Ciprofloxacin is a second-generation fluoroquinolone antibiotic widely used in modern medicine to combat a broad range of bacterial infections. This potent antimicrobial agent has gained popularity for its effectiveness, particularly against gram-negative bacteria. Its wide application in treating respiratory, urinary, gastrointestinal, and skin infections makes it one of the most prescribed antibiotics worldwide.
Ciprofloxacin is a light yellow crystalline powder, which is soluble in water and insoluble in ethanol. The molecular weight of ciprofloxacin is 334.3 g/mol. It is available in tablets, oral suspensions, intravenous solutions, and ophthalmic drops. It is also known by various brand names such as Cipro IV, Ciproxima, Cipro XR, Ciprobay, Ciprofloxacino, Cetraxal, Cipromycin, Ciproquinol, etc.
■Structure:-
- The molecular formula of ciprofloxacin is [C17H18FN3O3]
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| Structure of Ciprofloxacin |
- The IUPAC name of ciprofloxacin is 1-cyclopropyl-6-Fluro-4-oxo-7-piperazine-1-ylquinoline-3-carboxylic acid.
■Mechanism of action:-
Ciprofloxacin, a potent second-generation fluoroquinolone antibiotic, exhibits its bactericidal action by interfering with essential bacterial enzymes involved in DNA processes. The primary targets of ciprofloxacin are DNA gyrase (topoisomerase II) and topoisomerase IV, both of which are crucial for bacterial DNA replication, transcription, repair, and recombination.
- Inhibition of DNA Gyrase: DNA Gyrase is responsible for introducing negative supercoils into DNA, a process vital for relieving torsional strain during DNA replication and transcription. Ciprofloxacin binds to the Gyra subunit of DNA Gyrase, forming a stable drug-enzyme-DNA complex. This prevents the re-ligation of DNA strands after being cut, leading to breaks in the bacterial DNA and eventual cell death.
- Inhibition of Topoisomerase IV: Topoisomerase IV is primarily involved in the separation of replicated chromosomal DNA into daughter cells during bacterial cell division. Ciprofloxacin interferes with this process by binding to the ParC subunit of the enzyme, halting the decatenation (unblinking) of DNA strands and thereby inhibiting cell division.
- Selective Toxicity: Ciprofloxacin demonstrates high selectivity for bacterial enzyme over human topoisomerase, making it a safer and targeted antibiotic. It is especially effective against gram-negative bacteria such as E. coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Salmonella species.
By disrupting both DNA supercoiling and chromosomal segregation, ciprofloxacin causes irreversible damage to bacterial DNA, leading to rapid microbial death. Its dual enzyme targeting mechanism contributes to its broad-spectrum antibacterial activity and clinical success in treating a wide range of infections.
■Uses:-
Ciprofloxacin is FDA-approved and globally prescribed for treating a wide array of acute and chronic infections, including:
- Bones and joint infections
- Endocarditis
- Gastroenteritis
- Malignant otitis externa
- Respiratory tract infections
- Cellulitis
- Urinary tract infections
- Prostatitis
- Anthrax exposure (post-exposure prophylaxis)
- Skin and soft tissue infection
Dosage and Administration of Ciprofloxacin:-
Ciprofloxacin is typically administered orally or intravenously depending on the severity of infection and site of infection. Dosage may vary from 250 mg to 750 mg twice daily for oral administration, or 200 to 400 mg every 8 to 12 hours intravenously. Ophthalmic and otic forms are used for eye and ear infections, respectively.
Always consult a healthcare provider for proper dosage and treatment duration based on individual medical conditions.
Common side-effects of Ciprofloxacin:-
While ciprofloxacin is generally well-tolerated, it may cause adverse effects in some individuals, especially with prolonged or high dose usage. Common side effects include:
- Diarrhea.
- Headache.
- Abdominal pain.
- Drowsiness.
- Dizziness or lightheadedness.
- Stomach upset.
- Nausea.
- Vomiting.
- Blurred vision.
Serious Warnings and Precautions:-
Ciprofloxacin comes with several black box warnings by the FDA due to potential serious adverse reactions:
- Tendonitis and tendon rupture
- Peripheral neuropathy
- Central nervous system effects (e.g., seizures, anxiety, confusion)
- Hypersensitivity reactions
- QT prolongation (risk of arrhythmia)
Patients with renal impairment, neurological disorders, or those on corticosteroid therapy are advised to use ciprofloxacin with caution.
Conclusion:-
Ciprofloxacin continues to be a cornerstone in the treatment of moderate to severe bacterial infections. especially those resistant to older-generation antibiotics. However, due to the rise in antibiotic resistance and its potential side effects, it is essential to use ciprofloxacin Bjudiciously and only under medical supervision.
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