Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Ciprofloxacin is an antibiotic that is used to
treat bacterial infections. Ciprofloxacin belongs to the fluoroquinolone class
of antibiotics which includes levofloxacin (Levaquin), ofloxacin (Floxin),
gatifloxacin (Tequin),
norfloxacin (Noroxin),
moxifloxacin (Avelox),
trovafloxacin (Trovan) and others. Ciprofloxacin stops the multiplication of
bacteria by inhibiting the reproduction and repair of their genetic material
(DNA). The FDA approved ciprofloxacin in October 1987.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 250, 500, and 750 mg. Tablets extended release (XR):
500 and 1000 mg. Microcapsules for suspension: 250 mg/5 ml, 500 mg/5 ml.
Injection or Injection concentrate: 200 and 400 mg.
STORAGE: Immediate release tablets: store below 30C (86F). Extended release
tablets: store between 15-30C (59-86F). Microcapsules: store below 25C (77F)
and protect from freezing. Injection: Store between 5-30C (41-86F) and avoid
freezing.
PRESCRIBED FOR: Ciprofloxacin is used to treat infections of the skin, lungs,
airways, bones, and joints caused by susceptible bacteria. Ciprofloxacin is also
frequently used to treat urinary infections caused by bacteria such as
E. coli.
Ciprofloxacin is effective in treating
infectious diarrheas caused by E. coli,
Campylobacter jejuni, and Shigella bacteria.
DOSING: For most infections the recommended oral dose for adults is 250-750
mg (immediate release tablets) every 12 hours or 500-1000 mg (extended release
tablets) every 24 hours. The usual intravenous dose is 200-400 mg every 8-12
hours.
DRUG INTERACTIONS: Ciprofloxacin administered together with theophylline can
lead to elevated, toxic blood levels of theophylline. Theophylline is used to
open airways in the treatment of asthma. Toxic levels of theophylline can lead
to seizures, and
disturbances in heart rhythm. If concurrent use of
ciprofloxacin and theophylline cannot be avoided, frequent blood tests to
monitor theophylline blood levels are recommended.
Iron salts (for example, ferrous sulfate) may reduce the absorption of ciprofloxacin
because of formation of a ciprofloxacin-iron complex that is not absorbable.
Antacids also may reduce the absorption of ciprofloxacin. If patients are
receiving iron salts or antacids and ciprofloxacin, the ciprofloxacin should be
given two hours before or six ours after the iron salt or antacid.
Ciprofloxacin may increase the blood thinning effect of warfarin
(Coumadin). The reason
for this is unknown. Anticoagulant activity should be monitored after starting
or stopping ciprofloxacin.
Sevelamer (Renagel) may reduce the absorption of ciprofloxacin and possibly
reduce the effectiveness of ciprofloxacin. Milk and orange juice also may reduce
the absorption of ciprofloxacin. Ciprofloxacin, as with iron and antacids,
should be given two hours before or six ours after milk or orange juice.
PREGNANCY: Ciprofloxacin should be avoided in
pregnancy, as safe use in
pregnant women has not been established.
Urinary tract infection (UTI) is an infection of the kidney, ureter, bladder, and/or urethra. Not
everyone with a UTI has symptoms. Common symptoms include a frequent urge to
urinate and a painful, burning when urinating.
Pneumonia is inflammation of one or both lungs with consolidation. Pneumonia is frequently but not always due to infection. The infection may be bacterial, viral, fungal or parasitic. Symptoms may include fever, chills, cough with sputum production, chest pain, and shortness of breath.
Diverticulitis is a condition in which diverticuli in the colon rupture. The rupture results in infection in the tissues that surround the colon. Diverticulitis symptoms include: abdominal pain, abdominal cramps, diarrhea, constipation, and bloating. Treatment methods include prescription medications, and in some cases, diverticulitis surgery.
Kidney infection (pyelonephritis) usually is caused from bacteria that have spread from the bladder from a UTI (urinary tract infection), poor hygiene, sexual intercourse, pregnancy, catheter, cystoscope exam, surgery, kidney stones, or prostate enlargement. Symptoms of kidney infection include: back pain, frequent urination, pain during urination, fever, and or pus or blood in the urine. Kidney infection is usually treated with antibiotics.
Clostridium difficile (C. difficile) is a bacterium, and is one of the most common causes of infection of the colon. C. difficile spores are found frequently in hospitals, nursing homes, extended care facilities, and nurseries for newborn infants. They can be found on bedpans, furniture, toilet seats, linens, telephones, stethoscopes, fingernails, rings, floors, infants' rooms, and diaper pails. They even can be carried by pets. Antibiotic-associated (C. difficile) colitis is an infection of the colon caused by C. difficile that occurs primarily among individuals who have been using antibiotics. Treatment for C. difficile colitis hydration, replenishment of electrolyte deficiencies, discontinuing the antibiotic that caused the colitis, and using antibiotics to eradicate the C. difficile bacterium.
Jock itch is an itchy red rash that appears in the groin area. The rash may be caused by a bacterial or fungal infection. People with diabetes and those who are obese are more susceptible to developing jock itch. Antifungal shampoos, creams, and pills may be needed to treat fungal jock itch. Bacterial jock itch may be treated with antibacterial soaps and topical and oral antibiotics.
Small intestinal bacterial overgrowth (SIBO) refers to a condition in which abnormally large numbers of bacteria (at least 100,000 bacteria per ml of fluid) are present in the small intestine and the types of bacteria in the small intestine resemble more the bacteria of the colon than the small intestine. There are many conditions associated with small intestinal bacterial overgrowth, to include: diabetes, scleroderma, Crohn's disease, and others. There is a striking similarity between the symptoms of irritable bowel syndrome and SIBO. It has been theorized that SIBO may be responsible for the symptoms of at least some patients with irritable bowel syndrome. Symptoms of SIBO include: excess gas, abdominal bloating, diarrhea, and abdominal pain.
Folliculitis is a skin condition that causes small red bumps to form around the hair follicles. Skin bacteria such as Staphylococcus and Pseudomonas my infect the follicles. Treatment involves over-the-counter bacterial washes, topical antibiotics, and/or topical steroids.
Salmonella bacteria are known to cause salmonellosis, typhoid fever, and paratyphoid fever in humans. Salmonella infection is usually caused by ingesting large amounts of the bacteria in contaminated food or water.
There are many types of E. Coli (Escherichia coli ). Pathogenic E. coli can cause urinary tract and bladder infections, or lead to sepsis. E coli O157:H7 (EHEC) causes bloody diarrhea and colitis. Complications of E. coli infection include hemorrhagic diarrhea, hemolytic-uremic syndrome, and thrombotic thrombocytopenic purpura. Symptoms include severe abdominal pain and bloody diarrhea. E coli O157:H7 commonly is due to eating raw or undercooked hamburger or raw milk or dairy products.
Cholera is an infectious disease characterized by intense vomiting and profuse watery diarrhea and that rapidly lease to dehydration and often death. Cholera is caused by infection with the bacteria Vibrio cholerae, which may be transmitted via infected fecal matter, food, or water.
Anthrax is a deadly infectious disease that may be transmitted to humans by infected animals or by biological warfare. There are three types of anthrax: cutaneous, inhalation, and gastrointestinal. Symptoms of cutaneous anthrax include a swollen glands, muscle ache, headache, fever, nausea, vomiting, and a red-brown raised spot that enlarges, blisters, and hardens, forming an ulcer crater with black crust. Symptoms of inhalation anthrax are flulike and may progress to respiratory distress, shock, coma, and death. Symptoms of gastrointestinal anthrax include loss of appetite, bloody diarrhea, and abdominal pain. Treatment for cutaneous anthrax involves penicillin, tetracycline, erythromycin, and ciprofloxin. Inhalation anthrax necessitates treatment with IV therapy with antibiotics.
Swimmer's ear (external otitis) is an infection of the skin that covers the outer ear canal. Causes of swimmer's ear include excessive water exposure that leads to trapped bacteria in the ear canal. Symptoms include a feeling of fullness in the ear, itching, and ear pain. Chronic swimmer's ear may be caused by eczema, seborrhea, fungus, chronic irritation, and other conditions. Common treatment includes antibiotic ear drops.
Shigellosis is a disease caused by the Shigella bacteria. Bloody diarrhea, stomach cramps and fever are common symptoms. Mild infections usually resolve on their own. Antibiotics are used to treat more severe cases.
Legionellosis is an infection caused by the Legionella pneumophila bacterium. There are two forms of legionellosis: Pontiac fever and Legionnaires' disease, which is the more severe of the two infections. Symptoms of Pontiac fever include fever, headache, muscle aches, and chills. Symptoms of Legionnaires' disease include cough, chills, fever and sometimes muscle aches, headaches, loss of appetite, diarrhea, and severe pneumonia. While Pontiac fever resolves on its own, Legionnaires' disease must be treated with antibiotics.
Tularemia (rabbit fever) is an infection caused by the Francisella tularensis bacteria. People can become infected with tularemia by coming into contact with infected animals or via a tick bite. Symptoms and signs include fever, headache and rash. Tularemia is treated with streptomycin or gentamicin.
Shigellosis is an infectious disease caused by a group of bacteria called
Shigella. Most who are infected with Shigella develop diarrhea, fever, and
stomach cramps starting a day or two after they are exposed to the bacteria. The
diarrhea is often bloody. Shigellosis usually resolves in 5 to 7 days. Persons
with shigellosis in the United States rarely require hospitalization. A severe
infection with high fever may be associated with seizures in children less than
2 years old. Some persons who are infected may have no symptoms at all, but may
still pass the Shigella bacteria to others.
What sort of germ is Shigella?
The Shigella germ is actually a family of bacteria that can cause diarrhea in
humans. They are microscopic living creatures that pass from person to person.
Shigella were discovered over 100 years ago by a Japanese scientist named Shiga,
for wh...
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