- Ciprofloxacin is a second-generation fluoroquinolone antibiotic with a molecular formula of C17H18FN3O3 and a molecular mass of 331.34 g/mol.
- Its structure features a fluorine atom at the 6-position and a piperazine ring at the 7-position, which are critical for its enhanced antibacterial activity and broad-spectrum coverage. These structural modifications differentiate it from earlier quinolones and contribute to its classification as a fluoroquinolone.
- The antibiotic exerts its bactericidal action by inhibiting bacterial DNA synthesis. It specifically targets bacterial DNA gyrase (topoisomerase II) and topoisomerase IV, enzymes essential for DNA replication, transcription, and repair. By binding to these enzymes, ciprofloxacin induces double-stranded DNA breaks, leading to rapid bacterial cell death. This mechanism is particularly effective against actively dividing bacteria.
- Ciprofloxacin demonstrates broad-spectrum activity against a wide range of gram-negative and gram-positive bacteria, with particularly potent activity against Enterobacteriaceae (e.g., Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis), Pseudomonas aeruginosa, and Neisseria gonorrhoeae. It is also effective against some atypical pathogens, such as Legionella pneumophila and Mycoplasma pneumoniae. However, its activity against gram-positive organisms, such as Streptococcus pneumoniae, is generally less robust compared to newer fluoroquinolones.
- The pharmacokinetic profile of ciprofloxacin includes excellent oral bioavailability (70-80%), rapid absorption, and widespread tissue distribution. It achieves high concentrations in the kidneys, prostate, lungs, and gastrointestinal tract, making it effective for treating urinary tract infections, respiratory infections, and intra-abdominal infections. Ciprofloxacin undergoes partial hepatic metabolism, with renal excretion being the primary route of elimination. Its half-life ranges from 3 to 5 hours, allowing for twice-daily dosing in most cases.
- Despite its efficacy, ciprofloxacin is associated with potential adverse effects, including gastrointestinal disturbances, central nervous system effects (e.g., headache, dizziness), and, rarely, tendonitis or tendon rupture. Its use is also limited by increasing bacterial resistance, particularly among gram-negative organisms.
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