Class: Antibacterials
Molecular Formula: C17H18FN3O3•ClH•H2O
CAS Number: 86393-32-0
Brands: Ciloxan, Cipro HC Otic Drops, Ciprodex
Introduction
Fluoroquinolone antibacterial.1 2 5 6 8
Uses for Ciprofloxacin Hydrochloride
Bacterial Ophthalmic Infections
Ophthalmic ointment: Treatment of conjunctivitis caused by susceptible strains of Staphylococcus aureus, S. epidermidis, Streptococcus pneumoniae, Haemophilus influenzae, or viridans streptococci.119
Ophthalmic solution: Treatment of conjunctivitis caused by susceptible strains of S. aureus, S. epidermidis, S. pneumoniae, or H. influenzae.1
Some clinicians suggest that quinolones be reserved principally for severe bacterial conjunctivitis because of potential development of quinolone resistance, and possibly, cost considerations.4 111 116
Ophthalmic solution: Treatment of keratitis (corneal ulcer) caused by susceptible strains of Pseudomonas aeruginosa, Serratia marcescens, S. aureus , S. epidermidis, S. pneumoniae, or viridans streptococci.1 24 25 26 27 101 102 103 112
Some clinicians suggest that single-agent topical fluoroquinolone therapy be considered for initial treatment in patients with equivocal gram stain results on diagnostic corneal smear, presence of >1 organism, contact lens associated keratitis (suspected to be caused by gram-negative bacteria), or in settings where culture and sensitivity tests are impossible or impractical.118
Bacterial Otic Infections
Ciprofloxacin-dexamethasone otic suspension: Treatment of acute otitis externa caused by susceptible strains of S. aureus or Ps. aeruginosa.125
Ciprofloxacin-hydrocortisone otic suspension: Treatment of acute otitis externa caused by susceptible strains of S. aureus, Ps. aeruginosa, or Proteus mirabilis.120
Ciprofloxacin-dexamethasone otic suspension: Treatment of acute otitis media caused by susceptible strains of S. aureus, S. pneumoniae, H. influenzae, Moraxella catarrhalis, or Ps. aeruginosa in patients with tympanostomy tubes.125
Ciprofloxacin Hydrochloride Dosage and Administration
General
Avoid contamination of container.1 116 119 120 125
Administration
Ophthalmic Administration
Apply topically to the eye as an ophthalmic ointment or solution.1 116 119
Not for injection.1 119
Remove contact lenses before administration of ophthalmic solution.1
For treatment of bacterial keratitis, administer ophthalmic solution around the clock.25 115
Otic Administration
Administered as otic suspension in fixed combination with dexamethasone or hydrocortisone.120 125
For otic use only.120 125 Not for ophthalmic use.120 125 Not for injection.120 125
Discard unused portion after therapy is completed.120 125
Prior to administration, warm container in hand for 1–2 minutes before use to avoid dizziness associated with instillation of cold solution into ear canal.120 125 Shake well before use.120 125
To administer fixed combination otic suspensions of ciprofloxacin with dexamethasone or hydrocortisone for treatment of acute otitis externa, instill drops while patient lies with affected ear upward; maintain position for 30–60 seconds to facilitate penetration of drops into ear.120 125 Repeat for opposite ear if necessary.120 125
To administer ciprofloxacin-dexamethasone otic suspension for treatment of acute otitis media in pediatric patients with tympanostomy tubes, instill drops while patient lies with affected ear upward.125 Pump tragus 5 times by pushing inward to facilitate penetration of drops into middle ear; maintain position for 60 seconds.125 Repeat for opposite ear if necessary.125
Dosage
Available as ciprofloxacin hydrochloride; dosage expressed in terms of ciprofloxacin.1 108 119 120 125
Pediatric Patients
Ophthalmic Infections
Conjunctivitis (S. aureus, S. epidermidis, S. pneumoniae, H. influenzae, or viridans streptococci)
Ophthalmic
Ointment: In children ≥2 years of age, apply approximately 1.27 cm (½ inch) ribbon into conjunctival sac of affected eye(s) 3 times daily for 2 days, then twice daily for next 5 days.119
Conjunctivitis (S. aureus, S. epidermidis, S. pneumoniae, or H. influenzae)
Ophthalmic
Solution: In children ≥1 year of age, 1 or 2 drops of 0.3% solution into conjunctival sac of affected eye(s) every 2 hours while awake for 2 days, then 1–2 drops every 4 hours while awake for next 5 days.1 3
Keratitis
Ophthalmic
Solution: In children ≥1 year of age, 2 drops of 0.3% solution into affected eye(s) every 15 minutes for 6 hours, followed by 2 drops every 30 minutes for remainder of first day.1 3 25 On the second day, instill 2 drops into affected eye(s) every hour, and on days 3–14, instill 2 drops every 4 hours.1 3 May continue longer than 14 days if corneal reepithelialization is not complete.1 3
Otic Infections
Otitis Externa (S. aureus or Ps. aeruginosa)
Otic
Ciprofloxacin-dexamethasone otic suspension: In children ≥6 months of age, 4 drops into canal of affected ear(s) twice daily for 7 days.125
Otitis Externa (S. aureus, Ps. aeruginosa, or P. mirabilis)
Otic
Ciprofloxacin-hydrocortisone otic suspension: In children ≥1 year of age, 3 drops into canal of affected ear(s) twice daily for 7 days.120
Otitis Media (Acute)
Otic
Ciprofloxacin-dexamethasone otic suspension: In children ≥6 months of age, 4 drops into affected ear(s) twice daily through tympanostomy tube for 7 days.125
Adults
Ophthalmic Infections
Conjunctivitis (S. aureus, S. epidermidis, S. pneumoniae, H. influenzae, or viridans streptococci)
Ophthalmic
Ointment: Apply approximately 1.27 cm (½ inch) ribbon into conjunctival sac of affected eye(s) 3 times daily for 2 days, then twice daily for next 5 days.119
Conjunctivitis (S. aureus, S. epidermidis, S. pneumoniae, or H. influenzae)
Ophthalmic
Solution: 1 or 2 drops of 0.3% solution into conjunctival sac of affected eye(s) every 2 hours while awake for 2 days, then 1–2 drops every 4 hours while awake for next 5 days.1 3
Keratitis
Ophthalmic
Solution: 2 drops of 0.3% solution into affected eye(s) every 15 minutes for 6 hours, followed by 2 drops every 30 minutes for remainder of first day.1 3 On the second day, instill 2 drops into affected eye(s) every hour, and on days 3–14, instill 2 drops every 4 hours.1 3 May continue longer than 14 days if corneal reepithelialization is not complete.1 3
Otic Infections
Otitis Externa (S. aureus or Ps. aeruginosa)
Otic
Ciprofloxacin-dexamethasone otic suspension: 4 drops into canal of affected ear(s) twice daily for 7 days.125
Otitis Externa (S. aureus, Ps. aeruginosa, or P. mirabilis)
Otic
Ciprofloxacin-hydrocortisone otic suspension: 3 drops into canal of affected ear(s) twice daily for 7 days.120
Cautions for Ciprofloxacin Hydrochloride
Contraindications
Known hypersensitivity to ciprofloxacin, other quinolones, or any ingredient in the formulation.1 119 120 125
Otic formulations contraindicated in patients with viral infections (i.e., herpes simplex, varicella) of external ear canal.120 125
Because commercially available ciprofloxacin-hydrocortisone fixed combination otic suspension is nonsterile, do not use if tympanic membrane is perforated.120
Warnings/Precautions
Sensitivity Reactions
Hypersensitivity
Serious, potentially fatal hypersensitivity reactions possible, occasionally after initial systemic dose.1 99 119 120 125 If allergic reaction occurs, discontinue ciprofloxacin and institute appropriate therapy if indicated.1 119 120 125
General Precautions
Infectious Complications.
Possible overgrowth of nonsusceptible organisms (e.g., fungi) with prolonged use; if superinfection occurs, discontinue drug and institute other appropriate therapy.1 119 120 125
Patient Monitoring
Ophthalmic: Careful monitoring, including slit-lamp biomicroscopy and fluorescein staining when appropriate, may be necessary.1 119
Otic: If otic infection is not improved after 1 week of treatment, obtain cultures to guide further treatment.120 125 If otorrhea persists after full course of therapy with ciprofloxacin-dexamethasone otic suspension, or if ≥2 episodes of otorrhea occur within 6 months, further evaluate to exclude underlying condition (e.g., cholesteatoma, foreign body, tumor).125
Ocular Effects
In patients with bacterial keratitis, white crystalline precipitate in superficial portion of corneal defect possible; onset generally is within 1–7 days after initiation of therapy (when solution is administered repeatedly at relatively short intervals) and resolution usually during later phase of continued therapy (when administration frequency is reduced).1 3 Precipitate does not appear to preclude continued use nor adversely affect visual outcome or clinical course of corneal ulcer.1 3 25 115 116 117
Use of Fixed Combination
When used in fixed combination with other agents, consider the cautions, precautions, and contraindications associated with the concomitant agents.
Specific Populations
Pregnancy
Category C.1 119 120 125
Lactation
Distributed into milk after systemic administration; it is not known whether distributed into milk after topical application to the eye or ear.1 119 120 125
Caution advised if ophthalmic solution or ointment is used in nursing women.1 119
Discontinue nursing or ciprofloxacin-steroid otic suspension preparations.120 125
Pediatric Use
Ophthalmic ointment: Safety and efficacy not established in children <2 years of age.119
Ophthalmic solution: Safety and efficacy not established in children <1 year of age.1
Ciprofloxacin-dexamethasone otic suspension: Safety and efficacy not established in children <6 months of age, but there are no known safety concerns or differences in disease process to preclude use in children <6 months of age.125
Ciprofloxacin-hydrocortisone otic suspension: Safety and efficacy not established in children <2 years of age, but there are no known safety concerns or differences in disease process to preclude use in children ≥1 year of age.120
Common Adverse Effects
Ophthalmic: local burning or discomfort, lid margin crusting, crystals/scales, foreign body sensation, itching, conjunctival hyperemia, bad taste, keratopathy.1 119
Otic: otic discomfort/pain/pruritus.120 125
Interactions for Ciprofloxacin Hydrochloride
No formal drug interaction studies to date.1 119 125 Since systemic absorption may occur following ophthalmic or otic1 119 125 administration, consider possible drug interactions such as those reported with systemic administration.1 119 125
Ciprofloxacin Hydrochloride Pharmacokinetics
Absorption
Bioavailability
Ophthalmic ointment: Extent of systemic absorption not evaluated, but mean maximal plasma ciprofloxacin concentrations expected to be <2.5 ng/mL, based on studies using 0.3% ophthalmic solution.119
Ophthalmic solution: Mean plasma ciprofloxacin concentrations generally averaged <2.5 ng/mL after topical application to each eye (1 drop of 0.3% ophthalmic solution every 2 hours while awake for 2 days, then every 4 hours while awake for 5 days).1
Ciprofloxacin-dexamethasone otic suspension: Following a single bilateral 4-drop otic dose in pediatric patients after tympanostomy tube insertion, measurable plasma ciprofloxacin or dexamethasone concentrations were observed after 6 hours in 2 or 5 of 9 patients, respectively.125 Peak plasma ciprofloxacin and dexamethasone concentrations were attained within 15 minutes to 2 hours.125
Ciprofloxacin-hydrocortisone otic suspension: Systemic exposure to ciprofloxacin expected to be below assay quantitation limits (0.05 mg/mL) and maximum plasma hydrocortisone concentration is predicted to be within range of endogenous hydrocortisone.120
Distribution
Extent
Distribution into human ocular tissues and fluids following topical ophthalmic or systemic administration not fully characterized to date.8 17
Distributed into milk after systemic administration; it is not known whether distributed into milk after topical application to the eye or ear.1 119 120 125
Stability
Storage
Ophthalmic
Ointment
2–25°C.119
Solution
2–25°C.1 Protect from light.1 108
Otic
Suspension
Ciprofloxacin-dexamethasone otic suspension: 15–30°C.125 Avoid freezing; protect from light.125
Ciprofloxacin-hydrocortisone otic suspension: <25°C.120 Avoid freezing; protect from light.120
Actions and SpectrumActions
Inhibits DNA synthesis via inhibition of type II DNA topoisomerases (DNA gyrase, topoisomerase IV).1 3 7 31 36 43 44 50 51 52 53 99
Usually bactericidal.1 3 6 37 40 41 42 43 44 45 47
Active in vitro against most gram-negative aerobic bacteria and many gram-positive aerobic bacteria,1 3 5 8 30 31 32 40 42 46 54 including penicillinase-producing, nonpenicillinase-producing, and oxacillin-resistant staphylococci;1 3 5 8 30 31 40 42 46 59 60 generally less active against gram-positive than gram-negative bacteria30 31 42 46 67 68 69 and less active in vitro on a weight basis against streptococci than against staphylococci.3 5 6 8 40 42 64 65 66 67 68 Most strains of Ps. cepacia, some strains of Ps. maltophilia, and most anaerobic bacteria, including Bacteroides fragilis and Clostridium difficile, are resistant.1 3 Inactive against fungi and viruses.1 3 5 6 8
Advice to Patients
Importance of discontinuing drug and informing clinician at first sign of rash or other sign of hypersensitivity.1 99 116 119 120 125
Importance of learning and adhering to proper administration techniques to avoid contamination of the product.1 116 119 120 125
Importance of not wearing contact lenses in presence of signs and symptoms of ophthalmic bacterial infections.119
Importance of informing clinicians of existing or contemplated therapy, including prescription and OTC drugs.1 119 120 125
Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.1 119 120 125
Importance of informing patients of other important precautionary information. (See Cautions.)1 119 120 125
Preparations
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
Routes | Dosage Forms | Strengths | Brand Names | Manufacturer |
|---|---|---|---|---|
Ophthalmic | Ointment | 0.3% (of ciprofloxacin) | Ciloxan | Alcon |
Solution | 0.3% (of ciprofloxacin) | Ciloxan (with benzalkonium chloride) | Alcon | |
Ciprofloxacin Ophthalmic Solution (with benzalkonium chloride) | Bausch & Lomb, Hi-Tech, Novex |
Routes | Dosage Forms | Strengths | Brand Names | Manufacturer |
|---|---|---|---|---|
Otic | Suspension | 0.2% (of ciprofloxacin) with Hydrocortisone 1% | Cipro HC Otic Drops (with benzyl alcohol 0.9%) | Alcon |
0.3% (of ciprofloxacin) with Dexamethasone 0.1% | Ciprodex (with benzalkonium chloride) | Alcon |
Comparative Pricing
This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 03/2011. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.
Ciloxan 0.3% Ointment (ALCON VISION): 3/$99.99 or 10/$267.97
Ciloxan 0.3% Solution (ALCON VISION): 5/$76.99 or 15/$210.96
Cipro HC 0.2-1% Suspension (ALCON VISION): 10/$135.99 or 30/$382.98
Ciprodex 0.3-0.1% Suspension (ALCON VISION): 7/$142.98 or 22/$407.95
Ciprofloxacin HCl 0.3% Solution (FALCON PHARMACEUTICALS): 5/$29.99 or 15/$79.96
Ciprofloxacin HCl 0.3% Solution (FALCON PHARMACEUTICALS): 10/$59.99 or 30/$159.96
Ciprofloxacin HCl 0.3% Solution (FALCON PHARMACEUTICALS): 2/$19.99 or 7/$45.97
Disclaimer
This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.
The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.
AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions July 2006. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.
References
1. Alcon Laboratories. Ciloxan (ciprofloxacin hydrochloride) ophthalmic solution prescribing information. Fort Worth, TX; 1999 Dec.
2. Alcon Laboratories. Product information form for American hospital formulary service: Ciloxan (ciprofloxacin HCl) 0.3% as base sterile ophthalmic solution. Fort Worth, TX: 1991 Mar.
3. Alcon Laboratories. Ciloxan product monograph. Ciloxan (ciprofloxacin HCl) 0.3% as base sterile ophthalmic solution. Fort Worth, TX: 1991 Apr.
4. Anon. Ophthalmic ciprofloxacin. Med Lett Drugs Ther. 1991; 33:52-3. [PubMed 2030657]
5. Campoli-Richards DM, Monk JP, Price A et al. Ciprofloxacin: a review of its antibacterial activity, pharmacokinetic properties and therapeutic use. Drugs. 1988; 35:373-447. [IDIS 240961] [PubMed 3292209]
6. Neu HC. Microbiologic aspects of fluoroquinolones. Am J Ophthalmol. 1991; 112:15-24S. [IDIS 284787] [PubMed 1882916]
7. Hooper DC. Mechanisms of action and resistance of older and newer fluoroquinolones. Clin Infect Dis. 2000; 31(Suppl 2):S24-8. [IDIS 454408] [PubMed 10984324]
8. Vance-Bryan K, Guay DRP, Rotschafer JC. Clinical pharmacokinetics of ciprofloxacin. Clin Pharmacokinet. 1990; 19:434-61. [PubMed 2292168]
9. Reidy JJ, Hobden JA, Hill JM et al. The efficacy of topical ciprofloxacin and norfloxacin in the treatment of experimental pseudomonas keratitis. Cornea. 1991; 10:25-8. [PubMed 1902152]
10. McDermott ML, Tran TD, Cowden JW et al. Corneal stromal penetration of topical ciprofloxacin in humans. Ophthalmology. 1993; 100:197-200. [PubMed 8437827]
11. O’Brien TP, Sawusch MR, Dick JD et al. Topical ciprofloxacin treatment of pseudomonas keratitis in rabbits. Arch Ophthalmol. 1988; 106:1444-6. [PubMed 3140772]
12. Rootman DS, Savage P, Hasany SM et al. Toxicity and pharmacokinetics of intravitreally injected ciprofloxacin in rabbit eyes. Can J Ophthalmol. 1992; 27:277-82. [PubMed 1451014]
13. Behrens-Baumann W, Martell J. Ciprofloxacin concentration in the rabbit aqueous humor and vitreous following intravenous and subconjuctival administration. Infection. 1988; 16:54-7. [PubMed 3360498]
14. Skoutelis AT, Gartaganis SP, Chrysanthopoulos CJ et al. Aqueous humor penetration of ciprofloxacin in the human eye. Arch Ophthalmol. 1988; 106:404-5. [IDIS 239150] [PubMed 3345156]
15. Bron A, Talon D, Cellier T et al. La ciprofloxacine: pénétration intra-camérulaire chez l’homme. Bull Soc Opht France. 1990; 40:805-11.
16. Sweeney G, Fern AI, Lindsay G et al. Penetration of ciprofloxacin into the aqueous humour of the uninflamed human eye after oral administration. Br Soc Antimicrob Chemother. 1990; 26:99-105.
17. Barza M. Use of quinolones for treatment of ear and eye infections. Eur J Clin Microbiol Infect Dis. 1991; 10:296-303. [PubMed 1864290]
18. El Baba FZ, Trousdale MD, Gauderman WJ et al. Intravitreal penetration of oral ciprofloxacin in humans. Ophthalmology. 1992; 99:483-6. [PubMed 1584563]
19. Gardner DK, Gabbe SG, Harter C. Simultaneous concentrations of ciprofloxacin in breast milk and in serum in mother and breast-fed infant. Clin Pharm. 1992; 11: 352-4. [IDIS 292898] [PubMed 1563233]
20. Cover DL, Mueller BA. Ciprofloxacin penetration into human breast milk: a case report. DICP. 1990; 24:703-4. [IDIS 268094] [PubMed 2375140]
21. Giamarellou H, Kanellas D, Kavouklis E et al. Comparative pharmacokinetics of ciprofloxacin, ofloxacin and pefloxacin in human aqueous humour. Eur J Clin Microbiol Infect Dis. 1993; 12:293-7. [PubMed 8513819]
22. Limberg MB. A review of bacterial keratitis and bacterial conjunctivitis. Am J Ophthalmol. 1991; 112:2-9S.
23. McDonnell PJ, Green WR. Conjunctivitis. In: Mandell GL, Douglas RG Jr, Bennett JE, eds. Principles and practices of infectious diseases. 3rd ed. New York: Churchill Livingstone; 1990:975-82.
24. Steinert RF. Current therapy for bacterial keratitis and bacterial conjunctivitis. Am J Ophthalmol. 1991; 112:10-4S.
25. Leibowitz HM. Clinical evaluation of ciprofloxacin 0.3% ophthalmic solution for treatment of bacterial keratitis. Am J Ophthalmol. 1991; 112:34-47S. [IDIS 288796] [PubMed 1882919]
26. Cokingtin CD, Hyndiuk RA. Insights from experimental data on ciprofloxacin in the treatment of bacterial keratitis and ocular infections. Am J Ophthalmol. 1991; 112:25-8S.
27. Insler MS, Fish LA, Silbernagel J et al. Successful treatment of methicillin-resistant Staphylococcus aureus keratitis with topical ciprofloxacin. Ophthalmology. 1991; 98:1690-2. [PubMed 1800931]
28. Sossi N, Feldman RM, Feldman ST et al. Mycobacterium gordonae keratitis after penetrating keratoplasty. Arch Ophthalmol. 1991; 109:1064-5. [IDIS 286440] [PubMed 1867541]
29. Hwang DG, Biswell R. Ciprofloxacin therapy of Mycobacterium chelonae keratitis. Am J Ophthalmol. 1993; 115:114-5. [IDIS 308488] [PubMed 8420364]
30. Nix DE, Devito JM. Ciprofloxacin and norfloxacin, two fluoroquinolone antimicrobials. Clin Pharm. 1987; 6:105-17. [IDIS 225594] [PubMed 3311572]
31. Wolfson JS, Hooper DC. The fluoroquinolones: structures, mechanisms of action and resistance, and spectra of activity in vitro. Antimicrob Agents Chemother. 1985; 28:581-6. [IDIS 207617] [PubMed 3000292]
32. Janknegt R. Fluorinated quinolones: a review of their mode of action, antimicrobial activity, pharmacokinetics and clinical efficacy. Pharm Weekbl [Sci]. 1986; 8:1-21. [IDIS 213999] [PubMed 3515312]
33. Verbist L. Quinolones: pharmacology. Pharm Weekbl [Sci]. 1986; 8:22-5. [IDIS 214000] [PubMed 3008075]
34. Neuman M. Clinical pharmacokinetics of the newer antibacterial 4-quinolones. Clin Pharmacokinet. 1988; 14:96-121. [IDIS 240310] [PubMed 3282749]
35. Jack DB. Recent advances in pharmaceutical chemistry: the 4-quinolone antibiotics. J Clin Hosp Pharm. 1986; 11:75-93. [IDIS 216892] [PubMed 3519688]
36. Bergan T. Quinolones. In: Peterson PK, Verhoef J, eds. The antimicrobial agents annual/1. Amsterdam: Elsevier Science Publishers BV; 1986: 164-78.
37. Miles. Cipro tablets (ciprofloxacin HCl) product monograph. West Haven, CT: 1987.
38. Crumplin GC. Aspects of chemistry in the development of the 4-quinolone antibacterial agents. Rev Infect Dis. 1988; 10(Suppl 1):S2-9. [IDIS 311592] [PubMed 3279494]
39. Miles Inc, West Haven, CT: Personal communication.
40. Kayser FH, Novak J. In vitro activity of ciprofloxacin against gram-positive bacteria: an overview. Am J Med. 1987; 82(Suppl 4A):33-9. [IDIS 230495] [PubMed 3555058]
41. Lagast H, Husson M, Klastersky J. Bactericidal activity of ciprofloxacin in serum and urine against Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus and Streptococcus faecalis. J Antimicrob Chemother. 1985; 16:341-7. [PubMed 2932416]
42. Eliopoulos GM, Gardella A, Moellering RC. In vitro activity of ciprofloxacin, a new carboxyquinoline antimicrobial agent. Antimicrob Agents Chemother. 1984; 25:331-5. [IDIS 183089] [PubMed 6721464]
43. Smith JT. The mode of action of 4-quinolones and possible mechanisms of resistance. J Antimicrob Chemother. 1986; 18(Suppl D):21-9. [PubMed 3542946]
44. Hooper DC, Wolfson JS, Ng EY et al. Mechanisms of action of and resistance to ciprofloxacin. Am J Med. 1987; 82(Suppl 4A):12-20. [IDIS 230492] [PubMed 3034057]
45. Reeves DS, Bywater MJ, Holt HA et al. In vitro studies with ciprofloxacin, a new 4-quinolone compound. J Antimicrob Chemother. 1984; 13:333-6. [IDIS 205465] [PubMed 6233250]
46. Terp DK, Rybak MJ. Ciprofloxacin. Drug Intell Clin Pharm. 1987; 21:568-74. [IDIS 232480] [PubMed 3301247]
47. Standiford HC, Drusano GL, Forrest A et al. Bactericidal activity of ciprofloxacin compared with that of cefotaxime in normal volunteers. Antimicrob Agents Chemother. 1987; 31:1177-82. [IDIS 234803] [PubMed 3631942]
48. Thadepalli H, Bansal MB, Rao B et al. Ciprofloxacin: in vitro, experimental, and clinical evaluation. Rev Infect Dis. 1988; 10:505-15. [IDIS 309934] [PubMed 3393781]
49. Diver JM, Wise R. Morphological and biochemical changes in Escherichia coli after exposure to ciprofloxacin. J Antimicrob Chemother. 1986; 18(Suppl D):31-41. [PubMed 3542947]
50. Domagala JM, Hanna LD, Heifetz CL et al. New structure-activity relationships of the quinolone antibacterials using the target enzyme: the development and application of a DNA gyrase assay. J Med Chem. 1986; 29:394-404. [IDIS 212485] [PubMed 3005575]
51. Zweerink MM, Edison A. Inhibition of Micrococcus luteus DNA gyrase by norfloxacin and 10 other quinolone carboxylic acids. Antimicrob Agents Chemother. 1986; 29:598-601. [IDIS 215018] [PubMed 3010848]
52. Hussy P, Maass G, Tummler B et al. Effect of 4-quinolones and novobiocin on calf thymus DNA polymerase α-primase complex, topoisomerases I and II, and growth of mammalian lymphoblasts. Antimicrob Agents Chemother. 1986; 29:1073-8. [PubMed 3015015]
53. Bearden DT, Danziger LH. Mechanism of Action of and resistance to quinolones. Pharmacotherapy. 2001; 21:224S-32S [IDIS 472236] [PubMed 11642689]
54. Sanders CC. Ciprofloxacin: in vitro activity, mechanism of action, and resistance. Rev Infect Dis. 1988; 10:516-27. [IDIS 309935] [PubMed 3293157]
59. Smith SM, Eng RH, Berman E. The effect of ciprofloxacin on methicillin-resistant Staphylococcus aureus. J Antimicrob Chemother. 1986; 17:287-95. [PubMed 2939049]
60. Smith SM, Eng RH. Activity of ciprofloxacin against methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother. 1985; 688-91. (IDIS 200502)
61. King A, Shannon K, Phillips I. The in-vitro activity of ciprofloxacin compared with that of norfloxacin and nalidixic acid. J Antimicrob Chemother. 1984; 13:325-31. [IDIS 223947] [PubMed 6233249]
62. Barry AL, Jones RN. In vitro activity of ciprofloxacin against gram-positive cocci. Am J Med. 1987; 82(Suppl 4A):27-32. [IDIS 230494] [PubMed 3578323]
63. Chau PY, Leung YK, Ng WW. Comparative in vitro antibacterial activity of ofloxacin and ciprofloxacin against some selected gram-positive and gram-negative isolates. Infection. 1986; 14(Suppl 4):S237-9. [PubMed 3469153]
64. Mandell W, Neu HC. In vitro activity of CI-934, a new quinolone, compared with that of other quinolones and other antimicrobial agents. Antimicrob Agents Chemother. 1986; 29:852-7. [PubMed 3729343]
65. Chin NX, Brittain DC, Neu HC. In vitro activity of Ro 23-6240, a new fluorinated 4-quinolone. Antimicrob Agents Chemother. 1986; 29:675-80. [IDIS 215029] [PubMed 3085584]
66. Fass RJ. In vitro activity of ciprofloxacin (Bay o 9867). Antimicrob Agents Chemother. 1983; 24:568-74. [IDIS 177504] [PubMed 6228192]
67. Chin NX, Neu HC. Ciprofloxacin, a quinolone carboxylic acid compound active against aerobic and anaerobic bacteria. Antimicrob Agents Chemother. 1984; 25:319-26. [IDIS 183087] [PubMed 6232895]
68. King A, Phillips I. The comparative in-vitro activity of eight newer quinolones and nalidixic acid. J Antimicrob Chemother. 1986; 18(Suppl D):1-20. [PubMed 3468100]
69. Barry AL, Jones RN, Thornsberry C et al. Antibacterial activities of ciprofloxacin, norfloxacin, oxolinic acid, cinoxacin, and nalidixic acid. Antimicrob Agents Chemother. 1984; 25:633-7. [IDIS 185381] [PubMed 6233935]
70. Young LS, Berlin OG, Inderlied CB. Activity of ciprofloxacin and other fluorinated quinolones against mycobacteria. Am J Med. 1987; 82(Suppl 4A):23-6. [IDIS 230493] [PubMed 3107379]
71. Gay JD, DeYoung DR, Roberts GD. In vitro activities of norfloxacin and ciprofloxacin against Mycobacterium tuberculosis, M. avium complex, M. chelonei, M. fortuitum, and M. kansasii. Antimicrob Agents Chemother. 1984; 26:94-6. [IDIS 187632] [PubMed 6236748]
72. Fenlon CH, Cynamon MH. Comparative in vitro activities of ciprofloxacin and other 4-quinolones against Mycobacterium tuberculosis and Mycobacterium intracellulare. Antimicrob Agents Chemother. 1986; 29:386-8. [IDIS 211610] [PubMed 2940969]
73. Aznar J, Caballero MC, Loxano MC et al. Activities of new quinoline derivatives against genital pathogens. Antimicrob Agents Chemother. 1985; 27:76-8. [IDIS 195272] [PubMed 3920959]
74. Ridgway GL, Mumtaz G, Gabriel FG et al. The activity of ciprofloxacin and other 4-quinolones against Chlamydia trachomatis and mycoplasmas in vitro. Eur J Clin Microbiol. 1984; 3:344-6. [IDIS 223936] [PubMed 6237903]
75. Heppleston C, Richmond S, Bailey J. Antichlamydial activity of quinolone carboxylic acids. J Antimicrob Chemother. 1985; 15:645-7. [PubMed 3159713]
76. Sanders CC, Sanders WE, Goering RV et al. Selection of multiple antibiotic resistance by quinolones, β-lactams, and aminoglycosides with special reference to cross-resistance between unrelated drug classes. Antimicrob Agents Chemother. 1984; 26:797-801. [IDIS 194031] [PubMed 6098219]
77. Barry AL, Jones RN. Cross-resistance among cinoxacin, ciprofloxacin, DJ-6783, enoxacin, nalidixic acid, norfloxacin, and oxolinic acid after in vitro selection of resistant populations. Antimicrob Agents Chemother. 1984; 25:775-7. [IDIS 223938] [PubMed 6234858]
78. Kaatz GW, Seo SM. Mechanism of ciprofloxacin resistance in Pseudomonas aeruginosa. J Infect Dis. 1988; 158:537-41. [PubMed 3137271]
79. Follath F, Bindschedler M, Wenk M et al. Use of ciprofloxacin in the treatment of Pseudomonas aeruginosa infections. Eur J Clin Microbiol. 1986; 5:236-40. [PubMed 2941289]
80. Scully BE, Parry MF, Neu HC et al. Oral ciprofloxacin therapy of infections due to Pseudomonas aeruginosa. Lancet. 1986; 1:819-22. [IDIS 214361] [PubMed 2870313]
81. Greenberg RN, Kennedy DJ, Reilly PM et al. Treatment of bone, joint, and soft-tissue infections with oral ciprofloxacin. Antimicrob Agents Chemother. 1987; 31:151-5. [IDIS 226537] [PubMed 3566245]
82. Piercy EA, Barbaro D, Luby JP et al. Ciprofloxacin for methicillin-resistant Staphylococcus aureus infections. Antimicrob Agents Chemother. 1989; 33:128-30. [IDIS 249464] [PubMed 2712546]
83. Smith SM, Eng RH, Tecson-Tumang F. Ciprofloxacin therapy for methicillin-resistant Staphylococcus aureus infections or colonizations. Antimicrob Agents Chemother. 1989; 33:181-4. [IDIS 251556] [PubMed 2719462]
87. Tartaglione TA, Raffalovich AC, Poynor WJ et al. Pharmacokinetics and tolerance of ciprofloxacin after sequential increasing oral doses. Antimicrob Agents Chemother. 1986; 29:62-6. [IDIS 212936] [PubMed 2942101]
88. Gonzalez MA, Uribe F, Moisen SD et al. Multiple-dose pharmacokinetics and safety of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother. 1984; 26:741-4. [IDIS 194086] [PubMed 6517556]
89. Hoffler J, Dalhoff A, Gau W et al. Dose- and sex-independent disposition of ciprofloxacin. Eur J Clin Microbiol. 1984; 3:363-6. [PubMed 6489328]
90. Wingender W, Graege KH, Gau W et al. Pharmacokinetics of ciprofloxacin after oral and intravenous administration in healthy volunteers. Eur J Clin Microbiol. 1984; 3:355-9. [PubMed 6489326]
91. Gasser TC, Ebert SC, Graversen PH et al. Ciprofloxacin pharmacokinetics in patients with normal and impaired renal function. Antimicrob Agents Chemother. 1987; 31:709-12. [IDIS 229463] [PubMed 3300537]
92. Hoffken G, Lode H, Prinzing C et al. Pharmacokinetics of ciprofloxacin after oral and parenteral administration. Antimicrob Agents Chemother. 1985; 27:375-9. [IDIS 197548] [PubMed 3158275]
93. Bergan T, Engeset A, Olszewski W. Does serum protein binding inhibit tissue penetration of antibiotics? Rev Infect Dis. 1987; 9:713-8. (IDIS 232250)
94. Giamarellou H, Kolokythas E, Petrikkos G et al. Pharmacokinetics of three newer quinolones in pregnant and lactating women. Am J Med. 1989; 87(Suppl 5A):49-51S.
95. Zeiler HJ, Petersen U, Ploschke HJ. Antibacterial activity of the metabolites of ciprofloxacin and its significance in the bioassay. Arzneimittelforschung. 1987; 37:131-4. [PubMed 3555512]
96. Tanimura H, Tominaga S, Rai F et al. Transfer of ciprofloxacin to bile and determination of biliary metabolites in humans. Arzneimittelforschung. 1986; 26:1417-20.
97. Parry MF, Smego DA, Digiovanni MA. Hepatobiliary kinetics and excretion of ciprofloxacin. Antimicrob Agents Chemother. 1988; 32:982-5. [IDIS 244087] [PubMed 3190199]
98. Drusano GL. An overview of the pharmacology of intravenously administered ciprofloxacin. Am J Med. 1987; 82(Suppl 4A):339-45. [IDIS 230552] [PubMed 3578325]
99. Bayer. Cipro I.V. (ciprofloxacin) for intravenous infusion prescribing information. West Haven, CT; 2002 Jun.
100. Christ W, Lehnert T, Ulbrich B. Specific toxicologic aspects of the quinolones. Rev Infect Dis. 1988; 10(Suppl 1):S141-6. [IDIS 311600] [PubMed 3279489]
101. Snyder ME, Katz HR. Ciprofloxacin-resistant bacterial keratitis. Am J Ophthalmol. 1992; 114:336-8. [IDIS 301719] [PubMed 1524125]
102. Eiferman RA, Forgey DR, Snyder J. The successful treatment of bacterial corneal ulcers with ciprofloxacin. Invest Ophthalmol Vis Sci. 1991; (Suppl 32):1171.
103. Abrams DA, Sarfarazi FA, Parks DJ et al. Topical ciprofloxacin versus conventional antibiotic therapy in the tre
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