Class: Fluoroquinolone Antibiotic
Dosage Forms. Microcapsules for Suspension: 250 mg/5 mL, 500 mg/5 mL; Tablet: 100 mg, 250 mg, 500 mg, 750 mg; Tablet Extended Release: 500 mg, 1000 mg
Common FDA Label Indication, Dosing, and Titration.
1. Anthrax, post exposure prophylaxis: Adults, 500 mg po q12h × at least 60 d, Children, 15 mg/kg po bid × at least 60 d, max 500 mg/dose
2. Bacterial prostatitis, chronic: 500 mg po q12h × 28 d
3. Bronchitis, lower respiratory tract infection, infection of bone, skin, or soft tissue, sinusitis: 500-750 mg po q12h × 7-14 d
4. Urinary tract infectious disease: 250-500 mg po q12h or 500 mg (extended release formulation) q24h × 3 d
Off-Label Uses.
1. Chancroid: 500 mg po bid × 3 d
2. Granuloma inguinale: 750 mg bid × at least 21 d MOA: Ciprofloxacin is a fluoroquinolone that inhibits bacterial DNA gyrase. It is highly active against aerobic, Gram-negative bacilli.
Drug Characteristics: Ciprofloxacin Oral
Medication Safety Issues: Ciprofloxacin Oral
Drug Interactions: Ciprofloxacin Oral
Adverse Reactions: Ciprofloxacin Oral
Efficacy Monitoring Parameters. Resolution of signs and symptoms of infection.
Toxicity Monitoring Parameters. Baseline SCr. If obtained, levels should be between 0.5 mcg/mL and 5 mcg/mL.
Key Patient Counseling Points. Seek medical attention if decreased urination, yellowing of eyes, blistering skin rash or extreme fatigue, unusual bruising or bleeding, shortness of breath or chest pain, tendon pain. Take with or without food, but not with milk, yogurt, or other dairy products or calcium-fortified products. If using antacids, sucralfate, or mineral supplements and multivitamins with calcium, iron, or zinc, take ciprofloxacin at least 2 h before or 6 h after these medicines.
Clinical Pearls. Not approved in children under 18 y except for anthrax and complicated UTIs. Requires medication guide when dispensed.