(for veterinary information only)
BRAND NAME: CIPRO, CIPRO XR
Human beings have been at odds with microbes since the beginning of time and the quest for new medications continues even today. When sulfa drugs came on the scene in the 1940's, an "age of antibiotics" was born and a new dimension had opened in the combat against microbes. From there a proliferation of antibiotics developed, each new medication exploiting a different aspect of bacterial metabolism until it seemed that the war on microbes would soon be won.
Despite this progress, one particular bacterial species remained seemingly invincible: Pseudomonas aeruginosa. This species of bacteria was able to change its antibiotic susceptibility with each antibiotic exposure, become resistant to multiple drugs in response to every medication used against it. Eventually, the aminoglycoside class of antibiotics was developed and there was finally a way to kill Pseudomonas fairly reliably but the price was that medication was injectable only, necessitating hospitalization for the patient, and potential kidney damage could result with prolonged use.
The second issue with ciprofloxacin use in pets is that bioavailability is highly variable between individuals. This means that a particular dose of ciprofloxacin might be absorbed just fine by one dog and not at all by another, yielding an unpredictable response or lack thereof. Higher doses are recommended to get the most medication into the patient's body where it can achieve its effect.
USES OF THIS MEDICATION
This medication may be used in either dogs or cats to combat different types of infections, especially those involving Pseudomonas and/or other Gram negative bacteria. Ciprofloxacin is also active against Staphylococci, and thus could be used for skin infections.
As with most oral medications, the most common side effects of ciprofloxacin are related to the GI tract: vomiting, diarrhea, reduced appetite.
Enrofloxacin, the first veterinary fluoroquinolone, was found to lead to retinal damage and blindness when used in higher doses in cats. This is because the feline retina has a tendency to accumulate enrofloxacin. Because ciprofloxacin is converted to enrofloxacin and because higher doses of ciprofloxacin are generally needed to overcome bioavailability issues, this may not be the best choice antibiotic for cats. That said, ciprofloxacin tends not to accumulate in the feline retina and the vision issues of enrofloxacin have not been reported with ciprofloxacin.
Fluoroquinolone antibiotics may lower the seizure threshold and increase a patient's tendency to have seizures. This is of no concern in a normal animal but is worth a cautionary statement for patients with a pre-existing seizure disorder.
Ciprofloxacin has been known to form crystals in urine and form actual bladder stones in human beings. Hydration should be maintained in pets taking ciprofloxacin to avoid any issues.
INTERACTIONS WITH OTHER DRUGS
Sucralfate (a medication used to treat stomach ulcers) may bind ciproflxacin and prevent it from entering the body. These medications should be given at least 2 hours apart if they are used together. A similar phenomenon occurs with magnesium and calcium-containing antacids.
Theophylline (an airway dilator) blood levels may be higher than usual if this medication is used concurrently with ciprofloxacin. The dose of theophylline may need to be reduced.
If ciprofloxacin is used with oral cyclosporine (an immunosuppressive medication used for inflammatory bowel disease), the kidney damaging properties of cyclosporine may become worse.
Medications or supplements containing iron, zinc, magnesium or aluminum will bind ciprofloxacin and prevent absorption into the body. Such medications should be separated from ciprofloxacin by at least 2 hours.
CONCERNS AND CAUTIONS
Pseudomonas infections are especially common in canine ears and if not controlled decisively, can become resistant. Higher doses of fluoroquinolones are needed to kill this particularly nefarious bacterium and there is significant expense associated. It is tempting to use ciprofloxacin as there is an inexpensive generic but if bioavailability proves inadequate and the infection prevails, it will become even more difficult to clear. In other words, it may not be worth taking a chance on using an inexpensive medication and the use of ciprofloxacin in this situation should be carefully weighed against the monetary savings.
Ciprofloxacin should not be used in pregnant, or nursing pets or in immature dogs unless the severity of the infection warrants it.
Page posted: 3/19/2016