Ciprofloxacin (Cipro) versus Other Antibiotics
- Ciprofloxacin vs Levofloxacin
- Ciprofloxacin vs Norfloxacin
- Ciprofloxacin vs Ofloxacin
- Ciprofloxacin vs Trimethoprim/Sulfamethoxazole
- Ciprofloxacin vs Amoxicillin
- Ciprofloxacin vs Azithromycin
- Ciprofloxacin vs Clarithromycin
- Ciprofloxacin vs Cefuroxime
- Ciprofloxacin vs Cefotaxim
- Ciprofloxacin vs Nitrofurantoin
Based on "Antibiotic and Chemotherapy"
written by Roger G. Finch
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% |
Both ofloxacin and ciprofloxacin are fluoroquinolones with similar properties. However, antibiotics differ in their antimicrobial activity, clinical uses, pharmacokinetic and interaction profiles.
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% |
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% |
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% |
Bacteriological 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% |
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 randomized, 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%) |
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%) |
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 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% |
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Published: March 31, 2008
Last reviewed: February 17, 2017