Cipromet Mechanism of Action

Pharmacotherapeutic Group: Antibacterial.
Ciprofloxacin (Cipromet) is a synthetic broad spectrum antibacterial agent.
Ciprofloxacin (Cipromet) is effective in-vitro against virtually all Gram-negative pathogens, including Pseudomonas aeruginosa. It is also effective against Gram-positive pathogens such as staphylococci and streptococci. Anaerobes are generally less susceptible.
Ciprofloxacin has a rapid bactericidal action, not only in the proliferation phase but also in the resting phase.
During the proliferation phase of a bacterium, a segmental twisting and untwisting of the chromosomes take place. An enzyme called DNA gyrase plays a decisive part in this process. Ciprofloxacin inhibits this DNA gyrase in a way that arrests the bacterial metabolism since vital information can no longer be read from the bacterial chromosome.
Resistance to Ciprofloxacin develops slowly and in stages (multiple-step type).
Plasmid-mediated resistance development of the kind that occurs with B-lactam antibiotics, aminoglycosides, and tetracyclines has not been observed with Ciprofloxacin. It is of clinical interest that plasmid-carrying bacteria are also completely sensitive to Ciprofloxacin.
On account of its special mode of action, Ciprofloxacin does not suffer from general parallel resistance to other important, chemically different active substance groups, such as B-lactam antibiotics, tetracyclines, macrolides or peptide antibiotics, sulphonamides, trimethoprim or nutrofuran derivatives, and aminoglycoside. In its indication area, Ciprofloxacin remains completely effective on pathogens resistant to the above-mentioned groups of antibiotics.
Parallel resistance is observed within the group of gyrase inhibitors. However, because of the high primary sensitivity to Ciprofloxacin shown by most organisms, parallel resistance is less pronounced with this drug. Ciprofloxacin is thus; often still effective on pathogens that are already resistant to the less effective gyrase inhibitors.
Because of its chemical structure Ciprofloxacin is completely effective on B-lactamase-forming bacteria.
Ciprofloxacin can be used in combination with another antibiotic. In vitro studies with usually sensitive-pathogen, carried out using Ciprofloxacin in combination with B-lactam antibiotics and aminoglycosides, have shown primarily additive or indifferent effects. Synergistic increases in efficacy were relatively rare and antagonistic effects are very rare.
Possible combination with drugs include: For pseudomonas: azloclilin, ceftazidime.
For streptococci: mezlocillin, azlocillin, other effective B-lactam antibiotics.
For staphylococci: B-lactam antibiotics, particularly isoxazolypenicillins, vancomycin.
For anaerobes: metronidazole, clindamycin.