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Ciprofloxacin (Cipro) versus Other Antibiotics

Ciprofloxacin vs Norfloxacin (Noroxin)

Urinary Tract Infections

Ciprofloxacin and norfloxacin have comparable efficacy and tolerability in the treatment of urinary tract infections 5, 6.

Results of double-blind, randomized controlled study of ciprofloxacin versus norfloxacin in uncomplicated urinary tract infections in women 5.
Ciprofloxacin
Norfloxacin
Regimen single 500 mg dose 400 mg twice-daily for 3 days
Bacteriologic cure rate 91.2% 91.9%
Clinical resolution rate 91.2% 93.8%


Results of open, randomized study of norfloxacin vs ciprofloxacin in complicated urinary tract infection 6.
Ciprofloxacin
Norfloxacin
Regimen 500 mg orally every 12 hours for 14-21 days 400 mg orally twice daily for 10-21 days)
Cure rate
79%
72%

Ciprofloxacin vs Ofloxacin (Floxin)

Ciprofloxacin has better activity against Gram-negative bacilli. Ofloxacin has a longer half-life and higher serum levels. Ofloxacin does not significantly alter theophylline concentrations.

Urinary tract infections

Ciprofloxacin and ofloxacin are equally effective in women with complicated lower urinary tract infection 11.

Results of double-blind, double-dummy randomized study of ciprofloxacin versus ofloxacin for complicated urinary tract infections in women 11.
Ciprofloxacin
Ofloxacin
Regimen 250 mg twice daily for 7 days. 200 mg twice daily for 7 days.
Sterile urine 5-9 days after the end of therapy 90.1% 87.2%
Sterile cultures 77.1% 76.1%
Clinical cure rate 5-9 days after cessation of therapy 97.2% 97.2%
Clinical cure rate 1 month after cessation of therapy 87.7% 87.3%

Ciprofloxacin vs Amoxicillin

Chronic obstructive airways disease (acute exacerbations)

Ciprofloxacin is more effective than amoxicillin in the treatment of acute exacerbations of chronic obstructive airways disease 19.

Results of comparison of amoxycillin and ciprofloxacin for acute exacerbations of chronic obstructive airways disease 19.
Ciprofloxacin
Amoxicillin
Success rate according to independent observer judgement
91.8%
73.1%

Ciprofloxacin vs Augmentin

Chronic suppurative otitis media

Ciprofloxacin seems to be an effective treatment of chronic otitis media, and superior to Augmentin 4.

Results of open randomized multicentre trial of ciprofloxacin versus amoxycillin/clavulanic acid in chronic suppurative otitis media in adults 4.
Ciprofloxacin
Amoxycillin/ clavulanic acid
Regimen 500 mg twice daily 500 mg three times daily
Otorrhoea resolution rate 57.5% (of 40 patients) 37.1% (of 35 patients)
Bacterial eradication rate 69.7% 27.3%

Sinusitis

Ciprofloxacin appears to be at least as effective as Augmentin in the treatment of chronic sinusitis 16.

Results of double-blind comparison of ciprofloxacin and amoxycillin/clavulanic acid for chronic sinusitis 16.
Ciprofloxacin
Amoxycillin/ clavulanic acid
Regimen 500 mg twice daily for 9 days 500 mg 3 times daily for 9 days
Nasal discharge disappearance rate 71 of 118 patients (60.2%) 69 of 123 patients (56.1%)
Clinical cure rate
58.6%
51.2%
Cacteriological eradication rate
88.9%
90.5%

Urinary tract infections

Ciprofloxacin is significantly more effective than Augmentin in the treatment of uncomplicated urinary tract infections 17.

Cystitis

Amoxicillin-clavulanate is not as effective as ciprofloxacin for acute uncomplicated cystitis, even in women infected with susceptible bacteria 18.

Results of randomized, single-blind trial of amoxicillin-clavulanate vs ciprofloxacin for uncomplicated cystitis in women 18.
Ciprofloxacin
Amoxycillin/ clavulanic acid
Regimen 250 mg twice daily for 3 days 500 mg/125 mg twice daily for 3 days
Clinical cure rate
124 of patients 162 (77%)
93 of 160 patients (58%)
Microbiological cure at 2 weeks
153 of 161 patients (95%)
118 of 156 patients (76%)
Vaginal colonization with E. coli at 2 weeks
10%
45%

Ciprofloxacin vs. Azithromycin (Zithromax)

Chronic prostatitis

Azithromycin is significantly more effective than ciprofloxacin in the treatment of chronic prostatitis caused by Chlamydia trachomatis.

Results of comparative analysis of azithromycin and ciprofloxacin for chronic prostatitis caused by C. trachomatis 2.
Ciprofloxacin
Azithromycin
Regimen 500 mg b.i.d. for 20 days 500 mg 3 times per week for 3 weeks
Bacterial eradication rate 17 of 44 patients 36 of 45 patients
Clinical cure rate 15 of 44 patients 31 of 45 patients

Shigellosis

Ciprofloxacin is somewhat more effective than azithromycin in the treatment of Shigellosis (a type of infective diarrhea) 12.

Results of randomized, double-blind comparison of azithromycin and ciprofloxacin for shigellosis 12.
Ciprofloxacin
Azithromycin
Regimen 500 mg every 12 hours for 5 days. 500 mg on day 1, followed by 250 mg once daily for 4 days
Clinical success rate
32 (89%) patients
28 (82%) patients
Bacteriologic success rate
36 (100%) patients
32 (94%) patients

Gonorrhea

Azithromycin is at least as effective and well tolerated as ciprofloxacin in the treatment of gonococcal infections 13.

Results of single-blind comparative study of azithromycin and ciprofloxacin for gonorrhea 13.
Ciprofloxacin
Azithromycin
Regimen single 500 mg dose single 1 g dose
Clinical and microbiological cure rates after 2 weeks
92.15%
(47 out of 51)
96.0%
(48 out of 50)

Ciprofloxacin vs Clarithromycin

Chronic bronchitis (acute bacterial exacerbations)

Ciprofloxacin provides longer infection-free interval and higher bacteriologic cure rate than clarithromycin 6, 14.

Results of double-blind study of ciprofloxacin vs. clarithromycin for acute bacterial exacerbations of chronic bronchitis 14.
Ciprofloxacin
Clarithromycin
Regimen 500 mg twice a day for 14 days 500 mg twice a day for 14 days
Clinical resolution rate
90% (89 of 99)
82% (75 of 91)
Median infection-free interval
142 days
51 days
Bacteriologic eradication rate
91% (86 of 95)
77% (67 of 87)


Results of multicenter, community-based, randomized study of ciprofloxacin and clarithromycin in acute bacterial exacerbations of complicated chronic bronchitis 6.
Ciprofloxacin
Clarithromycin
Regimen 750 mg twice a day for 10 days 500 mg twice a day for 10 days
Clinical success rate in the efficacy-valid patients 90% (272 of 302) 88% (274 of 313)
Clinical success rate in the intent-to-treat population 90% (283 of 314) 88% (281 of 321)
Bacteriologic response for efficacy-valid patients at the end of therapy 98% (119 of 122) 93% (103 of 111)
Eradication rates for 3 most commonly isolated Gram-negative pathogens 100% 95%
Superinfections due to respiratory tract pathogens 4 organisms 10 organisms
Adverse effects 74 (20%) patients reported
118 study-emergent adverse events
62 (17%) patients reported 103 study-emergent adverse events
Most frequent adverse effects headache, abdominal pain, diarrhea, nausea, and vomiting diarrhea, nausea, vomiting, and taste perversion

Sinusitis

Cure rates immediately after antibiotic therapy are higher with clarithromycin. However relapses rates are twice as higher with clarithromycin 15.

Results of andomized, double-blind trial of ciprofloxacin versus clarithromycin for acute bacterial sinusitis 15.
Ciprofloxacin
Clarithromycin
Regimen 500 mg twice daily for 10 days 500 mg twice daily for 14 days
Clinical resolution and improvement at the end of therapy rate
84%
91%
Relapse rate
7 patients (4%)
18 patients (10%)

Ciprofloxacin (Cipro) vs Cefuroxime (Ceftin)

Sinusitis

Ciprofloxacin is as effective as cefuroxime axetil in the treatment of acute sinusitis 7.

Results of randomized, double-blind trial of ciprofloxacin versus cefuroxime axetil for acute bacterial sinusitis 7.
Ciprofloxacin
Cefuroxime
Regimen 500 mg twice daily for 10 days 250 mg twice daily for 10 days
Clinical efficacy rate at the end of treatment
87%
83%
Clinical efficacy rate at 2-4-week follow-up
91%
88%
Bacteriologic eradication at end of therapy
97%
95%

Rhinosinusitis

Ciprofloxacin and cefuroxime are equally effective in acute rhinosinusitis21.

Results of open, prospective, randomized trial of ciprofloxacin versus cefuroxime axetil for acute rhinosinusitis 13.
Ciprofloxacin
Cefuroxime
Regimen 500 mg twice daily for 10 days 250 mg twice daily for 10 days
Clinical resolution 559 of 613 patients (91.2%) 546 of 606 patients (90.1%)
Number of adverse events,
nausea
diarrhea
80
18
7
81
12
14

Gonorrhea

Single dose cefuroxime axetil is as effective as a single dose of ciprofloxacin in the treatment of uncomplicated gonorrhea caused by penicillinase-producing Neisseria gonorrhoeae (PPNG). However cefuroxime appears to be less effective than ciprofloxacin in treating urethral gonococcal infections in men, although both are highly effective in treating cervical gonococcal infections in women 9.

Results of randomized, multicenter, investigator-blind trial of cefuroxime axetil and ciprofloxacin for uncomplicated gonorrhea 9.
Ciprofloxacin
Cefuroxime
Regimen 500 mg as a single dose 1,000 mg as a single dose
Eradication of N. gonorrhoeae in females with rectal infections 25 of 25 (100%) 29 of 30 (97%)
Eradication of pharyngeal infections in males 8 of 8 patients 4 of 10 patients
Eradication of PPNG from the cervix 32 of 32 (100%) 22 of 23 (96%)

Ciprofloxacin vs Cefotaxime

Skin infections

Oral ciprofloxacin may be more effective than parenteral cefotaxime in the treatment of infections of the skin and skin structure. Cefotaxime treatment is more likely to result in bacteriologic failure in patients with polymicrobial infected ulcers 10.

According to the another research, ciprofloxacin is as effective as intravenous cefotaxime in the treatment of skin and skin structure infections 20.

Results of double-blind comparison of ciprofloxacin with cefotaxime for skin and skin structure infections 20.
Ciprofloxacin
Cefotaxime
Regimen 750 mg twice daily 2.0 g I.V. 3 times daily
Clinical cure rate 77% (24 patients of 31) 76% (22 patients of 28)


Results of double-blind, randomized study of ciprofloxacin and cefotaxime for cutaneous infections 3.
Ciprofloxacin
Cefotaxime
Regimen 750 mg twice daily, for 7-21 days 2.0 g I.V. 3 times daily, for 7-21 days
Clinical response per infected site: Resolution
88%
69%
Clinical response per infected site: Improvement
8%
25%
Clinical response per infected site:
Failure
4%
6%
Bacteriologic response per site:
Eradication
88%
69%
Bacteriologic response per site:
Marked reduction
3%
Bacteriologic response per site:
Recurrence
6%
Bacteriologic response per site:
Persistence
12%
22%

Further reading

References
  • 1. Richard GA, Klimberg IN, Fowler CL, Callery-D'Amico S, Kim SS. Levofloxacin versus ciprofloxacin versus lomefloxacin in acute pyelonephritis. Urology. 1998 Jul;52(1):51-5. PubMed
  • 2. Skerk V, Schonwald S, Krhen I, Banaszak A, Begovac J, Strugar J, Strapac Z, Vrsalovic R, Vukovic J, Tomas M. Comparative analysis of azithromycin and ciprofloxacin in the treatment of chronic prostatitis caused by Chlamydia trachomatis. Int J Antimicrob Agents. 2003 May;21(5):457-62. PubMed
  • 3. Parish LC, Asper R. Systemic treatment of cutaneous infections. A comparative study of ciprofloxacin and cefotaxime. Am J Med. 1987 Apr 27;82(4A):227-9. PubMed
  • 4. Legent F, Bordure P, Beauvillain C, Berche P. Controlled prospective study of oral ciprofloxacin versus amoxycillin/clavulanic acid in chronic suppurative otitis media in adults. Chemotherapy. 1994;40 Suppl 1:16-23. PubMed
  • 5. Auquer F, Cordón F, Gorina E, Caballero JC, Adalid C, Batlle J; Urinary Tract Infection Study Group. Single-dose ciprofloxacin versus 3 days of norfloxacin in uncomplicated urinary tract infections in women. Clin Microbiol Infect. 2002 Jan;8(1):50-4. PubMed
  • 6. Anzueto A, Niederman MS, Haverstock DC, Tillotson GS. Efficacy of ciprofloxacin and clarithromycin in acute bacterial exacerbations of complicated chronic bronchitis: interim analysis. Clin Ther. 1997 Sep-Oct;19(5):989-1001.
  • 7. Johnson PA, Rodriguez HP, Wazen JJ, Huck W, Shan M, Tosiello R, Heyd A, Echols RM. Ciprofloxacin versus cefuroxime axetil in the treatment of acute bacterial sinusitis. J Otolaryngol. 1999 Feb;28(1):3-12. PubMed
  • 8. Talan DA, Stamm We, Reuning-Scherer J, et al: Ciprofloxacin 7-day vs tmp/smx 14-day +/- ceftriaxone for acute uncomplicated pyelonephritis: A randomized double-blind trial. 8th International Congress on Infectious Diseases. 1998.
  • 9. Thorpe EM, Schwebke JR, Hook EW 3rd, Rompalo A, McCormack WM, Mussari KL, Giguere GC, Collins JJ. Comparison of cefuroxime axetil with ciprofloxacin in treatment of uncomplicated gonorrhea caused by penicillinase-producing and non-penicillinase-producing Neisseria gonorrhoeae strains. Antimicrob Agents Chemother. 1996 Dec;40(12):2775-80. PubMed
  • 10. Gentry LO, Ramirez-Ronda CH, Rodriguez-Noriega E, Thadepalli H, del Rosal PL, Ramirez C. Oral ciprofloxacin vs parenteral cefotaxime in the treatment of difficult skin and skin structure infections. A multicenter trial. Arch Intern Med. 1989 Nov;149(11):2579-83. PubMed
  • 11. Raz R, Naber KG, Raizenberg C, Rohana Y, Unamba-Oparah I, Korfman G, Yaniv I. Ciprofloxacin 250 mg twice daily versus ofloxacin 200 mg twice daily in the treatment of complicated urinary tract infections in women. Eur J Clin Microbiol Infect Dis. 2000 May;19(5):327-31. PubMed
  • 12. Khan WA, Seas C, Dhar U, Salam MA, Bennish ML. Treatment of shigellosis: V. Comparison of azithromycin and ciprofloxacin. A double-blind, randomized, controlled trial. Ann Intern Med. 1997 May 1;126(9):697-703. PubMed
  • 13. Gruber F, Brajac I, Jonjic A, Grubisic-Greblo H, Lenkovic M, Stasic A. Comparative trial of azithromycin and ciprofloxacin in the treatment of gonorrhea. J Chemother. 1997 Aug;9(4):263-6. PubMed
  • 14. Chodosh S, Schreurs A, Siami G, Barkman HW Jr, Anzueto A, Shan M, Moesker H, Stack T, Kowalsky S. Efficacy of oral ciprofloxacin vs. clarithromycin for treatment of acute bacterial exacerbations of chronic bronchitis. The Bronchitis Study Group. Clin Infect Dis. 1998 Oct;27(4):730-8. PubMed
  • 15. Clifford K, Huck W, Shan M, Tosiello R, Echols RM, Heyd A. Double-blind comparative trial of ciprofloxacin versus clarithromycin in the treatment of acute bacterial sinusitis. Ann Otol Rhinol Laryngol. 1999 Apr;108(4):360-7. PubMed
  • 16. Legent F, Bordure P, Beauvillain C, Berche P. A double-blind comparison of ciprofloxacin and amoxycillin/clavulanic acid in the treatment of chronic sinusitis. Chemotherapy. 1994;40 Suppl 1:8-15. PubMed
  • 17. Abbas AM, Chandra V, Dongaonkar PP, Goel PK, Kacker P, Patel NA, Shrivastava OP, Thakkar B, Tillotson GS. Ciprofloxacin versus amoxycillin/clavulanic acid in the treatment of urinary tract infections in general practice. J Antimicrob Chemother. 1989 Aug;24(2):235-9. PubMed
  • 18. Hooton TM, Scholes D, Gupta K, Stapleton AE, Roberts PL, Stamm WE. Amoxicillin-clavulanate vs ciprofloxacin for the treatment of uncomplicated cystitis in women: a randomized trial. JAMA. 2005 Feb 23;293(8):949-55. PubMed
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  • 21. Weis M, Hendrick K, Tillotson G, Gravelle K. Multicenter comparative trial of ciprofloxacin versus cefuroxime axetil in the treatment of acute rhinosinusitis in a primary care setting. Rhinosinusitis Investigation Group. Clin Ther. 1998 Sep-Oct;20(5):921-32. PubMed

Published: March 31, 2008
Last updated: April 03, 2014

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