Indications

Civox (Ciprofloxacin) is a synthetic quinolone antibiotic indicated for the treatment of single or mixed infections, especially those resistant to other antibiotics like Aminoglycosides, Penicillins, and Cephalosporins.

It is indicated for a wide range of infections caused by susceptible organisms, including:

• Severe systemic infections: Septicaemia, bacteraemia, peritonitis, infected burns, and infections in immunosuppressed patients.
• Respiratory Tract Infections: Lobar and bronchopneumonia, acute/chronic bronchitis, cystic fibrosis exacerbation, and empyema.
• Urinary Tract Infections: Urethritis, cystitis, pyelonephritis, prostatitis, and epididymitis (uncomplicated and complicated).
• Skin and Soft Tissue Infections: Infected ulcers, wound infections, abscesses, cellulitis, and infected burns.
• Gastro-intestinal Infections: Enteric fever and infective diarrhea.
• Biliary Tract and Intra-abdominal Infections: Cholangitis, cholecystitis, and intra-abdominal abscesses.
• Bone and Joint Infections: Osteomyelitis and septic arthritis.
• Pelvic Infections: Salpingitis, endometritis, and pelvic inflammatory diseases.
• Eye, Ear, Nose, and Throat Infections: Otitis media, sinusitis, tonsillitis.
• Gonorrhoea: Including urethral, rectal, and pharyngeal gonorrhoea.

Pharmacology

Ciprofloxacin is a broad-spectrum, synthetic quinolone anti-infective agent. Its bactericidal action results from interference with the enzyme DNA gyrase, which is essential for bacterial DNA synthesis. It is active against most Gram-negative aerobic bacteria (including Pseudomonas aeruginosa) and Gram-positive aerobic bacteria (including methicillin-resistant staphylococci). It is rapidly and well-absorbed from the GI tract and has a half-life of about 3.5 hours.

Dosage (Adults)

The dosage depends on the severity and type of infection, as well as the patient's condition.

Impaired Renal Function: Dosage adjustment (reducing total daily dose by half) is usually required only in severe renal impairment (Creatinine Clearance <20  ml/minute ). Elderly: No dosage adjustment is generally necessary. Children/Adolescents: Use is generally not recommended due to potential arthropathy risk; if the benefit outweighs the risk, the dosage is 7.5−15  mg/kg/day in two divided doses.

Contraindications

Patients with a history of hypersensitivity to Ciprofloxacin or to other quinolones.

Side Effects

Common side effects include gastrointestinal disturbances (nausea, diarrhea, vomiting, abdominal pain), CNS disturbances (headache, dizziness, confusion, convulsions), and hypersensitivity reactions (skin rash, pruritus). Less common reactions include joint pain, photosensitivity, and transient increases in liver enzymes or renal levels. There is a risk of hypoglycemia and mental health adverse effects.

Pregnancy & Lactation

Use during pregnancy and in nursing mothers is not recommended because Ciprofloxacin has been shown to cause arthropathy (joint damage) in immature animals.

Precautions & Warnings

• Use with caution in patients with known or suspected CNS disorders (e.g., epilepsy, arteriosclerosis) or other factors that predispose to seizures.
• Take with or without meals, but drink fluids liberally.
• Avoid concurrent administration with Magnesium or Aluminum-containing antacids, sucralfate, or products containing Calcium, Iron, or Zinc. These must be taken two hours after or six hours before Civox.
• Do not take concurrently with milk or other dairy products alone, as this significantly reduces absorption (dietary calcium as part of a meal is acceptable).

Overdose Effects

Overdose may lead to seizures, hallucinations, confusion, abdominal discomfort, renal and hepatic impairment, crystalluria, haematuria, and reversible renal toxicity.

Therapeutic Class

4-Quinolone preparations, Anti-diarrhoeal Antimicrobial drugs.

Storage Conditions

Keep below 30∘C , protected from light and moisture, and out of the reach of children.