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CIPRO ®

Cipro ® (Ciprofloxacin ) is a powerful and versatile antibiotic used to treat adults with infections caused by certain bacteria. Cipro is also widely used to prevent or slow the progress of the disease Anthrax after exposure.

Cipro ®


Cipro ® is manufactured by Bayer.

Chemical Name : Ciprofloxacin

Important Note
The following information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist or other healthcare professional. It should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. Consult your healthcare professional before using this drug.

Uses
Cipro (Ciprofloxacin) stops multiplication of bacteria by inhibiting the reproduction and repair of their genetic material (DNA). Cipro (Ciprofloxacin) is used to treat infections of the skin, lungs, airways, bones, and joints caused by susceptible bacteria. Cipro (Ciprofloxacin) is also frequently used to treat urinary infections caused by bacteria such as E.coli. This antibiotic is also FDA-approved for treatment of anthrax.

How to take this medication
Cipro (Ciprofloxacin) may be taken with or without meals; the preferred dosing time is 2 hours after a meal. Drink plenty of liquids while taking this medicine and take antacids that contain magnesium, aluminum, or calcium; iron; zinc;sucralfate; or didanosine chewable tablets or oral solution 2 hours after or 6 hours before taking this medicine. Do not take Cipro (Ciprofloxacin) with yogurt or milk alone. However, calcium as part of a meal does not affect this medicine. Do not consume products that contain caffeine (coffee, tea, cola) while taking Cipro (Ciprofloxacin).

Side Effects
Every medicine can cause side effects, but many people have no, or minor, side effects. Common side effects include nausea, diarrhea, headache, restlessness, stomach pain/cramps, rash,vomiting, headache, anxiety, nightmares. Contact your doctor or pharmacist if any of the following occurs: Convulsions, increased pressure within the head, dizziness, suicidal thoughts; hallucinations, loss of consciousness, tingling, severe allergic reactions (hives; itching; difficulty breathing, swelling of the face, tongue or lips), sleeplessness, bloody stools, yellowing of the skin or eyes, fatigue.

Failure to take all of the medicine may prevent complete elimination of bacteria, allowing the infection to return. If severe diarrhea, stomach cramps/pain, or bloody stools occurs, immediately contact your health care provider at once. This could be a sign of a serious side effect requiring immediate medical attention. Do not treat diarrhea without talking to your doctor.

Precautions
Before using Cipro (Ciprofloxacin), tell your health care provider about any of the following: if you are pregnant, planning to become pregnant, or breastfeeding; if you are taking any prescription medicine, nonprescription medicine, herbal preparation, or dietary supplement; if you have a history of hardening of the arteries in the brain; if you have gonorrhea; if you have impaired kidney function; if you have a history of seizures; if you are taking warfarin; if you are taking theophylline or you consume large amounts of caffeine.

Overdose
If overdose is suspected, contact your local poison control center or emergency room immediately.

Missed Dose
If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not take a double dose to make up for a missed one.

Storage
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed.

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 Therapeutic manipulation of the enteric microflora in inflammatory bowel diseases: antibiotics, probiotics, and prebiotics.

Crohn's disease, ulcerative colitis, and pouchitis are caused by overly aggressive immune responses to a subset of commensal (nonpathogenic) enteric bacteria in genetically predisposed individuals. Clinical and experimental studies suggest that the relative balance of aggressive and protective bacterial species is altered in these disorders. antibiotics can selectively decrease tissue invasion and eliminate aggressive bacterial species or globally decrease luminal and mucosal bacterial concentrations, depending on their spectrum of activity. Alternatively, administration of beneficial bacterial species (probiotics), poorly absorbed dietary oligosaccharides (prebiotics), or combined probiotics and prebiotics (synbiotics) can restore a predominance of beneficial Lactobacillus and Bifidobacterium species. Current clinical trials do not fulfill evidence-based criteria for using these agents in inflammatory bowel diseases (IBD), but multiple nonrigorous studies and widespread clinical experience suggest that metronidazole and/or Ciprofloxacin (Cipro) can treat Crohn's colitis and ileocolitis (but not isolated ileal disease), perianal fistulae and pouchitis, whereas selected probiotic preparations prevent relapse of quiescent ulcerative colitis and relapsing pouchitis. These physiologic approaches offer considerable promise for treating IBD, but must be supported by rigorous controlled therapeutic trials that consider clinical disease before their widespread clinical acceptance. These agents likely will become an integral component of treating IBD in combination with traditional anti-inflammatory and immunosuppressive agents.

Diagnosis and treatment of patients with pouchitis.

Pouchitis is the most common long-term complication of ileal pouch-anal anastomosis in patients with underlying ulcerative colitis. Clinical symptoms of pouchitis are not specific, and they can be caused by other conditions such as rectal cuff inflammation and irritable pouch syndrome. Therefore, to make an accurate diagnosis, endoscopic evaluation together with symptom assessment is necessary. Among five available treat-first and test-first strategies, the initial approach with pouch endoscopy without histology was the most cost-effective strategy for the diagnosis of pouchitis. On the basis of clinical course, pouchitis can be classified into acute, relapsing and chronic forms. Pouchitis can also be classified into three categories based on the response to antibacterial therapy: antibacterial-responsive; antibacterial-dependent; and antibacterial-resistant. Metronidazole and Ciprofloxacin (Cipro) are both effective in treating acute pouchitis. Although antibacterial therapy can induce and maintain remission, probiotics such as VSL#3 can also be used as to maintain clinical remission and prevent relapse in patients with relapsing or chronic pouchitis. For patients with chronic pouchitis that is resistant to antibacterials, therapy with anti-inflammatory agents and immunomodulators is often required.

Yersinia septic shock following an autologous transfusion in a pediatric patient.

Although the literature on infections transmitted via transfused blood focuses on viruses, Yersinia enterocolitica can also cause severe infections in patients receiving transfusions. A 13-year-old patient developed severe sepsis after an autologous blood transfusion contaminated with Y. enterocolitica. The patient was an otherwise healthy female undergoing posterior spinal fusion for congenital scoliosis. Prior to surgery, the patient donated blood for perioperative and postoperative use. A few days before the donation, she had complained of abdominal pain and was experiencing mild diarrhea. The patient received four units of packed red blood cells (PRBCs) during the surgery. Intraoperatively, the patient developed fever up to 103.6 degrees F, became hypotensive requiring epinephrine and dopamine, and developed metabolic acidosis with serum bicarbonate concentration dropping to 16 mmol/l. The surgery team believed the patient was experiencing malignant hyperthermia and attempted to cool patient during the procedure. Postoperatively, the patient was transferred to the pediatric intensive care unit and treated for severe shock of unknown etiology. The patient further developed disseminated intravascular coagulation. The patient received supportive care and was started on ampicillin/sulbactam on postoperative day (POD) one which was changed to clindamycin, Ciprofloxacin (Cipro) and tobramycin on POD two when blood cultures grew gram-negative bacilli. On POD three, cultures were identified as Y. enterocolitica and antibiotics were changed to tobramycin and cefotaxime based on susceptibility data. Sequelae of the shock included adult respiratory distress syndrome requiring intubation and a tracheostomy and multiple intracranial hemorrhagic infarcts with subsequent seizure disorder. Due to severe lower extremity ischemia, she required a bilateral below the knee amputation. The cultures of the snippets from the bags of blood transfused to the patient also grew Y. enterocolitica. This case illustrates the importance of considering transfusion related bacterial infections in patients receiving PRBCs. All patients in shock following any type of transfusion may require aggressive antibiotic therapy, until the diagnosis and etiology are known. Copyright 2003 Elsevier Science Ltd.

Antimicrobial drug resistance in Salmonella: problems and perspectives in food- and water-borne infections.

Strains of Salmonella spp. with resistance to antimicrobial drugs are now widespread in both developed and developing countries. In developed countries it is now increasingly accepted that for the most part such strains are zoonotic in origin and acquire their resistance in the food-animal host before onward transmission to humans through the food chain. Of particular importance since the early 1990s has been a multiresistant strain of Salmonella typhimurium definitive phage type (DT) 104, displaying resistance to up to six commonly used antimicrobials, with about 15% of isolates also exhibiting decreased susceptibility to Ciprofloxacin (Cipro). Mutations in the gyrA gene in such isolates have been characterised by a PCR LightCycler-based gyrA mutation assay, and at least four different mutations have been identified. Multiple resistance (to four or more antimicrobials) is also common in the poultry-associated pathogens Salmonella virchow and Salmonella hadar, with an increasing number of strains of these serotypes exhibiting decreased susceptibility to Ciprofloxacin (Cipro). Multiple resistance is also being found in other serotypes in several other European countries, and has been associated with treatment failures. For Salmonella typhi, multiple drug resistance is now the norm in strains originating in the Indian subcontinent and south-east Asia. Such multiresistant strains have been responsible for several epidemics and some of these have been associated with contaminated water supplies. Furthermore, an increasing number of multiresistant strains of S. typhi are now exhibiting decreased susceptibility to Ciprofloxacin (Cipro), with concomitant treatment failures. In developed countries antimicrobial resistance in zoonotic salmonellas has been attributed to the injudicious use of antimicrobials in food-producing animals. It is hoped that the application of Codes of Practice for the use of such agents, which have been prepared by the pharmaceutical industry in response to widespread international concern about the development of drug resistance in bacterial pathogens, will now result in a widespread reduction in the incidence of drug-resistant salmonellas in food production animals and humans on an international scale.

 

 

 

 

09th February 2010
antibiotics antibiotics antivirals & antibiotics