How It Works: Ciprofloxacin is an antibiotic. Antibiotics can improve acne symptoms by limiting the growth of bacteria that contribute to Acne Vulgaris.
When is this medication used? Ciprofloxacin is rarely used as a treatment for acne. Ciprofloxacin is generally combined with additional medications for the treatment of moderate to severe acne vulgaris (Acne Types: 3-4). Ciprofloxacin is almost never used alone as a monotherapy.
Frequency of ciprofloxacin Resistant P. acnes Bacteria: Occasional. (What does this mean?)
Official Name: Ciprofloxacin
Popular Brand Names: Cipro, Ciloxin, Ciflox, Ciplex, Baycip.
Related Medications: Levofloxacin, Moxifloxacin, Sparfloxacin, Gatifloxacin, Nadifloxacin, Nalidixic Acid, Ofloxacin and Norfloxacin.
Ciprofloxacin and Acne
Oral ciprofloxacin is occasionally prescribed for the treatment of acne vulgaris, but it is poorly suited for this application. Ciprofloxacin is primarily used for short courses of treatment, and often in combination with a second antibiotic. Most strains of P. acnes bacteria are susceptible to quinolone family antibiotics (at least initially). However, most acne patients will require continuing antibiotic treatment to control their acne symptoms. Over time, there is a significant probability that the acne-causing P. acnes bacteria of a patient will develop resistance to ciprofloxacin.
Additionally, the risk of side effects with ciprofloxacin is greater than with most other antibiotics. The combination of these factors makes ciprofloxacin a poor choice for ongoing control of acne symptoms. However, there may be a limited role for ciprofloxacin in the treatment of acne vulgaris. Ciprofloxacin may act synergistically with other classes of antibiotics, because they target different functions that are essential to the survival of the target bacteria. The addition of a short course of ciprofloxacin treatment to a standard course of anti-acne antibiotics may accelerate the resolution of symptoms by killing the P. acnes bacteria more rapidly and efficiently. An example of this type of treatment might be a patient who is prescribed a continuing dose of co-trimoxazole, with a supplemental 4-day course of ciprofloxacin at the start of treatment. This method of antibiotic use is not widely used for acne treatment, but it is a relatively common approach for the treatment of severe acute infections.
While most ciprofloxacin prescriptions are for the oral version of the antibiotic, topical ciprofloxacin (and other topical versions of quinolone antibiotics) may be an effective adjunctive therapy for acne for mild to severe acne. In general, ciprofloxacin is used to treat many types of infections caused by susceptible bacteria including: bone and joint infections, gastroenteritis, endocarditis, respiratory tract infections, cellulitis, urinary tract infections, prostatitis, certain skin infections and anthrax and more.
Patient Reviews of Ciprofloxacin
Ciprofloxacin is a medication that is rarely used to treat acne vulgaris.
Ciprofloxacin appears to be moderately effective for treating acne vulgaris. It is most effective when combined with a complimentary antibiotic. Ciprofloxacin is rarely used alone (mono-therapy).
Ciprofloxacin Cost and Availability
If possible, ciprofloxacin should be obtained through consultation of a qualified medical professional. Many dermatologists and physicians are familiar with this medication. Many doctors are comfortable with the use of this medication, but some are not. It is not commonly used for the treatment of acne. Ciprofloxacin is available in both generic and brand name formulations. Generic ciprofloxacin tends to be moderately expensive and brand name ciprofloxacin tends to be expensive.
Side Effects of Ciprofloxacin
Serious side effects are more common with the quinolone family antibiotics than with many other types of antibiotics. Ciprofloxacin has many of the normal risks associated with antibiotic use, including gastrointestinal problems and allergic reactions. Allergic reactions often involve skin rashes, hives, fever, headaches, joint pain and nausea. In addition to these standard risks, there are several more warnings that are specific for ciprofloxacin (and other quinolone antibiotics). In 2004, warning labels were added to ciprofloxacin regarding risks of tendon damage, peripheral neuropathy (irreversible nerve damage) and heart problems. Certain psychiatric reactions may also occur. Elderly people and children are at the highest risk of adverse reactions. The use of ciprofloxacin in children and pregnant women is severely limited. Some adverse reactions to ciprofloxacin treatment may occur and continue after use has been discontinued.
For more in-depth information about potential side effects of ciprofloxacin treatment, refer to the physician’s insert for ciprofloxacin, or consult a medical professional. For more information about contraindications in general, refer to Avoiding Negative Drug Interactions.
Ciprofloxacin is a member of a class of antibiotics called quinolones. It is probably best known as the first line treatment for anthrax infection. Ciprofloxacin kills bacteria by inhibiting an essential bacterial enzyme called DNA gyrase. DNA gyrase allows bacteria to access and replicate their genetic code. Treatment with ciproflixacin prevents this enzyme from functioning properly, and therefore prevents the bacteria from reading and copying their own DNA.
Ciprofloxacin is the most commonly used antibiotic in the quinolone family. Ciprofloxacin is widely available in both brand name and generic formulations around the world. Throughout the early 2000’s, global annual sales of ciprofloxacin exceeded $1 billion (US$). Recently, serious questions have been raised about potential side effects related to ciprofloxacin use, which has begun to suppress sales of the medication. Many quinolones, including ciprofloxacin have been implicated in joint and tendon related problems, and there are several lawsuits in progress that are related to this issue.
Problems associated antibiotic resistant bacteria are a major problem with ciprofloxacin (and other quinolone antibiotics). It is much easier for bacteria to develop resistance to ciprofloxacin, than it is to develop resistance to most other types of antibiotics. The development of ciprofloxacin resistance only requires small mutations in the bacterial genetic code, and this makes it easy for bacteria to spontaneously acquire resistance to this family of antibiotics. Many medical and scientific professionals advocate using alternative antibiotics, when possible, to preserve the effectiveness of the quinolone family for urgent cases of infection. Quinolones may also be prescribed in combination with additional antibiotics to imrpove their efficacy and prevent the development of antibiotic resistance.
Additional Names for Ciprofloxacin: Aceoto, Alciprocin, Antox, Bactall, Bactiflox, Baycip, Benzing, Biofloxcin, Biofloxin, C-Flox, Cetraxal, Cetraxan, Cifloc, Ciflodal, Ciflosacin, Ciflox, Cifloxager, Cifloxin, Cifran, Cilofloc, CiloQuin, Cilox, Cip eco, Ciperus, Cipflox, Ciphin, Ciprenit, Ciprex, Ciprinol, Ciprobay, Ciprobel, Ciprocinal, Ciprodar, Ciprodex, Ciprodox, Ciprodura, Ciprofat, Ciprofloksacin, Ciproflox, Ciprofloxacina, Ciprofloxacine, Ciprofloxacino, Ciprofloxacinum, Ciprogen, Ciprogis, Ciprohexal, Ciprol, Ciprolet, Ciprolon, Cipromed, Cipromid, Ciprox, Ciproxan, Ciproxin, Ciproxina, Ciproxine, Ciprum, Citeral, Clioxan, Cyprofloksacyna, Displotin, Dynafloc, Emicipro, Flokisyl, Floxacin, Giroflox, Grifociprox, Gyracip, Ificipro, Isino, Lucipro, Maxiflox, Medaflox, Neoflox, Neofloxin, Nivoflox, Peiton, Prociflor, Proflaxin, Proquin, Proxacin, Quilox, Quintor, Sanfloks, Serviflox, Truoxin, Üro Ciproxin, Viprolox and Zumaflox
References and Sources
PDR Staff Writers. 2011. 2011 Physicians’ Desk Reference
Gallagher. 2011. Antibiotics Simplified, Second Edition
Habif. 2009. Clinical Dermatology
Goodheart. 2006. Acne For Dummies
Bartlett. 2012. Johns Hopkins ABX Guide 2012 (Johns Hopkins Medicine)
Ciprofloxacin @ PubMed Health – The National Institute of Health (US) offers basic comprehensive information about most common medications.
Ciprofloxacin @ Wikipedia – Wikipedia is an excellent resource for learning about how medications work.
Ciprofloxacin Physician’s Insert – The physician’s insert for a medication contains nearly all of the relevant information, including indications, dosage information and background data.
Scientific Research Articles
Coates, et al. 2002. Prevalence of antibiotic-resistant propionibacteria on the skin of acne patients: 10-year surveillance data and snapshot distribution study.
Vali, et al. 2009. The Efficacy of Topical Solution of 0.3% Ciprofloxacin in Treatment of Mild to Moderate Acne Vulgaris.
Nenoff, et al. 2006. Acne vulgaris and bacterial skin infections: review of the topical quinolone nadifloxacin.
Mory, et al. 2004. In vitro activities of cefotaxime, vancomycin, quinupristin/dalfopristin, linezolid and other antibiotics alone and in combination against Propionibacterium acnes isolates from central nervous system infections.
Kawada, et al. 2004. Clinical effectiveness of levofloxacin for inflammatory acne with high lesion concentrations.
Ross, et al. 2003. Phenotypic and genotypic characterization of antibiotic-resistant Propionibacterium acnes isolated from acne patients attending dermatology clinics in Europe, the U.S.A., Japan and Australia.
Ramage, et al. 2003. Formation of Propionibacterium acnes biofilms on orthopaedic biomaterials and their susceptibility to antimicrobials.
Behra-Milliet, et al. 2002. Antianaerobic activity of moxifloxacin compared with that of ofloxacin, ciprofloxacin, clindamycin, metronidazole and β-lactams.
Campoli-Richards, et al. 1988. Ciprofloxacin. A review of its antibacterial activity, pharmacokinetic properties and therapeutic use.
Barry, et al. 1984. Antibacterial activities of ciprofloxacin, norfloxacin, oxolinic acid, cinoxacin, and nalidixic acid.
Smith, et al. 1996. Susceptibility testing of Propionibacterium acnes comparing agar dilution with E test.
Vogt, et al. 1992. Comparative activity of the topical quinolone OPC-7251 against bacteria associated with acne vulgaris.
Pankuch, et al. 1993. Susceptibilities of 428 gram-positive and -negative anaerobic bacteria to Bay y3118 compared with their susceptibilities to ciprofloxacin, clindamycin, metronidazole, piperacillin, piperacillin-tazobactam, and cefoxitin.