PharmacodynamicsAntimicrobial broad-spectrum fluoroquinolone. The drug inhibits the enzyme DNA-gyrase of bacteria, resulting in disrupted DNA replication and synthesis of cellular proteins of bacteria. Ciprofloxacin acts as a reproducing organisms, and on being in the resting phase. For ciprofloxacin susceptible gram-negative aerobic bacteria: enterobacteria (E.coli, Salmonellaspp., Shigellaspp., Citrobacterspp., Klebsiellaspp., Edwardsiellatarda, Enterobacterspp., Proteusmirabilis, Proteusvulgaris, Serratiamarcescens, Hafniaalvei, Providenciaspp., Morganellamorganii, Vibriospp., Yersiniaspp.), other Gram-negative bacteria (Haemophilusspp., Pseudomonasaeruginosa, Pseudomonasshigelloides, Campilobacterjeiuni, Neisseria, spp.); some intracellular pathogens: Legionellapneumophila, Brucellaspp., Chlamydiatrachomatis, Listeriamonocytogenes, Mycobacteriumtuberculosis, Mycobacteriumkansasii, Mycobacteriumaviumintracellulare. To ciprofloxacin and susceptible Gram-positive aerobic bacteria: Staphylococcusspp. (S.aureus, S.hominis, S.saprophyticus), Streptococcusspp. (St. pyogenes, St.agalactiae). Bolshinstvostafilokokkov, ustoychivyhkmetitsillinu, ustoychivyitsiprofloksatsinu. The sensitivity of bacteria Streptococcus pneumoniae, Enterococcus faeclis moderate. For drug resistant Corinebacterium spp., Bacteroides fragilis, Pseudomonas maltophilia, Ureaplasma urealyticum, Clostridium difcile, Nocardia asteroids. PharmacokineticsAt intake, especially on an empty stomach, ciprofloxacin is well absorbed from the gastrointestinal tract. Peak plasma concentrations are observed 1-2 hours after ingestion. The volume of distribution in the body is 2-3.5 L / kg. In the cerebrospinal fluid drug in small quantities, where its concentration is 6-10% of that of serum. High concentrations of the drug observed in the bile, lung, kidney, liver, gall bladder, uterus, seminal fluid, prostate tissue, tonsils, endometrium, fallopian tubes and ovaries. The concentration of drug in these tissues than in serum. Ciprofloxacin is also well into the bone, eye fluid, bronchial secretion, saliva, skin, muscle, pleura, peritoneum, lymph. Accruing to the concentration of ciprofloxacin in the neutrophils of blood in the 2-7 times higher than in serum. The degree of binding of ciprofloxacin to plasma proteins is 30%. The half-life - about 4 hours in patients with unchanged renal function half-life is increased. The main mode of excretion of ciprofloxacin from the body - the kidneys. A urine output of 50-70%. From 15 to 30% is excreted in the feces. Patients with severe renal impairment (creatinine clearance below 20 ml/min/1, 73 m2) should be administered half the daily dose. Indications for use
The drug is indicated for the treatment of infections in cancer patients. Tablets are taken on an empty stomach with plenty of water. Ciprofloxacin dose depends on disease severity, type of infection, body condition, age, weight and renal function in patients. In severe infections, complicated, and depending on the pathogen (eg, infections caused by P. Aeruginosa), the daily dose can be increased to 750 mg 3 times. In acute gonorrhea enough single oral administration of 250-500 mg. In the treatment of elderly patients the dose of ciprofloxacin may be reduced depending on the concentration of serum creatinine, type and severity of disease. Dosage in patients with severe renal impairment |