Role of ciproxin in Presented by: Dr. ayesha inam Ho medical a unit 1

List of contents  Definition & Etiology  Transmission  Pathogenesis  Signs and symptoms  Investigation  Prevention  Treatment  Cipro highlights  Side effects  contraindications 2

Typhoid fever An infectious feverish disease caused by the bacterium Salmonella and less commonly by Salmonella paratyphi. Acute generalized infection of the reticulo endothelial system, intestinal lymphoid tissue, and the gall bladder. 3

RISK AREA Typhoid Fever is still common in the developing world. It affects about 21.5 million people worldwide every year.

Transmission fecal-oral route close contact with patients or carriers contaminated water and food flies and cockroaches. 5

6 PATHOGENESIS

Signs & symptoms First week: Slowly rising temperature with relative,bradycardia,malaise headache and cough Second week: High fever, delerium, bradycardia, hepatospleenomegaly, rose spots Third week: Encephalitis, septicemia, intestinal haemorrhage and perforation Fourth week: This carries into final fourth week. 7

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Investigations  Routine examination  Bacteriogical examination Blood,Urine, stool and bone marrow culture  Serological examination Widal test 9

prevention Safe drinking water Good sanitary system Hand washing Safe disposal of feces and urine Vaccination 10

Treatment 1. General 2. Sypmtomatic 3. Specific Quinolones(first choice) Cephalosporin chloremphenicol In conjunction with metronidazole 11

cipfroxin(Ciprofloxacin)  Cipro is an broad spectrum antibiotic in a group of drugs called fluoroquinolones. Availability  Ciprofloxacin is available as:  tablets (100 mg, 250 mg, 500 mg, 750 mg or 1000 mg)  intravenous solutions (5% and 10%, 100 mL) 12

cipro highlights Most potent fluorinated quinolone Broad spectrum antibiotic Rapid bactericidal activity at low concentration Rapid blood and tissue distribution Good bioavailability Extended half life Well tolerated by all patients Convenient BD dose 13

Common side effects Diarrhea; dizziness; headache; loss of appetite; nausea serious side effects peripheral neuropathy,spontaneous tendon rupture tendonitis,acute liver failure or serious liver injury (hepatitis),phototoxicity reactions.Psychotic reactions acute pancreatitis, bone marrow depression. 14

Contraindications Coadministration with drugs metabolized by CYP1A2 "Concomitant administration with tizanidine history of hypersensitivity to ciprofloxacin. "Local I.V. site reactions are more frequent pediatric population,pregnant and nursing mothers 15

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