofloxacin is not recommended for the treatment of tuberculosis.

As well as in combination with other specific drugs:

• Complicated intra-abdominal infections (in combination with metronidazole);
• Empirical therapy for febrile neutropenic patients (in combination with piperacillin)

Oral and intravenous fluoroquinolones are not licensed by the U.S. FDA for use in children due to the risk of permanent injury to the musculoskeletal system, with two exceptions as outlined below.

Indications include:

• Complicated urinary tract infections and pyelonephritis due to Escherichia coli

• Inhalational anthrax (postexposure)

Ciprofloxacin is not recommended to treat community acquired pneumonia (CAP) as a stand-alone first-line agent due to its modest activity against Streptococcus pneumoniae, a common causative pathogen. "Respiratory quiniolones" such as levofloxacin, having greater activity against this pathogen, are recommended as first line agents for the treatment of CAP in patients with important co-morbidities and in patients requiring hospitalization (Infectious Diseases Society of America 2007). The guidelines include a warning that "Data exist suggesting that resistance to macrolides and older fluoroquinolones (ciprofloxacin and levofloxacin) results in clinical failure. Other studies have shown that repeated use of fluoroquinolones predicts an increased risk of infection with fluoroquinolone-resistant pneumococci...."

Ciprofloxacin may be licensed for other uses, or restricted, by the various regulatory agencies worldwide.