Antimicrobial Action

Ciprofloxacin is bactericidal and acts by inhibiting DNA gyrase and topoisomerase IV, which are essential enzymes in the reproduction of
bacterial DNA. It has a broader spectrum of activity and is more potent in vitro than the non-fluorinated quinolone nalidixic acid although
resistance to many species or strains previously sensitive is emerging. Activity may be reduced in acid media and in the presence of urine
but not of serum.
Spectrum of activity. Among Gram-negative aerobic bacteria, ciprofloxacin may be active in vitro against Enterobacteriaceae, including
Escherichia coli and Citrobacter, Enterobacter, Klebsiella, Proteus, Providencia, Salmonella, Serratia, Shigella, and Yersinia spp. It may also
exhibit activity against Pseudomonas aeruginosa and Neisseria gonorrhoeae. H. influenzae, Moraxella catarrhalis (Branhamella catarrhalis),
and N. meningitidis are all sensitive. Other Gram-negative aerobic bacteria reported to be sensitive to ciprofloxacin have included Gardnerella
vaginalis, Helicobacter pylori, Legionella spp., Pasteurella multocida, and Vibri o spp. Variable activity has been reported against Acinetobacter
spp., Brucella melitensis, and Campylobacter spp.
Among Gram-positive aerobic bacteria, ciprofloxacin is active against staphylococci, including penicillinaseproducing and penicillinase
nonproducing strains, and against some MRSA. Streptococci, in particular Streptococcus pneumoniae and enterococci, are less susceptible. Other
Gram-positive bacteria sensitive to ciprofloxacin in vitro are Bacillus spp.; variable activity has been noted for Corynebacterium spp.
Most anaerobic bacteria, including Bacteroides fragilis and Clostridium difficile, are resistant to ciprofloxacin, although some other Clostridium
spp. may be susceptible.
Ciprofloxacin has some activity against mycobacteria, mycoplasmas, rickettsias, Chlamydia trachomatis, and Ureaplasma urealyticum.
Acquired resistance. Resistant strains, particularly of MRSA, Ps. aeruginosa, E. coli, Klebsiella pneumoniae, C. jejuni, N. gonorrhoeae, and Str.
Pneumoniae have emerged during treatment with ciprofloxacin although there are widely differing patterns of resistance geographically.
Resistance to ciprofloxacin has usually been chromosomally mediated although plasma-mediated resistance has recently been noted.

Aksi antimikroba
Ciprofloxacin adalah bakterisida dan bertindak dengan menghambat girase DNA dan topoisomerase IV,
yang merupakan enzim penting dalam reproduksi DNA bakteri. Ia memiliki spektrum yang lebih luas dari
kegiatan dan lebih kuat in vitro dari asam non-fluorinated kuinolon nalidiksat meskipun resistensi
terhadap banyak spesies atau strain yang sebelumnya sensitif muncul. Aktivitas dapat dikurangi dalam
media yang asam dan dengan adanya urin tapi bukan dari serum.
Spektrum aktivitas. Di antara bakteri aerob gram negatif, ciprofloxacin mungkin aktif in vitro terhadap
Enterobacteriaceae, termasuk Escherichia coli dan Citrobacter, Enterobacter, Klebsiella, Proteus,
Providencia, Salmonella, Serratia, Shigella, dan Yersinia spp. Hal ini juga mungkin menunjukkan
aktivitas terhadap Pseudomonas aeruginosa dan Neisseria gonorrhoeae. H. influenzae, Moraxella
catarrhalis (Branhamella catarrhalis), dan N. meningitidis semua sensitif. bakteri aerob Gram negatif
lainnya dilaporkan peka terhadap ciprofloxacin telah disertakan Gardnerella
vaginalis, Helicobacter pylori, Legionella spp., Pasteurella multocida, dan Vibri o spp. Kegiatan variabel
telah dilaporkan terhadap Acinetobacter spp., Brucella melitensis, dan Campylobacter spp.
Di antara bakteri aerob Gram-positif, ciprofloxacin aktif terhadap staphylococcus, termasuk
penicillinaseproducing dan penisilinase strain non-penghasil, dan terhadap beberapa MRSA.
Streptokokus, di pneumoniae Streptococcus tertentu dan enterococci, kurang rentan. bakteri Gram-positif
lainnya peka terhadap ciprofloxacin in vitro adalah Bacillus spp .; Kegiatan variabel telah dicatat untuk
Corynebacterium spp.
Kebanyakan bakteri anaerob, termasuk Bacteroides fragilis dan Clostridium difficile, tahan terhadap
ciprofloxacin, meskipun beberapa spp lainnya Clostridium. mungkin rentan.
Ciprofloxacin memiliki beberapa aktivitas terhadap mycobacteria, mycoplasmas, Rickettsia, Chlamydia
trachomatis, dan Ureaplasma urealyticum.
resistensi yang diperoleh. strain resisten, khususnya dari MRSA, Ps. aeruginosa, E. coli, Klebsiella
pneumoniae, C. jejuni, N. gonorrhoeae, dan Str. Pneumoniae telah muncul selama pengobatan dengan
ciprofloxacin meskipun ada pola yang sangat berbeda dari perlawanan geografis.
Resistensi terhadap ciprofloxacin biasanya sudah kromosom dimediasi meskipun perlawanan plasmadimediasi baru-baru ini mencatat.