Editing Ciprofloxacin (section)

===Bacterial resistance===
{{see also|Antibiotic abuse|Antibiotic resistance}}

As a result of its widespread use to treat minor infections readily treatable with older, narrower-spectrum antibiotics, many bacteria have developed resistance to this drug, leaving it significantly less effective than it would have been otherwise.<ref name="pmid10341191">{{cite journal |vauthors = Vatopoulos AC, Kalapothaki V, Legakis NJ |title = Bacterial resistance to ciprofloxacin in Greece: results from the National Electronic Surveillance System. Greek Network for the Surveillance of Antimicrobial Resistance |journal = Emerging Infectious Diseases |volume = 5 |issue = 3 |pages = 471–6 |date = 1999 |pmid = 10341191 |pmc = 2640758 |doi = 10.3201/eid0503.990325 }}</ref><ref>{{cite web |url = http://www.health.state.mn.us/news/pressrel/2009/bacterial022609.html |title=Bacterial resistance prompts concern among health officials |publisher= Minnesota Department of Health |date=26 February 2009 |url-status=dead |archive-url=https://web.archive.org/web/20090305232555/http://www.health.state.mn.us/news/pressrel/2009/bacterial022609.html |archive-date=5 March 2009 }}</ref>

[[Antibiotic resistance|Resistance]] to ciprofloxacin and other [[fluoroquinolone]]s may evolve rapidly, even during a course of treatment. Numerous [[pathogen]]s, including [[enterococci]], ''[[Streptococcus pyogenes]]'', and ''[[Klebsiella pneumoniae]]'' (quinolone-resistant) now exhibit resistance.<ref>M Jacobs, Worldwide Overview of Antimicrobial Resistance. International Symposium on Antimicrobial Agents and Resistance 2005.</ref> Widespread veterinary usage of fluoroquinolones, particularly in Europe, has been implicated.<ref>{{cite press release |title=Update on Extra-Label Use of Fluoroquinolones |url=https://www.fda.gov/AnimalVeterinary/NewsEvents/CVMUpdates/ucm127657.htm |publisher=[[Center for Veterinary Medicine]] (CVM) |date=16 July 1996 |access-date=12 August 2009 |url-status=live |archive-url=https://web.archive.org/web/20100309003153/https://www.fda.gov/AnimalVeterinary/NewsEvents/CVMUpdates/ucm127657.htm |archive-date=9 March 2010}}</ref> Meanwhile, some ''[[Burkholderia cepacia]]'', ''[[Clostridium innocuum]]'', and ''[[Enterococcus faecium]]'' strains have developed resistance to ciprofloxacin to varying degrees.<ref>{{cite web |title=Ciprofloxacin Data Sheet |url=http://www.toku-e.com/Upload/Products/PDS/20120618005735.pdf |date=1 December 2010 |publisher=Toku-E |url-status=dead |archive-url=https://web.archive.org/web/20131009014110/http://www.toku-e.com/Upload/Products/PDS/20120618005735.pdf |archive-date=9 October 2013 |access-date=20 June 2012}}</ref>

Fluoroquinolones had become the class of antibiotics most commonly prescribed to adults in 2002.<ref name="pmid15745724">{{cite journal |vauthors = Linder JA, Huang ES, Steinman MA, Gonzales R, Stafford RS |title = Fluoroquinolone prescribing in the United States: 1995 to 2002 |journal = The American Journal of Medicine |volume = 118 |issue = 3 |pages = 259–68 |date = March 2005 |pmid = 15745724 |doi = 10.1016/j.amjmed.2004.09.015 }}</ref> Nearly half (42%) of those prescriptions in the US were for conditions not approved by the FDA, such as acute bronchitis, otitis media, and acute upper respiratory tract infection.<ref name="pmid15745724"/>