II. Activity Spectrum (See Class I and Class II below)

  1. Gram Negative Rod coverage (see other Fluoroquinolones)
  2. Some atypical Bacteria coverage (Class II only)
  3. See Ciprofloxacin below for other activity

III. Preparations: Class I

  1. Indications
    1. Uncomplicated Urinary Tract Infections
  2. Similar spectrum to first generation agents
    1. Improved Gram Negative coverage over first generation
    2. Low systemic drug concentrations
  3. Agents
    1. Lomefloxacin (Maxaquin)
    2. Enoxacin (Penetrex)
    3. Norfloxacin (Noroxin)

IV. Preparations: Class II

  1. Indications
    1. Complicated Urinary Tract Infections
    2. Specific types of Bacterial Gastroenteritis
    3. Prostatitis
    4. Sexually Transmitted Disease
    5. Avoid in community acquired Pneumonia
      1. Risk of pneumococcal bacteremia and Meningitis
  2. Additional Indications for Ciprofloxacin
    1. Pseudomonas aeruginosa
    2. Bacillus anthracis or Anthrax (first line agent)
    3. Vibrio Cholerae (Norfloxacin also covers)
    4. Yersinia pestis or Plague (first line agent)
    5. Tularemia (alternative medication)
  3. Significantly more active than Class I agents
    1. Broader Gram Negative coverage than Class I agents
    2. High systemic drug concentrations
    3. Some atypical Bacteria coverage
    4. Pseudomonas aeruginosa (Ciprofloxacin only)
  4. Agents
    1. Ciprofloxacin (Cipro)
    2. Ofloxacin (Floxin)

V. Directions

  1. Take on an empty Stomach
  2. Take more than 1 hour before or two hours after food

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Cost: Medications

Ciprofloxacin (on 6/18/2017 at Walmart.com)
Ciprofloxacin 250mg #14 tablets for $4.00 $0.29 each
Ciprofloxacin 250mg #42 tablets for $10.00 $0.24 each
Ciprofloxacin 500mg #20 tablets for $4.00 $0.20 each
Ciprofloxacin 500mg #60 tablets for $10.00 $0.17 each
ciprofloxacin (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
CIPROFLOXACIN 0.2% OTIC SOLN Generic $6.19 each
CIPROFLOXACIN 0.3% EYE DROP Generic $1.28 per ml
CIPROFLOXACIN HCL 250 MG TAB Generic $0.12 each
CIPROFLOXACIN HCL 500 MG TAB Generic $0.15 each
CIPROFLOXACIN HCL 750 MG TAB Generic $0.27 each
ofloxacin (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
OFLOXACIN 0.3% EAR DROPS Generic $10.63 per ml
OFLOXACIN 0.3% EYE DROPS Generic $2.93 per ml

Ontology: Ciprofloxacin (C0008809)

Definition (CHV) a drug used to treat a cancer as well as an infection
Definition (NCI) A synthetic broad spectrum fluoroquinolone antibiotic. Ciprofloxacin binds to and inhibits bacterial DNA gyrase, an enzyme essential for DNA replication. This agent is more active against Gram-negative bacteria than Gram-positive bacteria. (NCI04)
Definition (NCI_NCI-GLOSS) A drug that is used to treat infections caused by bacteria and is being studied in the treatment of bladder cancer. Cipro is a type of fluoroquinolone.
Definition (CSP) broad spectrum antimicrobial carboxyfluoroquinoline.
Definition (MSH) A broad-spectrum antimicrobial carboxyfluoroquinoline.
Definition (PDQ) A synthetic broad spectrum fluoroquinolone antibiotic. Ciprofloxacin binds to and inhibits bacterial DNA gyrase, an enzyme essential for DNA replication. This agent is more active against Gram-negative bacteria than Gram-positive bacteria. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=40784&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=40784&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C375" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D002939
SnomedCT 392412000, 330416009, 372840008, 7577004
LNC LP15380-6, MTHU004599
English Ciprofloxacin, 3-Quinolinecarboxylic acid, 1-cyclopropyl-6-fluoro-1,4-dihydro-4-oxo-7-(1-piperazinyl)-, Ciprofloxacin [eye], 1-Cyclopropyl-6-fluoro-1,4-dihydro-4-oxo-7-(1-piperazinyl)-3-quinolinecarboxylic Acid, Ciprofloxacin ophthalmic preparation, Ciprofloxacin ophthalmic preparation (product), ciprofloxacin, Ciprofloxacin opthalmic preparation (product), Ciprofloxacin opthalmic preparation, CIPROFLOXACIN, ciprofloxacin (medication), Ciprofloxacin [Chemical/Ingredient], Ciprofloxacin [eye] (product), Ciprofloxacin product, Ciprofloxacin (product), Ciprofloxacin (substance), CPFX, Ciprofloxacin [eye] (substance)
Swedish Ciprofloxacin
Czech ciprofloxacin
Finnish Siprofloksasiini
Russian TSIPROFLOKSATSIN, ЦИПРОФЛОКСАЦИН
Croatian CIPROFLOKSACIN
Spanish ciprofloxacina, ciprofloxacina (producto), ciprofloxacino, ciprofloxacino (producto), ciprofloxacino (sustancia), ciprofloxacina [uso oftálmico], ciprofloxacina [uso oftálmico] (producto), ciprofloxacina (sustancia), ciprofloxacina [oftálmica] (producto), ciprofloxacina [oftálmica], ciprofloxacina, preparado oftálmico (producto), ciprofloxacina, preparado oftálmico, preparado oftálmico con ciprofloxacina (producto), preparado oftálmico con ciprofloxacina, Ciprofloxacino
Polish Cyprofloksacyna, Ciprofloksacyna
Japanese シプロフロキサシン, シプロキサン, 塩酸シプロフロキサシン, シプロフロキサシン塩酸塩
Portuguese Ciprofloxacina, Ciprofloxacino
French Ciprofloxacine
German Ciprofloxacin
Italian Ciproflossacina

Ontology: Norfloxacin (C0028365)

Definition (NCI) A synthetic, broad-spectrum fluoroquinolone with antibacterial activity. Norfloxacin inhibits activity of DNA gyrase, thereby blocking bacterial DNA replication. Norfloxacin concentrates in the renal tubules and bladder and is bactericidal against a wide range of aerobic gram-positive and gram-negative organisms.
Definition (MSH) A synthetic fluoroquinolone (FLUOROQUINOLONES) with broad-spectrum antibacterial activity against most gram-negative and gram-positive bacteria. Norfloxacin inhibits bacterial DNA GYRASE.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D009643
SnomedCT 330406001, 387271008, 49485009
LNC LP16156-9, MTHU008461
English Norfloxacin, 3-Quinolinecarboxylic acid, 1-ethyl-6-fluoro-1,4-dihydro-4-oxo-7-(1-piperazinyl)-, Norfloxacin [eye], 1,4-Dihydro-1-ethyl-6-fluoro-4-oxo-7-(1-piperazinyl)-3-quinolinecarboxylic Acid, norfloxacin, norfloxacin (medication), norfloxacin ophthalmic, Norfloxacin [Chemical/Ingredient], Norfloxacin [eye] (product), Norfloxacin (product), Norfloxacin (substance), Norfloxacin [eye] (substance), NORFLOXACIN
Swedish Norfloxacin
Czech norfloxacin
Finnish Norfloksasiini
Russian NORFLOKSATSIN, НОРФЛОКСАЦИН
Japanese ノルフロキサシン
Spanish norfloxacino, norfloxacino (producto), norfloxacina, norfloxacina (producto), norfloxacino (sustancia), norfloxacina [uso oftálmico] (producto), norfloxacina [uso oftálmico], norfloxacina (sustancia), norfloxacina [oftálmica] (producto), norfloxacina [oftálmica], Norfloxacino
Polish Norfloksacyna
French Norfloxacine
German Norfloxacin
Italian Norfloxacina
Portuguese Norfloxacino