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Ciprofloxacin: the Traveler’s Panacea

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Cipro is used to treat a laundry list of bacterial infections, including anthrax, a number of bone and joint infections, and most relevant for travelers, bacterial diarrhea. It is the atomic bomb of antibiotics.

Widely prescribed for a variety of infections, cipro has lost its potency over recent years. Some strains of bacteria have become resistant. This is what typically happens when bacteria get to face off against an antibiotic with frequency – at some point, a mutated form of the bacteria will emerge and cipro won’t be able to handle it. For now, cipro remains a standard in your travel health arsenal. Read the tips here to better understand where and how to get cipro, and how to take it responsibly.

Do you Need Cipro?

Depends on where you are traveling. If you are heading to any developing world country, we would strongly recommend bringing it along. If you are traveling to a first world country, you can do without it.

How do you get cipro?

It is possible to get a cipro prescription before traveling. If you are taking cipro for the first time, I would schedule a consultation at a travel health clinic. If you are taking other prescription drugs, cipro may interfere with them. Also, you may be allergic to fluoroquinolone antibiotics (cipro is an antibiotic within this class). Finally, a doctor at a travel health clinic will be able to answer any specific questions you have about dosage and use.

If you have experience taking cipro responsibly, you can buy it without a prescription in almost any developing world pharmacy. I buy a generic version when I am in West Africa for as little as $4 a box, much cheaper than what you would pay in a first world country, depending on your health insurance (if you have it).

What should cipro be taken for?

The primary reason cipro is a travel health essential is because of its effectiveness in dealing with intestinal bacterial infections, otherwise known as traveler’s diarrhea.

It should not, however, be taken at the onset of diarrhea (doing so contributes to bacterial resistance of the antibiotic). It should be used as a last resort. If diarrhea lasts for longer than three days, cipro can be taken twice daily, once in the morning, once in the evening (typically a 500mg dose each time), for three days. Again, if you are taking it for the first time, you should consult a doctor at a travel health clinic before using it.

Keep in mind that cipro does not treat all forms of diarrhea. Amoebic dysentery, for example, requires a different set of drugs. If you are experiencing other symptoms besides the diarrhea, such as fever or blood or mucous in your stool, you should get to a clinic asap. Cipro will only treat bacterial forms of traveler’s diarrhea.

Typically, cipro will provide relief within 24 hours after the first two doses (500 mg each). If you find yourself not improving after two days of taking cipro, you should go to a clinic. You could have a bacteria resistant to the antibiotic or you might have a non-bacterial disease. Examples of non-bacterial GI diseases would include amoebic dysentery and giardia, although there is some evidence now that cipro can treat giardia as well (you can read up on this here, but we would insist that you talk to a doctor before trying this as a treatment for giardia).

For more on traveler’s diarrhea see our post titled How to Prevent and Treat Traveler’s Diarrhea.

Other considerations

Cipro is destructive and it will kill good bacteria in addition to bad. It is for this reason that we strongly recommended taking probiotics to restore the beneficial bacteria in your gut.

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{ 6 comments… add one }

  • Zoe October 30, 2015, 8:28 pm

    I had giardia a few months ago (which I got from crashing my dirt bike face first into a stagnant pool of muddy water), and now am in Mexico and fear I have it again but am not positive it’s not travelers diarrhea (which I’ve never had) and don’t want to unnecessarily take drugs if I don’t need to. If it’s been more than three days and hasn’t gone away on its own, then do you think it’s more than travelers diarrhea? Also am considering just taking Cipro because I have it and not trying to find some metronidazole, but again, afraid of having to take the latter anyway. Help?

    • phil October 31, 2015, 5:34 am

      Hi Zoe,
      Sorry to hear about this!! Well, the best option would be to go to a clinic and have a proper analysis done, which would include a stool sample. If you are far from a clinic and you are not improving, you could take the cipro, which would rule out the possibility of any bacterial infection. We have explored some evidence that cipro may also destroy giardia, but more extensive research still needs to be done. You can read about that study here: http://sickontheroad.com/2015/01/02/treat-giardia-ciprofloxacin/ In any case, if it’s bacterial, you can believe that cipro will destroy it. As I said, though, seeing a doctor and having a proper diagnosis is your best option here.

  • Dustin January 22, 2017, 2:01 am

    Hi Phil, thank you for your useful article. I am currently in Indonesia (Lombok) and started to feel ill 2.5 days ago. It started with body aches and then developed into a fever and frequent diarrhea (no vomitting). I started taking Cipro yesterday morning, so far have taken 1500mg. The fever is gone but the diarrhea is continuing. I am not really nauseous but do have gassy pains and stomach cramping sporadically.

    I’ve taken cipro probably three or four times in the past for travelers diarrhea, including exactly 1 year ago in the same place. In the past I’ve always remembered diarrhea stopping relatively quickly after first dose. Now about 36 hrs later, I’m concerned that maybe I have something resistant to cipro or something viral rather than bacterial. There really are no good clinics around. Any advice you can offer?
    Thank you!

    • phil January 22, 2017, 4:56 am

      Obviously that’s a great sign if the fever is gone. Bacterial GI issues are definitely most common, but it is possible to have something parasitic depending on where you are. If it persists, I would definitely try to get yourself to a decent clinic even if it means traveling a bit. Is there a pharmacy close by? Depending on what parasites are endemic there, metronidazole may do the trick. I would only recommend these things, however, if you really do not have access to a clinic (i.e. it’s too dangerous to get to one).

  • Michael March 3, 2017, 11:38 pm

    I’m in Mexico at the moment … been here 25 times before and only had a problem once before. Anyway, I had a horrible day where I wanted to die! Diarrhea, vomiting, high fever, chills, sweats, chills, sweats …. dillusional… dizziness. I talked my way into some Cipro from the local pharmacy and took 1000mg this morning and plan to take 500mg every 12 hours for 3 days. Is this going to work? I have never felt this sick in my life!

    • phil March 15, 2017, 5:48 am

      Hey Michael,

      If it is a bacterial issue, then yes. If you have a parasite like giardia or if you amoebic dysentery or the like, then no. I would imagine you would start feeling better after 2-3 doses of cipro if it’s bacterial. If there is no improvement, then definitely get yourself to a clinic for a proper diagnosis.
      Cheers,
      Phil

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