Cipro is used in adults for a vast number of infections that are caused by susceptible bacteria. These include urinary tract infections, chronic bacterial prostatitis, lower respiratory tract infections, acute sinusitis, skin infections, bone and joint infections, intra-abdominal infections (in combination with the antibiotic metronidazole [Flagyl]), infectious diarrhea and more.
Cipro has particular adverse effects, as discussed below, which prohibit its use as a drug of first choice in children except in very specific circumstances. Cipro may be used in children who have complicated urinary tract infections and pyelonephritis (kidney infection) due to E. coli in whom first line antibiotics are not an option due to allergy or bacterial resistance.
Children may also be given Cipro to reduce the progression of disease following exposure to aerolized Bacillus anthracis (Anthrax) and as drops placed in the ear for ear infections caused by susceptible strains of Pseudomonas aeruginosa or Staphylococcus aureus.
Though Cipro has such widespread uses, it should be used with caution in individuals with certain medical conditions. Ciprofloxacin may worsen the neurological disease Myasthenia gravis. Dosage adjustment is required in people with impaired kidney function as this may increase the risk of tendon rupture, as might Rheumatoid arthritis. Additionally, Cipro used concomitantly with NSAIDs may increase the risk of seizures in individuals with seizure disorders.
The side effects of Cipro are as widespread as its uses. Cipro may adversely affect all systems of the body. The most frequent side effects of Cipro in children are: dizziness, insomnia, nervousness, somnolence, fever, headache and restlessness with I.V. administration, diarrhea, nausea, vomiting, abdominal pain, upset stomach, rash and runny nose.
Cipro causes many of these same side effects in adults. Additional side effects of Cipro that occur less commonly in adults and children include the following:
-Effects on the digestive system- pancreatitis, cholestatic jaundice, gastrointestinal bleeding, increased liver enzymes (ALT and AST)
-Effects on the urinary system: acute renal failure, crystalluria, urethral bleeding, albuminuria
-Effects on the musculoskeletal system: tendonitis, tendon rupture, joint pain
-Effects on the nervous system: migraine, drowsiness, ataxia, hallucinations, confusion, hyperesthesia
-Effects on the respiratory system: bronchospasm, laryngeal edema
-Effects on the cardiovascular system: angina pectoris, atrial flutter, torsade de pointes
-Effects on the skin: photosensitivity, Stevens-Johnson syndrome,erythema multiforme, exfoliative dermatitis, fixed eruption, pruritis (itching)
-Effects on the hematological system- anemia, agranulcytosis, bone marrow depression, prolongation of PT and INR, hemolytic anemia
Cipro can be administered by mouth, intravenously, and as eye drops. Additionally, there are immediate release and extended release formulations of Cipro tablets. There are several brand name versions of Cipro available in the United States including Cetraxal®; Ciloxan®; Cipro®; Cipro® I.V.; Cipro® XR; and Proquin® XR.. Canada also has several formulations including Apo-Ciproflox®; Ciloxan®; and Cipro®.
Cipro is an effective antibiotic for many infectious conditions. However, this medication is associated with numerous side effects, some of which are potentially severe enough to be fatal. Individuals should speak with their physician to determine is Cipro is truly the right choice for themselves or their child.
Source: Lexi-Comp Online. 2010.
Published by Nicole Evans M.D.
Nicole Evans is a resident physician with a passion for integrative medicine. She enjoys writing on topics that explore both the world of Western medicine and that of complementary and alternative medicine... View profile
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