시프로플록사신
Ciprofloxacin
Ciprofloxacin HCl
다른 이름: Cipro XR · Cipro I.V. · Ciloxan · ciprofloxacine · ciprofloxacinum · ciprofloxacino · Bay-q-3939
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Susceptible infections | 5-15 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
| UTI | 10 mg/kg PO once daily (q24h) | PO | q24h | 7-14 days | 🌎 NA |
| Skin, soft tissue infections | 10-15 mg/kg PO once daily (q24h) | PO | q24h | 7-14 days | 🌎 NA |
| Bone systemic infections, bacteremia and more resistant pathogens (e.g., Enterobacter) | 20 mg/kg PO once daily (q24h) | PO | q24h | 7-14 days | 🌎 NA |
| Pyoderma | 11 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
| Ocular infections | 1 drop to affected eye | topical | q6h | Not specified | 🌍 EU |
| Severe ocular infections (intensive therapy) | 1 drop to affected eye | topical | q30-120mins | 1-2 days | 🌍 EU |
- Susceptible infections: Avoid or reduce dosage in severe renal failure; avoid in young animals or pregnant/breeding animals.
- Ocular infections: Standard therapy
- Severe ocular infections (intensive therapy): For short-term intensive use
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Susceptible infections | 5-15 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
| Ocular infections | 1 drop to affected eye | topical | q6h | Not specified | 🌍 EU |
| Severe ocular infections (intensive therapy) | 1 drop to affected eye | topical | q30-120mins | 1-2 days | 🌍 EU |
- Susceptible infections: Avoid or reduce dosage in severe renal failure; avoid in young animals or pregnant/breeding animals.
- Ocular infections: Standard therapy
- Severe ocular infections (intensive therapy): For short-term intensive use
소형 포유류
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Susceptible infections (Rabbits) | 5-20 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
| Susceptible infections (Chinchillas, Gerbils, Guinea Pigs, Hamsters, Mice, Rats) | 7-20 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
| Pasteurellosis (Rabbits) | 15-20 mg/kg PO twice daily | PO | twice daily | minimum of 14 days in mild cases and up to several months in chronic infections | 🌎 NA |
- Pasteurellosis (Rabbits): ciprofloxacin or enrofloxacin
페렛
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Susceptible infections | 5-15 mg/kg PO twice daily | PO | twice daily | — | 🌎 NA |
새
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Susceptible gram-negative infections | 20-40 mg/kg PO twice daily | PO | twice daily | — | 🌎 NA |
| Susceptible gram-negative infections | 20 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
| Susceptible gram-negative infections | 10-15 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
| Susceptible infections (Ratites) | 3-6 mg/kg PO twice daily | PO | twice daily | — | 🌎 NA |
- Susceptible gram-negative infections: Using ciprofloxacin 500 mg tablets. Crushed tablet goes into suspension well, but must be shaken well before administering.
- Susceptible gram-negative infections: Using crushed tablets
- Susceptible gram-negative infections: Using crushed tablets or suspend
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
시프로플록사신(Ciprofloxacin)은 2세대 플루오로퀴놀론계 항생제로 인의에서 널리 사용되며 수의학에서도 허가 외(off-label)로 자주 사용됩니다.
- 항균 스펙트럼: 광범위 항생제로 많은 그람 음성 간균 및 구균(녹농균, 대장균, 클레브시엘라 종 포함)과 일부 그람 양성균(메티실린 내성균을 포함한 포도상구균 종 등)에 매우 효과적입니다. 혐기성 세균과 대부분의 연쇄상구균에 대한 활성은 약합니다.
- 약동학적 특징: 개에서 경구 생체이용률은 엔로플록사신보다 현저히 낮고 불규칙합니다(엔로플록사신이 >80%인 반면 약 40-50%에 불과). 따라서 개에서 엔로플록사신을 1:1로 대체하는 경구약으로는 일반적으로 간주되지 않습니다.
- 임상적 유용성: 진정한 정맥주사(IV) 플루오로퀴놀론 제제가 필요하거나, 특정 배양 검사 결과에 따른 치료, 또는 더 큰 경구 투여 용량이 필요할 때 주로 선택됩니다.
작용 기전
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 → prevents DNA supercoiling and relaxation → halts DNA replication and transcription → 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).
안전성·주의사항
금기사항
- 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
부작용
- 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)
- Nausea (reported in humans)
- Visual disturbances (reported in humans)
주의
Caution: Use with care in patients with severe renal or hepatic impairment (dosage adjustments may be required to prevent accumulation).
- Hydration: Animals should not be allowed to become dehydrated during therapy due to the risk of crystalluria.
- Neurologic: Use with caution in patients with seizure disorders due to potential CNS stimulation.
- Feline Retinal Toxicity: Use high doses in cats with caution. While retinal toxicity appears less likely than with enrofloxacin (as ciprofloxacin is less lipophilic), caution is still advised.
약물 상호작용
May bind to ciprofloxacin and prevent its absorption; separate doses by at least 2 hours
Synergism may occur against some bacteria (particularly Pseudomonas aeruginosa)
May exacerbate nephrotoxicity and reduce the metabolism of cyclosporine
Severe hypoglycemia possible
Decreased ciprofloxacin absorption; separate doses by at least two hours
Increased MTX levels possible with resultant toxicity
May antagonize the antimicrobial activity of fluoroquinolones; concomitant use not recommended
May alter phenytoin levels
Blocks tubular secretion of ciprofloxacin and may increase its blood level and half-life
Increased risk for cardiotoxicity
May inhibit absorption of ciprofloxacin; separate doses by at least 2 hours
May increase theophylline blood levels
Potential for increased warfarin effects
모니터링
- 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
약동학
반감기
흡수
Well absorbed after oral administration in most species, but in dogs, bioavailability is at least half that of enrofloxacin. Poorly absorbed in ponies (2-12%). Oral bioavailability is ~50% in calves and ~40% in pigs.
분포
In humans, Vd is ~23.5 L/kg and 20-40% bound to serum proteins. Protein binding is ~70% in calves and ~23% in pigs.
대사
Metabolized to various metabolites that are less active than the parent compound. (Note: Ciprofloxacin is itself a major active metabolite of enrofloxacin in many species).
배설
Approximately 15-50% eliminated unchanged into the urine by both tubular secretion and glomerular filtration. Metabolites are eliminated in both urine and feces.
과다투여
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.
제품
제형
- Extended-release oral tablets
- Microcapsules for oral suspension
- Solution for injection
- Ophthalmic: 0.3% solution in 5 ml bottle
동물용의약품
- None
인용의약품
- Ciprofloxacin Oral Tablets: 100 mg, 250 mg, 500 mg & 750 mg; Cipro®; generic
- Ciprofloxacin Extended-Release Oral Tablets: 500 mg & 1000 mg; Cipro XR®; generic
- Ciprofloxacin Microcapsules for Oral Suspension: 250 mg/5 mL (5%) & 500 mg/5 mL (10%) when reconstituted; Cipro®
- Ciprofloxacin Solution for Injection: 200 mg & 400 mg in 100 mL & 200 mL in 5% dextrose flexible containers (0.2%); Cipro® I.V.; generic
- Ciloxan 0.3% w/v eye drops, solution
규제 현황
Subject to veterinary prescription. Fluoroquinolones are restricted for use only when other antibiotics are ineffective.
POM-V or POM (human crossover). Must adhere to responsible antimicrobial use guidelines.
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Tablets should be stored in tight containers at temperatures less than 30°C. Protect from strong UV light. The injection should be stored at 5°-25°C and protected from light and freezing.
보호자 정보
중요: 감염이 완전히 치료될 수 있도록 처방된 대로 정확히 투여하고, 임의로 투여를 건너뛰지 마십시오.
- 투여 방법: 공복에 투여하는 것이 가장 좋습니다. 위장 장애를 일으키는 경우 소량의 간식과 함께 주어도 되지만, 유제품(치즈, 우유, 요구르트)과 함께 주어서는 절대 안 됩니다. 칼슘이 약물의 흡수를 방해합니다.
- 영양제: 제산제, 철분 또는 아연 보충제와는 최소 2시간의 간격을 두고 투여하십시오.
- 수분 공급: 소변에 결정이 생기는 것을 방지하기 위해 반려동물이 항상 신선한 물을 충분히 마실 수 있도록 해주십시오.
- 부작용: 구토, 식욕 부진 또는 비정상적인 신경 증상(어지러움이나 떨림 등)이 있는지 관찰하십시오. 이러한 증상이 나타나면 수의사에게 연락하십시오.
- 성장기 반려동물: 관절 및 연골 문제를 일으킬 수 있으므로 어리고 성장 중인 동물에게는 일반적으로 사용을 피합니다.
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