์ํ๋กํ๋ก์ฌ์
**์ํ๋กํ๋ก์ฌ์ (Ciprofloxacin)**์ 2์ธ๋ **ํ๋ฃจ์ค๋กํด๋๋ก ๊ณ ํญ์์ **๋ก ์ธ์์์ ๋๋ฆฌ ์ฌ์ฉ๋๋ฉฐ ์์ํ์์๋ ํ๊ฐ ์ธ(off-label)๋ก ์์ฃผ ์ฌ์ฉ๋ฉ๋๋ค. * **ํญ๊ท ์คํํธ๋ผ**: ๊ด๋ฒ์ ํญ์์ ๋ก ๋ง์ ๊ทธ๋ ์์ฑ ๊ฐ๊ท ๋ฐ ๊ตฌ๊ท (๋ น๋๊ท , ๋์ฅ๊ท , ํด๋ ๋ธ์์๋ผ ์ข ํฌํจ)๊ณผ ์ผ๋ถ ๊ทธ๋ ์์ฑ๊ท (๋ฉํฐ์ค๋ฆฐ ๋ด์ฑ๊ท ์ ํฌํจํ ํฌ๋์๊ตฌ๊ท ์ข ๋ฑ)์ ๋งค์ฐ ํจ๊ณผ์ ์ ๋๋ค. ํ๊ธฐ์ฑ ์ธ๊ท ๊ณผ ๋๋ถ๋ถ์ ์ฐ์์๊ตฌ๊ท ์ ๋ํ ํ์ฑ์ ์ฝํฉ๋๋ค. * **์ฝ๋ํ์ ํน์ง**: ๊ฐ์์ ๊ฒฝ๊ตฌ ์์ฒด์ด์ฉ๋ฅ ์ ์๋กํ๋ก์ฌ์ ๋ณด๋ค ํ์ ํ ๋ฎ๊ณ ๋ถ๊ท์นํฉ๋๋ค(์๋กํ๋ก์ฌ์ ์ด >80%์ธ ๋ฐ๋ฉด ์ฝ 40-50%์ ๋ถ๊ณผ). ๋ฐ๋ผ์ ๊ฐ์์ ์๋กํ๋ก์ฌ์ ์ 1:1๋ก ๋์ฒดํ๋ ๊ฒฝ๊ตฌ์ฝ์ผ๋ก๋ ์ผ๋ฐ์ ์ผ๋ก ๊ฐ์ฃผ๋์ง ์์ต๋๋ค. * **์์์ ์ ์ฉ์ฑ**: ์ง์ ํ ์ ๋งฅ์ฃผ์ฌ(IV) ํ๋ฃจ์ค๋กํด๋๋ก ์ ์ ๊ฐ ํ์ํ๊ฑฐ๋, ํน์ ๋ฐฐ์ ๊ฒ์ฌ ๊ฒฐ๊ณผ์ ๋ฐ๋ฅธ ์น๋ฃ, ๋๋ ๋ ํฐ ๊ฒฝ๊ตฌ ํฌ์ฌ ์ฉ๋์ด ํ์ํ ๋ ์ฃผ๋ก ์ ํ๋ฉ๋๋ค.
์์ฉ ๊ธฐ์ : Ciprofloxacin is a **bactericidal**, **concentration-dependent** antibiotic. * It enters the bacterial cell and inhibits two key type-II topoisomerase enzymes: **DNA gyrase** (primary target in gram-negative bacteria) and **Topoisomerase IV** (primary target in gram-positive bacteria). * Inhibition of these enzymes โ prevents DNA supercoiling and relaxation โ halts DNA replication and transcription โ rapid bacterial cell death (within 20-30 minutes of exposure). * Exhibits a significant **post-antibiotic effect (PAE)**, meaning bacterial growth continues to be suppressed even after drug concentrations fall below the minimum inhibitory concentration (MIC).
๋๋ฌผ ์ข ๋ณ ์ฉ๋
- Susceptible infections ยท 5-15 mg/kg PO q12h ยท PO ยท q12h ยท Avoid or reduce dosage in severe renal failure; avoid in young animals or pregnant/breeding animals.
- Ocular infections ยท 1 drop to affected eye ยท topical ยท q6h ยท Not specified ยท Standard therapy
- Severe ocular infections (intensive therapy) ยท 1 drop to affected eye ยท topical ยท q30-120mins ยท 1-2 days ยท For short-term intensive use
- Susceptible infections ยท 5-15 mg/kg PO twice daily ยท PO ยท twice daily
- Susceptible gram-negative infections ยท 20-40 mg/kg PO twice daily ยท PO ยท twice daily ยท Using ciprofloxacin 500 mg tablets. Crushed tablet goes into suspension well, but must be shaken well before administering.
- Susceptible gram-negative infections ยท 20 mg/kg PO q12h ยท PO ยท q12h ยท Using crushed tablets
- Susceptible gram-negative infections ยท 10-15 mg/kg PO q12h ยท PO ยท q12h ยท Using crushed tablets or suspend
- Susceptible infections (Ratites) ยท 3-6 mg/kg PO twice daily ยท PO ยท twice daily
- Susceptible infections (Rabbits) ยท 5-20 mg/kg PO q12h ยท PO ยท q12h
ํฌ์ฌ ๊ฒฝ๋ก
๊ธ๊ธฐ
- Hypersensitivity to fluoroquinolones
- Small and medium breed dogs 2-8 months of age (due to cartilage damage)
- Large and giant breed dogs during their rapid growth phase (past 8 months of age)
- Known hypersensitivity to ciprofloxacin or other fluoroquinolones
์ด์๋ฐ์
- GI distress (vomiting, anorexia)
- Cartilage abnormalities in young, growing animals
- CNS stimulation (dizziness, seizures)
- Crystalluria
- Hypersensitivity reactions
- Local irritation after application
- Local burning and itching (reported in humans)
- Lid margin crusting (reported in humans)
- Hyperaemia (reported in humans)
- Taste disturbances (reported in humans)
- Corneal staining (reported in humans)
- Keratitis (reported in humans)
- Lid oedema (reported in humans)
- Lacrimation (reported in humans)
- Photophobia (reported in humans)
- Corneal infiltrates (reported in humans)
์ฝ๋ฌผ ์ํธ์์ฉ
- Antacids/Dairy Products (Mg++, Al+++, Ca++) ยท May bind to ciprofloxacin and prevent its absorption; separate doses by at least 2 hours
- Antibiotics (aminoglycosides, 3rd-generation cephalosporins, extended-spectrum penicillins) ยท Synergism may occur against some bacteria (particularly Pseudomonas aeruginosa)
- Cyclosporine ยท May exacerbate nephrotoxicity and reduce the metabolism of cyclosporine
- Glyburide ยท Severe hypoglycemia possible
- Iron, Zinc (oral) ยท Decreased ciprofloxacin absorption; separate doses by at least two hours
- Methotrexate ยท Increased MTX levels possible with resultant toxicity
- Nitrofurantoin ยท May antagonize the antimicrobial activity of fluoroquinolones; concomitant use not recommended
- Phenytoin ยท May alter phenytoin levels
- Probenecid ยท Blocks tubular secretion of ciprofloxacin and may increase its blood level and half-life
- Quinidine ยท Increased risk for cardiotoxicity
- Sucralfate ยท May inhibit absorption of ciprofloxacin; separate doses by at least 2 hours
- Theophylline ยท May increase theophylline blood levels
๋ชจ๋ํฐ๋ง
- Clinical efficacy
- Adverse effects (GI signs, CNS stimulation)
- Hydration status
- Clinical resolution of ocular infection
- Corneal healing (via fluorescein staining)
- Signs of local irritation or hypersensitivity
๊ณผ์ฉ๋
Little specific information is available for ciprofloxacin overdosage in veterinary species. Overdoses may result in GI distress, CNS signs (tremors, seizures), or renal toxicity (crystalluria). Treatment should consist of supportive care, maintaining adequate hydration to prevent crystalluria, and gastric decontamination if ingestion was recent. See the enrofloxacin monograph for more extrapolated information.
VetSheet ์ฝ๋ฌผ ๋ ํผ๋ฐ์ค๋ ๋ฉดํ ์์ ์ ๋ฌธ๊ฐ๋ฅผ ์ํ ์์ ์์ฌ๊ฒฐ์ ๋ณด์กฐ ๋๊ตฌ์ด๋ฉฐ, ์ ๋ฌธ์ ํ๋จ์ด๋ ์ ์กฐ์ฌ์ ์ต์ ๋ผ๋ฒจ์ ๋์ ํ์ง ์์ต๋๋ค.