Foods Ciprofloxacin

Fluoroquinolones Not approved by the United States Food and Drug Administration for use in children except for anthrax (ciprofloxacin). MRSA, methicillin-resistant 5. aureus MSSA, methicillin-sensitive 5. aureus. 

The good bioavailability of orally administered ciprofloxacin obviates the need for the more expensive intravenous formulation. I.v. ciprofloxacin is only given to patients who have severe sepsis or severe nausea and vomiting. Ciprofloxacin s elimination is 50% hepatic and 50% renal. Therefore, dose reduction is recommended only in case creatinine clearance drops to < 10 ml/min. Prevention of food-borne disease requires efforts at many levels. Monitoring safety of food processing, vector control, surveillance of outbreaks, education on personal hygiene and improving sanitation and access to safe water supplies are all necessary measures to reduce the incidence of GTI. 

The quinolones are rapidly and almost completely absorbed after oral administration and are widely distributed in body tissues. Levels in extravascular spaces can often exceed serum levels. Levels lower than those found in serum occur in CSF, bone, and prostatic fluids. Ciprofloxacin and ofloxacin have been detected in breast milk and ofloxacin levels in ascites fluid are close to serum levels. Food ingestion does not affect bioavailability, which ranges from 50 to 95%. The half-life for most quinolones is 3 to 4 hours. 

Duan, J. and Z. Yuan. 2001. Development of an indirect competitive ELISA for ciprofloxacin residues in food animal edible tissues. J. Agric. Food Chem. 49 1087-1089. 

Milk and dairy foods decrease the absorption of some tetracyclines (doxycycline and minocycline are not affected), some quinolone antibiotics (absorption of ciprofloxacin and norfloxacin is decreased but ofloxacin is not affected), penicillamine and alendronate. Large volumes of milk can reduce the ulcer-healing properties of bismuth tripotassium dicitratobismuthate (bismuth chelate),... 

Magnesium trisilicate is used in oral pharmaceutical formulations and food products as a glidant. It is also used therapeutically as an antacid, and also for the treatment of ciprofloxacin overdose or toxicity. ... 

Tarbin, J.A. lyier, D.J. Shearer, G. Analysis of enrofloxacin and its metabolite ciprofloxacin in bovine and porcine muscle by high-performance liquid chromatography following cation exchange clean-up. Food Addit.Contam., 1992, 9, 345—350... 

ABSORPTION, FATE, AND EXCRETION The quinolones are weU absorbed after oral administration and are widely distributed. Peak serum levels of the fluoroquinolones occur within 1-3 hours of an oral dose of 400 mg. Relatively low serum levels are reached with norfloxacin and limit its usefulness to the treatment of urinary tract infections. Food does not impair oral absorption but may delay the time to peak serum concentrations. Oral doses in adults are 200-400 mg every 12 hours for ofloxacin, 400 mg every 12 hours for norfloxacin and pefloxacin, and 250-750 mg every 12 hours for ciprofloxacin. Bioavailabrlity of the fluoroquinolones exceeds 50% for all agents and 95% for several. The serum half-lives range from 3 to 5 hours for norfloxacin and ciprofloxacin to 20 hours for sparfloxacin. The volume of distribution of quinolones is high, with concentrations in urine, kidney, lung and prostate tissue, stool, bUe, and macrophages and neutrophils higher than serum levels. Quinolone concentrations in CSF, bone, and prostatic fluid are lower than in serum. Pefloxacin and ofloxacin levels in ascites fluid approach serum levels, and ciprofloxacin, ofloxacin, and pefloxacin have been detected in human breast milk. 

Taking your antibiotic with food may help reduce this sick feeling. Ciprofloxacin and doxycycline should not be taken within 2 hours ol taking antacids. Ciprofloxacin and doxycycline should not be taken with dairy or calcium-fortified products (such as ice cream or calcium-fortified orange juice). 

Hoffken G, Lode H, Wiley R, Glatzel TD, Sievers D, Olschewski T, Borner K, Koeppe T. Pharmacokinetics and bioavailability of ciprofloxacin and ofloxacin effect of food and antacid intake. Rev Infect Dis (1988) 10 (Suppl 1), S138-S139. 

Apart from dairy products (p.332), most foods delay but do not reduce the absorption of ciprofloxacin, enoxacin, gemifloxacin, lomefloxacin, ofloxacin or sparfloxacin. A high-fat/high-calcium breakfast did not reduce ciprofloxacin levels. Calcium-fortified orange juice significantly reduces the absorption of ciprofloxacin, but not gatifloxacin or levofloxacin. 

Apart from dairy products (p.332), quinolones can be given with food without any decrease in levels. However, calcium-fortified foods may cause significant interactions with ciprofloxacin. 

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