Synonym
Fluoroquinolones
Classification
Ciprobay® is the trade name of the antibiotic ciprofloxacin, which belongs to the group of substances known as fluoroquinolones or gyrase inhibitors. Fluoroquinolones are divided into four groups, the main differences being their different mechanisms of action and applicability. Ciprobay® belongs to Group II together with Tarivid (active ingredient: ofloxacin) and Enoxor (active ingredient: enoxacin).
Effect
Bacteria possess an enzyme that is mainly involved in the construction of the bacteria DNA. This enzyme is called DNA gyrase or DNA topoisomerase II. The enzyme causes the twisted structure typical of DNA. Fluoroquinolones are now able to inhibit this enzyme in bacteria, which leads to bacterial cell death. It thus has a degenerative bactericidal effect.
Fields of application
Group II fluoroquinolones are so-called broad-spectrum antibiotics that cover a broad strain of pathogens. Ciprofloxacin belongs to the standard substance of fluoroquinolones, which is given most frequently. It is effective against Enterobacteriaceae and Haemophilus Influenzae, somewhat weaker against Staphylococci, Pneumococci, Enterococci, against Chlamydia, Legionella, Mycoplasma and against Pseudomonas.
It is mainly used for infections of the respiratory tract and urinary tract. In addition, patients with inflammation of the skin, soft tissue, bone and joints are prescribed Ciprobay® or other fluoroquinolones from this group. The drug is also used to treat infections of the gastrointestinal tract, such as salmonella or shigella infections.
However, it is also used to treat severe systemic infections of the body up to life-threatening sepsis (blood poisoning). The effectiveness against pneumococci is reduced for group II substances. However, the effectiveness against Pseudomonas is very high.
Side effects
Complaints of the gastrointestinal tract, including nausea, vomiting and diarrhoea as well as nerve irritation and associated headaches, dizziness, psychosis, agitation and seizures have been observed. In addition, hypersensitivity reactions of the skin (photosensitization) can sometimes occur. A cartilage-damaging effect is also attributed to fluoroquinolones. The risk of cartilage damage or muscle tendon rupture is particularly high when combined with glucocorticoids (cortisone), especially in patients in the growth phase, and should therefore be avoided.
Interactions
In order not to reduce the absorption of fluoroquinolones, the parallel administration of the following drugs should be avoided: stomach acid inhibitors (so-called antacids), calcium, magnesium, iron, zinc, multivitamins and sucralfate. By raising the pH or by complex formation, parallel administration leads to the reduced absorption described above. The following substances have a degradation inhibition and thus a strengthening effect: Theophylline, caffeine, ciclosporin A, anticoagulants, glibenclamide (antidiabetic). The parallel administration of these substances should be carefully considered.
Contraindication
Under no circumstances should Ciprobay® be given during pregnancy or while breast-feeding, as an increased risk of cartilage damage to the child is suspected. As ciprofloxacin is excreted via the kidneys, patients with renal insufficiency should also be prescribed alternative preparations.
