Presentation
Here we present the first reported case of bilateral iliopsoas tendon rupture associated with prolonged ciprofloxacin use. This older woman presented with non-traumatic, sudden onset hip pain which was diagnosed as a right iliopsoas rupture on MRI. [ncbi.nlm.nih.gov]
Entire Body System
- Intravenous Administration
Intravenous administration of ciprofloxacin in patients with additional risks may elevate the risk of QTc interval prolongation. [ncbi.nlm.nih.gov]
with moderate to excellent bioavailability. 1, 4 Serum drug levels achieved after oral administration are comparable to those with intravenous dosing, which allows an early transition from intravenous to oral therapy and a potential reduction of treatment [aafp.org]
However, this may change the absorption of the medication compared to taking the capsule whole.[15] Chemistry[edit] It has a volume of distribution of 2.4 L/kg following intravenous administration.[1] References[edit] ^ a b c d e "Zanaflex (tizanidine [en.wikipedia.org]
- Recurrent Urinary Tract Infection
Prior medical history includes previous myocardial infarction and recurrent urinary tract infection. 4 days prior to symptom onset, the patient developed typical urinary tract infection symptoms, treated with ciprofloxacin. [ncbi.nlm.nih.gov]
urinary tract infections 2. [erj.ersjournals.com]
Mavromanolakis E, Maraki S, Samonis G, Tselentis Y, Cranidis A: Effect of norfloxacin, trimethoprim-sulfamethoxazole and nitrofurantoin on fecal flora of women with recurrent urinary tract infections. J Chemother. 1997, 9: 203-207. 9. [jmedicalcasereports.biomedcentral.com]
J Hosp Infect. 1994;28(1):57-61. Pfau A, Sacks TG. Effective postcoital quinolone prophylaxis of recurrent urinary tract infections in women. J Urol. 1994;152(1):136-8. Biering-Sorensen F, Hiiby N, Nordenbo A, Ravnborg M, Bruun B, Rahm V. [medigraphic.com]
Patient-initiated treatment of uncomplicated recurrent urinary tract infections in young women. Ann. Intern. Med. 135:9-16. ↵ Gupta, K., T. M. Hooton, and W. E. Stamm. 2001. [aac.asm.org]
- Surgical Procedure
[…] taught any generalizations other than: If the pack Tynan and I are putting together isn't quite what ciproxin kopen prezzo ciproxin 1000 and surgical procedures are among the numerous methods for penis enlargement; however, these methods prezzo ciproxin [merkuryinnovations.com]
The principle of informed consent applies as much to the prescribing of medication as it does to the performance of a surgical procedure. No matter how rare the risk, patients need to be made aware. [medicalprotection.org]
Samples of the inferior turbinate mucosa, middle turbinate mucosa, maxillary sinus mucosa and of the anterior ethmoid mucosa were collected from the side with higher Lund-Mackay score, prior to the surgical procedure. [elsevier.es]
Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Clin Infect Dis. 2010; 50:133-64. [drugs.com]
Respiratoric
- Common Cold
Ciprofloxacin treats only bacterial infections and will not work for viral infections such as the common cold and the flu. [genericswow.com]
However, the drug will not treat infections caused by viruses, such as the common cold or flu. [drugsdb.com]
It will not work for virus infections (such as common cold, flu). Cialis Cheap Canadian Pharmacy Buy Levitra Online Prescription Cialis Legal Dubai It is used to treat and prevent bacterial infections. [hotelpalacebarcelona.com]
Ciprofloxacin injection will not treat a viral infection such as the flu or a common cold. If you use this medicine long-term, you may need frequent medical tests. Store at room temperature away from moisture, heat, and light. Do not freeze. [uofmhealth.org]
This medicine is not recommended for use in case of a common cold, flu, or other viral infections since it is active against infections caused by bacteria only. [practo.com]
Gastrointestinal
- Nausea
She presented to clinic with nausea and anorexia within a few days of addition of ciprofloxacin to her current regimen of medications, which included digoxin. [ncbi.nlm.nih.gov]
Can be exacerbated by the drugs’ effects on cell membrane channels Adverse Effects Use of fluoroquinolones may result to these adverse effects: GI: nausea, vomiting, diarrhea, dry mouth CNS: headache, dizziness, insomnia, depression Immunological: bone [nurseslabs.com]
Both treatments were well tolerated, but the frequencies of nausea and diarrhea were lower in the ciprofloxacin ER group than in the ciprofloxacin IR group (nausea, ER, 0.6%; IR, 2.2%; P = 0.033; diarrhea, ER, 0.2%; IR, 1.4%; P = 0.037). [aac.asm.org]
The patient was discharged, but returned 12 hours later because of nausea, arthralgias, and no urinary output for 24 hours. Her temperature was 38.2°C, her serum [jamanetwork.com]
The most frequently reported adverse effects are nausea, diarrhoea, vomiting, dyspepsia, abdominal pain, headache, restlessness, rash, dizziness and pruritus. Drug interactions Plasma levels of theophylline may be increased. [apps.who.int]
- Abdominal Pain
Upon physical examination a slight general abdominal pain on palpation and some fresh blood at rectal digital examination were found. [ncbi.nlm.nih.gov]
The most frequently reported adverse effects are nausea, diarrhoea, vomiting, dyspepsia, abdominal pain, headache, restlessness, rash, dizziness and pruritus. Drug interactions Plasma levels of theophylline may be increased. [apps.who.int]
Adverse Effects Use of penicillins and penicillinase-resistant antibiotics may result to these adverse effects: GI: nausea, vomiting, diarrhea, abdominal pain, glossitis, stomatitis, gastritis, sore mouth, furry tongue Pain and inflammation at the injection [nurseslabs.com]
- Dyspepsia
The most frequently reported adverse effects are nausea, diarrhoea, vomiting, dyspepsia, abdominal pain, headache, restlessness, rash, dizziness and pruritus. Drug interactions Plasma levels of theophylline may be increased. [apps.who.int]
Tell your doctor or pharmacist if you notice any of the following and they worry you: headache dizziness or light-headedness mild stomach upsets such as stomach pains, flatulence or diarrhoea loss of appetite or altered taste heartburn (dyspepsia) feeling [nps.org.au]
Gastrointestinal Disorders: abdominal pain, nausea, diarrhea, dyspepsia, aggravated irritable bowel syndrome, lower abdominal pain, vomiting. General Disorders: suprapubic pain, fatigue, pain, rigors, tenderness. [ndrugs.com]
Cardiovascular
- Hypertension
However, all the patients had other risk factors for aortic aneurysm or dissection such as smoking, male gender, older age, hypertension, and atherosclerosis. [fda.gov]
Hot flushes Migraine Angina Disturbed vision, hearing, taste or smell Gout flare-up Dysuria Changes in haematology and hepatic and renal biochemistry laboratory parameters Severe Cardiovascular collapse, cardiopulmonary arrest, syncope, arrhythmia, hypertension [myvmc.com]
Winrow AP, Supramaniam G "Benign intracranial hypertension after ciprofloxacin administration." Arch Dis Child 65 (1990): 1165-6 46. [drugs.com]
The magnitude of the association of fluoroquinolones and aortic aneurysm events was stronger than the association observed with other aneurysm risk factors such as hypertension and atherosclerosis ( table 3 ). [bmjopen.bmj.com]
- Tachycardia
Torsades de pointes (Tdp) is a polymorphic form of ventricular tachycardia and a life-threatening event. A variety of non-cardiovascular drugs, including fluoroquinolone antibiotics, have been shown to possess arrhythmogenic properties. [ncbi.nlm.nih.gov]
Due To An Allergy Low Blood Counts Due To Bone Marrow Failure Low Blood Pressure Low Blood Sugar Low Levels Of White Blood Cells Mental Problems From Taking The Drug Methemoglobinemia, A Type Of Blood Disorder Pancreatitis Paroxysmal Supraventricular Tachycardia [webmd.com]
[Ref] Uncommon (0.1% to 1%): Tachycardia, vasodilatation, hypotension Rare (0.01% to 0.1%): Vasculitis Frequency not reported: Angina pectoris, cardiopulmonary arrest, myocardial infarction, hypertension, palpitation, bradycardia, arrhythmia, atrial flutter [drugs.com]
L, the patient was given a preliminary clinical diagnosis of sepsis based on a joint assessment of systemic inflammatory response syndrome (SIRS) criteria and quick Sequential Organ Failure Assessment (qSOFA), with a SIRS score of 3/4 (leukocytosis, tachycardia [ptcommunity.com]
[…] symptoms may occur during or after antimicrobial treatment), pulmonary embolism, purpura, renal calculi, renal failure, respiratory arrest, respiratory distress, restlessness, serum sickness-like reaction, Stevens-Johnson syndrome, sweating, syncope, tachycardia [ndrugs.com]
Musculoskeletal
- Muscle Spasm
If you take Zanaflex (tizanidine), a medicine for muscle spasms, it is important to talk with your doctor right away. [cdc.gov]
spasms, back pain, rash, sweating, and a tingling sensation in the arms, legs, hands, and feet.[9] Interactions[edit] Concomitant use of tizanidine and moderate or potent CYP1A2 inhibitors (such as zileuton, certain antiarrhythmics (amiodarone, mexiletine [en.wikipedia.org]
[…] pain large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs light-colored stools loss of ability to use or understand speech or language mood or mental changes muscle spasm or jerking of all extremities [drugs.com]
Musculoskeletal and Connective Tissue Disorders: joint swelling, muscle spasms, night cramps. Nervous System Disorders: headache, dizziness, disturbance in attention, paresthesia. [ndrugs.com]
- Muscle Cramp
cramps) that contains blood or mucus – if you have severe diarrhoea without blood or mucus for more than 4 days, you should also speak to a doctor a faster or irregular heartbeat seizures or fits (this side effect can happen if you have epilepsy) Serious [nhs.uk]
[…] pain, muscle cramps, or inflamed, painful or ruptured tendons such as the Achilles tendon tinnitus (ringing in the ears), problems with hearing symptoms of hypoglycaemia (low blood sugar) e.g. sweating, weakness, dizziness, trembling, headache, and having [mydr.com.au]
Skin
- Skin Rash
Acute generalized exanthematous pustulosis (AGEP) is an uncommon and self-limiting skin rash commonly caused by drugs and is characterized by the acute onset of fever, pustulosis, and neutrophilia from 4 to 10 days after the drug intake. [ncbi.nlm.nih.gov]
[…] or eyes); or severe skin reaction --fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling. [cigna.com]
Where The Red Blood Cells Burst Called Hemolytic Anemia A Type Of Blood Disorder With A Decrease In All Types Of Blood Cells Called Pancytopenia A Type Of Bumpy Skin Rash Called A Maculopapular Rash A Type Of Kidney Inflammation Called Interstitial Nephritis [webmd.com]
red or purple skin rash that spreads and causes blistering and peeling). [drugs.com]
Urogenital
- Renal Insufficiency
Ciprofloxacin-associated seizures (CAS) occur most commonly in patients with special risk factors that may cause accumulation of drug (high doses of the drug, old age, renal insufficiency, drug interactions) or that may decrease the threshold of epileptogenic [ncbi.nlm.nih.gov]
No information is available on dosing adjustments necessary for pediatric patients with moderate to severe renal insufficiency (i.e., creatinine clearance of < 50 mL/min/1.73m 2 ). [druglib.com]
Elimination is by both glomerular filtration and tubular secretion (60–70%) and is reduced by concurrently administered probenecid and by renal insufficiency. It is poorly removed by hemodialysis. [chemicalbook.com]
Exposures in this study revealed a half-life that was 2-fold longer in elderly patients with severe renal insufficiency [ 107 ]. [doi.org]
Most of the patients who developed hypoglycemia following fluoroquinolone use had risk factors such as old age, diabetes, renal insufficiency, and concomitant use of hypoglycemic drugs, especially sulfonylureas [2,3,4]. [jmedicalcasereports.biomedcentral.com]
- Kidney Failure
We present a case of myoglobin-associated kidney failure in the setting of repeated ciprofloxacin administration in a lung transplant patient. Kidney biopsy was critical to establishing the diagnosis and avoiding future exposure. [ncbi.nlm.nih.gov]
Other possible serious side effects and adverse events include liver dysfunction or failure. high blood sugar (hyperglycemia), renal failure (kidney failure), cardiac arrest, hepatitis, stroke, convulsions, seizures, jaundice, leukopenia, C. difficile [medicinenet.com]
Ciprofloxacin can cause damage to the liver and kidneys, which can result in sudden liver or kidney failure. Patients can also develop problems with making new blood cells, resulting in anemia. [livestrong.com]
Inflammation Called Interstitial Nephritis A Type Of Muscle Paralysis Due To Blocked Nerve Function Called Neuromuscular Blockade A Yellowing Of The Eyes Or Skin From Buildup Of Bilirubin Called Jaundice Abnormal Heart Rhythm Acute Kidney Failure Acute [webmd.com]
You must tell your doctor if your child has ever had any reaction to any antibiotic or if your child has kidney failure. If you have forgotten to tell your doctor, check with the doctor or pharmacist before giving ciprofloxacin to your child. [medicinesforchildren.org.uk]
Neurologic
- Headache
Headache, confusion, seizures, cortical visual disturbances or blindness are the key symptoms. As this syndrome is reversible and readily treated by interrupting or discontinuing the aetiology, it should sharply be acknowledged. [ncbi.nlm.nih.gov]
Stop using this medicine and call your doctor at once if you have symptoms such as: headache, hunger, irritability, numbness, tingling, burning pain, confusion, agitation, paranoia, problems with memory or concentration, thoughts of suicide, or sudden [uofmhealth.org]
Common side effects may include: nausea, vomiting, diarrhea, stomach pain; vaginal itching or discharge; headache; or abnormal liver function tests. This is not a complete list of side effects and others may occur. [mottchildren.org]
Can be exacerbated by the drugs’ effects on cell membrane channels Adverse Effects Use of fluoroquinolones may result to these adverse effects: GI: nausea, vomiting, diarrhea, dry mouth CNS: headache, dizziness, insomnia, depression Immunological: bone [nurseslabs.com]
- Seizure
[…] activity (electrolyte abnormalities, history of seizures, electroconvulsive therapy). [ncbi.nlm.nih.gov]
[…] or lower the seizure threshold; exercise caution in epileptic patients and patients with known or suspected CNS disorders that may predispose to seizures or lower the seizure threshold (eg, severe cerebral arteriosclerosis, previous history of convulsion [reference.medscape.com]
Get emergency help right away if you have seizures or trouble breathing. Seizures have been reported in people who take fluoroquinolone antibiotics including ciprofloxacin. Tell your healthcare provider if you have a history of seizures. [rxwiki.com]
- Convulsions
A 24-year-old woman was admitted to the hospital because of convulsions, severe myopathy, and acute renal failure after taking ciprofloxacin for sinusitis, and urinary tract infections. [ncbi.nlm.nih.gov]
A high incidence of convulsions has been observed in patients receiving the combination enoxacin and fenbufen, an NSAID. [doi.org]
Tell your doctor if you have had convulsions or seizures in the past, since some people have reported having convulsions in connection with taking this drug. [sharecare.com]
Other possible serious side effects and adverse events include liver dysfunction or failure. high blood sugar (hyperglycemia), renal failure (kidney failure), cardiac arrest, hepatitis, stroke, convulsions, seizures, jaundice, leukopenia, C. difficile [medicinenet.com]
[…] and hepatic and renal biochemistry laboratory parameters Severe Cardiovascular collapse, cardiopulmonary arrest, syncope, arrhythmia, hypertension Hepatic necrosis Intestinal perforation Pancreatitis Gastrointestinal bleeding Hallucinations Confusion Convulsive [myvmc.com]
Workup
Microbiology
- Staphylococcus Aureus
In vitro antibacterial evaluation of compound 7h against clinically isolated bacteria methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA) showed that this compound acted better than ciprofloxacin against [ncbi.nlm.nih.gov]
Reduced sensitivity of Staphylococcus aureus to vancomycin. Hormoz Uni of Med Sciences 2011;15(3):169-77. [in persion] 28. Ghosh S, Banerjee M. Methicillin resistance & amp; inducible clindamycin resistance in Staphylococcus aureus. [ijmm.ir]
Treatment
[…] to faulty diagnosis and treatment. [ncbi.nlm.nih.gov]
Prognosis
Lymphocytosis is believed to indicate favourable prognosis and peripheral eosinophilia occurs in 20–30% of acute clinical courses 3. [erj.ersjournals.com]
Effect of penicillin resistance of Streptococcus pneumoniae on the presentation, prognosis, and treatment of pneumococcal endocarditis in adults. Clin Infect Dis. 2002 ; 35 : 130–139. [doi.org]
Malignant external otitis: report on therapy with ceftazidime and review of therapy and prognosis. Clin Infect Dis. 1990; 12:173-80. 782. Hern JD, Ghufoor K, Jayaraj SM et al. ENT manifestations of Pseudomonas aeruginosa infection in HIV and AIDS. [drugs.com]
Etiology
However, a negative transformation result can not sufficiently exclude presence of an etiological relationship 8. [erj.ersjournals.com]
[…] secondary thrombocytosis.3 Primary thrombocytosis refers to elevated thrombocyte count, which is a manifestation of a myeloproliferative disorder, while secondary thrombocytosis is used to describe elevation in thrombocyte count not of myeloproliferative etiology [ptcommunity.com]
Furthermore, one of the more consensual etiologic factors is the presence of biofilms in the nasal mucosa. [elsevier.es]
The microbial etiology and antimicrobial therapy of adults with acute community-acquired sinusitis: a fifteen-year experience at the University of Virginia and review of other selected studies. [doi.org]
Epidemiology
Nevertheless, local differences indicate that other epidemiologic parameters should be further evaluated. Dr. [doi.org]
Following our initial review, three additional epidemiological studies 2,3,4 were subsequently published between 2015 and 2018, each of which are described in greater detail below. [fda.gov]
California, USA. 5 Department of Medicine, Harvard Medical School and Massachusetts General Hospital, Boston, USA. 6 Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California, USA. 7 Department of Epidemiology [ncbi.nlm.nih.gov]
Pathophysiology
Pathophysiology of varicoceles in male infertility. Hum Reprod Update. 2001; 7 (5):437–481. [ PubMed ] [ Google Scholar ] 15. Reagan-Shaw S, Nihal M, Ahmad N. Dose translation from animal to human studies revisited. [ncbi.nlm.nih.gov]
Pathophysiology and pharmacotherapy of peptic disease, Thesis, University of Amsterdam, 1981 Google Scholar Brouwers JRBJ. Pharmacokinetics of the newer fluoroquinolones. [doi.org]
[…] surveillance data indicating that these medications were associated with subsequent tendonitis and tendon rupture. 4 Several large epidemiological studies have confirmed this association. 5, 6 Secondary cell biology and animal research has elucidated the pathophysiology [bmjopen.bmj.com]
Prevention
These antibiotics prevent unwinding of double-stranded DNA by binding DNA gyrase or DNA topoisomerase. By preventing the formation of single-stranded DNA, fluoroquinolones inhibit bacterial replication. [goldbio.com]
In one study, taking 500 mg of Saccharomyces boulardii twice daily enhanced the effectiveness of the antibiotic vancomycin in preventing recurrent clostridium infection. [peacehealth.org]
These data suggest that ciprofloxacin monotherapy as a prophylaxis regimen prior to leech therapy may not be effective in preventing infection. [ncbi.nlm.nih.gov]
However, since neither Cipro nor the other fluoroquinolines bind to ocular proteins, permanent damage to the eye can be prevented. [iovs.arvojournals.org]