Absorption of ciprofloxacin can be reduced if it is taken at the same time as dairy products, antacid or iron preparations; ciprofloxacin should be dosed at least four hours apart from these products. Quinolones can inhibit the cytochrome P450 system, and thus interact with a number of different drugs. Some of these interactions can be potentially serious: for example, ciprofloxacin can cause an increase in theophylline levels, potentially leading to toxicity.


Erythromycin was the first macrolide to be developed, and has been a mainstay of treatment for many infections for the last forty years. More recently clarithromycin and azithromycin have become available in the UK. Their main benefits are that they offer easier dosing, are more tolerable to take and do not have as many drug interactions.

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