Ciprofloxacin

General

• Type: Fluoroquinolones
• Dosage Forms: IV; PO (Standard: 100, 250, 500; ER 500, 1000)
• Common Trade Names: Cipro

Adult Dosing

General

• PO
  • 250-750mg PO q12h
  • First Dose: 250-750mg PO x1
• IV
  • 200-400mg IV q12
  • First Dose: 400mg IV x 1
  • Alt: 400mg IV q8h

UTI

• Uncomplicated
  • 500mg ER PO q24h x 3 days
  • Alt: 250mg PO q12h x 3 days
• Complicated
  • IV: 400mg IV q12h x 7-14 days
  • PO: 1000mg ER PO q24h x 7-14 days
    • Alt: 500mg PO q12h x 7-14 days

Anthrax

• Inhalational, GI, Oropharyngeal
  • 400mg IV q12h OR 500mg PO q12 x 60 days
  • First dose: 400mg IV + 1-2 additional antibiotics
• Cutaneous
  • 400mg IV q12h OR 500mg PO q12 x 7-10 days
    • Info: Give x 60 days if bioterrorism suspected
• Post-Exposure Prophylaxis
  • 500mg PO q12h x 60 days (or exposure excluded)

Traveler's Diarrhea

• 750mg PO BID x 1-3 days

Typhoid Fever

• 500mg PO q12h x 2 weeks

Chancroid

• 500mg PO q12h x 3 days

Salmonella

• Acute
  • 500-750mg PO q12h x 3-7 days
    • Extend treatment x 1 week if immunocompromised
• Chronic Carrier
  • 750mg PO q12h x 1 month

Pediatric Dosing

General

• PO
  • 20-30mg/kg/day PO divided q12h
  • First Dose: 10-15mg/kg PO x 1
  • Max: 750mg/dose PO
• IV
  • 15-30mg/kg/day IV divided q8-12h
  • First Dose: 5-15mg/kg IV x 1
  • Max: 400mg/dose IV

Anthrax

Max (All): 400mg/dose IV or 500mg/dose PO

• Inhalational, GI, Oropharyngeal
  • 20-30mg/kg/day IV/PO divided q12h x 60 days
  • First Dose: 10-15mg/kg IV x 1 (give with 1-2 additional antibiotics)
• Cutaneous
  • 20-30mg/kg/day IV/PO divided q12h x 7-10 days
  • First Dose: 10-15mg/kg IV/PO x 1
    • Info: Give x 60 days if bioterrorism suspected
• Post-Exposure Prophylaxis
  • 20-30mg/kg/day PO divided q12h x 60 days (or exposure excluded)
  • First Dose: 10-15mg/kg PO x 1

UTI, Complicated (1-17 Years Old)

Not first line given adverse effects

• IV
  • 6-10mg/kg IV q8h
  • First Dose:
  • Max: 400mg/dose IV
• PO
  • 10-20mg/kg PO q12h
  • First Dose:
  • Max: 750mg/dose PO

Special Populations

• Drug ratings in pregnancy: C (but indicated for anthrax)
• Lactation risk categories: Probably safe
• Renal Dosing
  • Adult: renal impairment less than creatinine clearance 30 mL/min, q24hrs instead of q12hrs
  • Pediatric
• Hepatic Dosing - no dose adjustments needed

Contraindications

• Allergy to class/drug
• Administration with Tizanidine

Adverse Reactions

Serious

• Prolonged QT interval and Syncope/Torsades de pointes
• Photosensitivity
• Stevens-Johnson syndrome/Toxic epidermal necrolysis
• Clostridium difficile diarrhea, Pseudomembranous enterocolitis
• Rupture of tendon or Tendinitis

Common

Common

• Rash
• Diarrhea/Nausea/Vomiting

Pharmacology

• Half-life:
• Metabolism:
• Excretion:
• Mechanism of Action:

Antibiotic Sensitivities

Group	Organism	Sensitivity
Gram Positive	Strep. Group A, B, C, G	I
	Strep. Pneumoniae	I
	Viridans strep	R
	Strep. anginosus gp	R
	Enterococcus faecalis	U
	Enterococcus faecium	R
	MSSA	S
	MRSA	R
	CA-MRSA	I
	Staph. Epidermidis	S
	C. jeikeium	R
	L. monocytogenes	S
Gram Negatives	N. gonorrhoeae	I
	N. meningitidis	S
	Moraxella catarrhalis	S
	H. influenzae	S
	E. coli	S
	Klebsiella sp	S
	E. coli/Klebsiella ESBL+	S
	E coli/Klebsiella KPC+	R
	Enterobacter sp, AmpC neg	S
	Enterobacter sp, AmpC pos	S
	Serratia sp	S
	Serratia marcescens	X1
	Salmonella sp	S
	Shigella sp	S
	Proteus mirabilis	S
	Proteus vulgaris	S
	Providencia sp.	S
	Morganella sp.	S
	Citrobacter freundii	S
	Citrobacter diversus	S
	Citrobacter sp.	S
	Aeromonas sp	S
	Acinetobacter sp.	I
	Pseudomonas aeruginosa	S
	Burkholderia cepacia	R
	Stenotrophomonas maltophilia	R
	Yersinia enterocolitica	S
	Francisella tularensis	X1
	Brucella sp.	X1
	Legionella sp.	S
	Pasteurella multocida	S
	Haemophilus ducreyi	X1
	Vibrio vulnificus	X1
Misc	Chlamydophila sp	S
	Mycoplasm pneumoniae	S
	Rickettsia sp	X1
	Mycobacterium avium	X1
Anaerobes	Actinomyces	R
	Bacteroides fragilis	R
	Prevotella melaninogenica	R
	Clostridium difficile	R
	Clostridium (not difficile)	I
	Fusobacterium necrophorum	X1
	Peptostreptococcus sp.	I

Key

• S susceptible/sensitive (usually)
• I intermediate (variably susceptible/resistant)
• R resistant (or not effective clinically)
• S+ synergistic with cell wall antibiotics
• U sensitive for UTI only (non systemic infection)
• X1 no data
• X2 active in vitro, but not used clinically
• X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
• X4 active in vitro, but not clinically effective for strep pneumonia

See Also

• Antibiotics (Main)

Source

• Micromedex

Authors

Ross Donaldson, Andy Gausepohl, Neil Young, Daniel Ostermayer