Talk:Ciprofloxacin

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2004-2005 Ciprofloxacin talk

Also implicated in the rise of resistant bacteria is the use of lower-cost, less potent fluoroquinones, and the widespread addition of Cipro and other antibiotics to the feed of farm animals, which leads to greater and more rapid weight gain, for reasons which are not clear.

the word sould be fluoroquinolones, or is it correct?

quinolones JFW | T@lk 08:45, 21 Nov 2004 (UTC)

The relative safety of Fluoroquinolones? These drugs can cause kidney damage, liver damage, neurological problems, weakened cartilidge...

It seems like this was written by a shill for the drug companies. I've taken drugs penicillin type drugs and I've taken a course of Cipro (for orchitis.) Cipro was much much harsher.

--Wiserd 8 July 2005 20:02 (UTC)

But will you concede that your personal experience may not reflect statistical reality? Allergies are much rarer, and the side-effects you kindly inserted are rarer e.g. than those in macrolides (stomach upset, transient hearing loss). This was not written by a "shill for the drug companies". The side-effects are not mentioned because thankfully they are rarer than therapeutic successes. I reckon your orchitis improved. JFW | T@lk 12:08, 10 July 2005 (UTC)[reply]

I'm not convinced the cipro was 100% successful in my case, though residual symptoms may be due to trauma\autoimmune response\some other non-bacterial factor. I'm going to head back to the Doctor as soon as I have time. But certainly my personal experience is far from a controlled study.

My language was a bit harsh. The use of cipro certainly outweighs the side effects in certain instances. But you have a lot of people self-administering cipro such as with the anthrax scare, overproscription, etc. and doing a great deal of harm to themselves, outside of the normal issues of antibiotic resistance.

The article on Cipro came across as a bit unbalanced, defending Bayer, praising cipro and offering no list of side effects or warnings. I suppose the Macrolides you mentioned don't have a list of side effects either (I just looked up their formatting now) though the tetracyclines, which I was going off of, did.

--Wiserd 23:33, 10 July 2005 (UTC)[reply]

I totally agree that people should not be self-administering any prescription drugs, and I think due to selective resistance this is especially important in antibiotics, as it harms more people than just the "patient".

I have condensed the side-effect area a bit. One has to be jolly careful with the reporting of side-effects in the medical literature. Often one or two cases of a side-effect are described, and in many instances the link is really really tentative (e.g. they were also taking other drugs at the same time).

I've also changed the links to the PubMed abstracts into actual academic references. Unfortunately the Brouwers article was not accessible as fulltext, and I've had to time to check which CYP450 isoenzyme is inhibited by cipro. JFW | T@lk 11:51, 11 July 2005 (UTC)[reply]

Thanks for tightening\cleaning things up. Very nice summation. I do think the neurological problems, particularly insomnia, feelings of dread, and some other more serious problems are genuine characteristics of ciprofloxacin since they seem to be characteristics of most fluoroquinolones. Significant phototoxicity is also a characteristic of most fluoroquinolones, though ciprofloxacin seems to be mild in this regard relative to others in its class.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15738624&query_hl=23 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12740182&query_hl=23

Likewise, the fluoroquinolones are generally chondrotoxic as well as weakening tendons, and this can be demonstrated in vivo in rats.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15456526&query_hl=21 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12052667&query_hl=2

"and I've had to time to check which CYP450 isoenzyme is inhibited by cipro."

"Likewise, quinolone antibiotics such as ciprofloxacin inhibit the metabolism of CYP1A2 substrates."

from - http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15058617&query_hl=36

--Wiserd 12:31, 12 July 2005 (UTC)[reply]

Better: please see PMID 1510417. PMID 12052667 is a good review, but one of us may need to read the fulltext to see what is worth mentioning. I don't think we should extensively mention animal studies. The Japanese study is not a good choice - most readers do not understand Japanese :0(. JFW | T@lk 13:49, 12 July 2005 (UTC)[reply]

Hai. Nihongo ga wakarimasen, ne. (Translation, " I don't understand Japanese")

--210.213.157.108 15:13, 2 August 2005 (UTC)[reply]

Action against Enterococcus?

According to their website: http://www.ciproxr.com/PAT/Patient_index.asp Cipro XR is active against Enterococcus faecalis, but this Wiki entry contradicts this. Which is right?

Cipro resistance is increasing. JFW | T@lk 02:43, 14 October 2005 (UTC)[reply]

I think it's only an incomplete list. You can see it:Ciprofloxacina. --F. Cosoleto 00:12, 15 October 2005 (UTC)[reply]

"Unfortunately?"

Removing that from the line that read "Unfortunately, Bayer took a financial blow..." Not that it's not a heartbreaker or anything.

I agree that it was not NPOV, but your sarcasm is misplaced. Bayer responded to a demand, which was a shrewd business decision which appears to be legitimate in any other branch of business apart from pharmaceuticals. JFW | T@lk 18:24, 31 January 2006 (UTC)[reply]

And a qualification: the business decision turned out to have been a bad one. JFW | T@lk 18:25, 31 January 2006 (UTC)[reply]

Contradiction

The DNA gyrase article says gyrase is only found in bacteria, while this article says it's found in both but it acts more on bacterial. Which is correct? --zandperl 19:23, 26 April 2006 (UTC)[reply]

just bacteria. Well prokaryotes to be more accurate. I don't see where this is in the article though. SenorKristobbal 11:47, 9 November 2006 (UTC)[reply]

cipro and quercetin

This article may discuss the interaction between Cipro and quercetin. I can only get the abstract, which gives results but not specific antibiotics used. [1] There seems to be a very minor but positive interaction between the two.

Some other cipro / fluoroquinolone issues

I am currently researching cipro for treatment of a pneumococcus (streptococcus pneumoniae) infection for a loved one. Spent a lot of time reading original research articles in refereed journals. Some issues I'm wondering if you all would think are worth adding:

Central Nervous System (CNS) side effects: There are reported psychotic reactions (hallucinations, paranoia. The research I found indicated these are all temporary events that go away quickly upon cessation of treatment. But does seem important to know about.
Interaction with NSAID: Should this be moved and / or repeated in the "interactions" section and not just "contraindications" section? Also, should ibuprofen be specifically mentioned?
Fluoroquinolones for streptococcus pneumoniae infections: While ciprofloxacin is not idea for raging strep pneumo infections, it may be appropriate for "mop up" after treatment with vancomycin. Important parameters are MIC levels and drug uptake. There are good reports out there showing that some 3rd generation fluorquinolone may be have much higher efficacy against strep pneumo than cipro. For example moxifloxacin may be 20 times more effective (I am not sure of the technical way of defining "efficacy").
Arthropathic side effects in children: I found some good articles that (a) demonstrate undetectable risk in pediatric usage and (b) explanations for why human side effects are much dimished compared with puppy or bunny models.

Let me know if you think these would be good additions to the article. I did spend quite a bit of time doing my own research while in the hosptial at nights. (I am a very new wiki user, so you may want to send me an email with your thoughts, I am not sure how I will notice updates to this page.) I will also look to update information I found on vancomycin and side effects. Skoch3 14:14, 21 December 2006 (UTC)[reply]

Business aspects

I've tagged the whole "Business aspects" section for a neutrality check. It is completely uncited, and statements such as "with the other drugs developed by other pharmaceutical companies relegated to 'me-too' status and forced to compete on the basis of lower cost" are not at all encyclopedic. I'll see if I can get to this later. Fvasconcellos (t·c) 04:00, 3 June 2007 (UTC)[reply]

This might help http://www.managingip.com/?ISS=13068&PUBID=198&Page=9&SID=486721&SM=&SearchStr= ? Dnadiver

Information lacking citation

Ciprofloxin can cause neurological agaitation in health young adults. A State toxicology report indicates that ciprofloxin caused a toxic reaction, grand maul seizure, permanent loss of conciousness and subsequent death in a 28 year old in North Alabama in 1992.

I cut this paragraph Snafflekid 22:40, 7 August 2007 (UTC)[reply]