Drug breakdown: Ciprofloxacin

Day 1: A by-product of chloroquine synthesis, quinolone antibiotics were discovered in the early 1960s. Already broad-spectrum, the addition of chemical groups such as fluorine led to the 2nd generation agents such as #ciprofloxacin, which have enhanced gram-ve action. Licensed in 1987.

Day 2: #ciprofloxacin adult uses: various respiratory tract infections, especially where gram-ve bacteria; upper UTIs; acute prostatitis; gonorrhoea; diabetic foot infection; gram-ve skin/bone infections; anthrax; surgical prophylaxis; fistulating Crohn's. NOTE: ineffective v Streptococcus spp. Children; severe respiratory and GI infections; complex UTI/pyelonephritis (not exhaustive). The usual adult oral dose range 500-750 mg twice daily, duration variable. i.v 400 mg every 12 hours given over 60 mins (not exhaustive). Formulations: tablet, suspension, infusion.

Day 3: #ciprofloxacin has good oral absorption and bioavailability. Avoid with dairy/calcium products 1-2 hours before or 4 hrs after as this reduces absorption. Low protein binding, high volume of distribution and high tissue drug concentrations. Some metabolism via CYP1A2, but majority undergoes renal excretion unchanged, t½ 4-7 hrs. #ciprofloxacin itself is a moderate inhibitor of CYP1A2, with relevance to drug-drug interactions.