What is Cipro?
Ciprofloxacin (Cipro®) is an antibiotic that belongs to the fluoroquinolone group and is prescribed to treat or prevent certain bacterial infections, including bacterial prostatitis. Extended-release forms of ciprofloxacin are used only to treat certain types of urinary tract infections. Ciprofloxacin works by disrupting the activity of an enzyme that bacteria require to replicate their DNA and to survive. About 80 percent of bacterial prostatitis cases are caused by Escherichia coli; the remaining 20 percent are caused by Enterobacter species, Klebsiella species, Proteus enterococci species, Pseudomonas species, or Staphylococcus species. Ciprofloxacin is effective against all of these bacteria.
Studies of Ciprofloxacin for Prostate Health
A multicenter, double-blind study evaluated the efficacy and safety of two fluoroquinolones—ciprofloxacin and levofloxacin—in men who had chronic bacterial prostatitis. The most common causes of chronic bacterial prostatitis in the men were Escherichia coli and Enterococcus faecalis.
A total of 377 men were randomly assigned to take either 500 mg of levofloxacin once daily or 500 mg of ciprofloxacin twice daily for 28 days. At the end of the study, the success rates (cured plus improved patients) were 75 percent for men who took levofloxacin and 72.8 percent for those who took, ciprofloxacin. Men in both treatments had similar relapse rates at six months, and the rates of side effects and tolerability were also similar between the two drugs. The authors concluded that once daily treatment with levofloxacin was just as effective and safe as twice daily treatment with ciprofloxacin. (Bundrick 2003)
A subsequent review of management of bacterial prostatitis published in BJU International noted that fluoroquinolones are the first treatment choice for chronic bacterial prostatitis, especially levofloxacin, which is equally effective as ciprofloxacin but can better penetrate the prostate and requires only once a day dosing. (Naber 2008)
A study from South Korea showed that the combination of garlic and ciprofloxacin was superior to ciprofloxacin alone in treating chronic bacterial prostatitis. Researchers evaluated the antimicrobial and anti-inflammatory properties of garlic along with the synergistic effect of garlic along with ciprofloxacin in adult rat models of chronic bacterial prostatitis. A total of 41 rats with the disease were randomly assigned to four treatment groups: control, garlic, ciprofloxacin, and garlic plus ciprofloxacin.
After three weeks of treatment, rats in the garlic group had a statistically significant decrease in bacterial growth and an improvement in inflammation of the prostate compared with the control group. However, the garlic plus ciprofloxacin group had a statistically significant decrease in bacterial growth and an improvement in inflammation of the prostate when compared with the ciprofloxacin. These results suggest garlic may provide both antimicrobial and anti-inflammatory benefits, as well as a synergistic effect with ciprofloxacin. The authors suggest combining garlic and ciprofloxacin in treating chronic bacterial prostatitis. (Sohn 2009)
How to Take Ciprofloxacin
Ciprofloxacin is available as regular tablets, liquid, and extended-release tablets. The recommended dose of ciprofloxacin for prostatitis is 500 mg every 12 hours for 28 days; however, your healthcare provider may prescribe a different treatment plan. The extended-release tablets are typically taken once daily. You should not take ciprofloxacin with dairy products (e.g., milk, cheese) or calcium-fortified juices alone, but you may take ciprofloxacin along with a meal that includes these foods or beverages.
Drug Interactions with Ciprofloxin
If you take ciprofloxacin along with an antacid that contains aluminum and/or magnesium, the antacid will bind with up to 90 percent of ciprofloxacin and make the dose nearly ineffective. Calcium, iron, zinc, and vitamin supplements also can interfere with ciprofloxacin. Therefore, ciprofloxacin should be taken separate from these antacids and supplements; consult your healthcare provider for the time span between use of these products. Ciprofloxacin should not be taken with theophylline, a treatment for asthma, because the antibiotic slows down the metabolism of theophylline and causes severe nervousness, possibly even death. The use of caffeine and caffeine products along with ciprofloxacin can cause a similar reaction, because the antibiotic leads to elevated blood levels of caffeine that affects the central nervous system.
Side Effects of Ciprofloxacin
Ciprofloxacin may cause confusion, diarrhea, dizziness, headache, heartburn, lightheadedness, nausea, stomach pain, tiredness, urgent need to urinate, and vomiting. Serious side effects may also occur, including but not limited to hives, swelling (face, neck, throat, tongue, arms, ankles, legs), severe diarrhea, pounding heartbeat, wheezing, difficulty breathing or swallowing, dark urine, hallucinations, anxiety, nervousness, thoughts of suicide, sleep problems, seizures, and pain, burning, tingling, or weakness in any part of the body. (National Institutes of Health)
Taking ciprofloxacin increases the risk of developing tendinitis (swelling of the fibrous tissue that connects bone to muscle) or a ruptured tendon, both during treatment or for up to several months after stopping treatment. Tendinitis and ruptured tendon may occur in people of any age, but the risk is greatest in people older than 60.
See also
Can a Prostate Biopsy Give You Prostatitis?
Treatment of prostatitis with levofloxacin
Can Cipro Before a Prostate Biopsy Increase the Risk of Infection?
References
Bundrick W et al. Levofloxacin versus ciprofloxacin in the treatment of chronic bacterial prostatitis: a randomized double-blind multicenter study. Urology 2003 Sep; 62(3): 537-41
Mobley JD, Kim ED. Prostatitis, bacterial. Emedicine: http://emedicine.medscape.com/article/437504-overview
Naber KG. Management of bacterial prostatitis: what’s new? BJU Int 2008 Mar; 101 Suppl 3:7-10
National Institutes of Health: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000878/
Sohn DW et al. Anti-inflammatory and antimicrobial effects of garlic and synergistic effect between garlic and ciprofloxacin in chronic bacterial prostatitis rat model. Int J Antimicrob Agents 2009 Sep; 34(3): 215-19
