Ciprofloxacin

C difficile risk
High
Oral Bioavailability
Excellent

Dosing

  • PNA/Bone-Joint/Febrile Neutropenia: 400 mg IV q8h, 750 mg PO q12h

  • Pyelo/Severe UTI, IAI: 400 mg IV q12h, 500 mg PO q12h

  • Cystitis: 200 mg IV q12h, 250 mg PO q12h

CrCl <30CrCl 50-30CrCl > 50- 400mg IV q24h

  • 500mg PO q24h- PNA/Bone-Joint/Febrile Neutropenia: 400 mg IV q12h, 500-750 mg PO q24h

  • Pyelo/Severe UTI, IA: 400 mg IV q24h, 500 mg PO q24h

  • Cystitis: 200 mg IV q24h, 250 mg PO q24hUsual adult dose

400mg IV or 500mg PO q24h

Dose after HD on dialysis days

400mg IV q12h

General Information

Pseudomonal and other gram negative infections of urinary tract, bone/joint, abdomen and other sites

Monitor QTc in patients with increased risk

  • GI upset

  • Black Box: Tendinopathy and rupture. Potentially permanent and disabling damage to tendons, muscles, joints, and nervous system including peripheral neuropathies.

  • C. difficile infection

  • CNS toxicity including fatigue, confusion, memory impairment, delirium, psychosis

  • Cardiac: QTc prolongation and risk for aortic aneurysm and dissection

  • Severe blood glucose disturbances, including hypoglycemic coma

  • Weakness exacerbation in myasthenia gravis

  • CYP1A2 inhibitor – increases plasma concentrations of CYP1A2 substrates (examples: Zyprexa, Clozaril, melatonin, Requip, mirtazapine, tizanidine, triamterene, theophylline)

  • Warfarin - Increased INR

  • Divalent & trivalent cations including Al, Ca, Fe, Mg (antacids, dairy products, iron supplements, some enteral feeds) - Decreased absorption

  • Cyclosporine - Increased levels of cyclosporine

  • Methadone - Lowered seizure threshold

  • Oral antidiabetic agents – increased risk of hyper and hypoglycemia, including hypoglycemic coma

  • QTc prolongation - Increased risk with other agents that prolong QTc

Antimicrobial class: Fluoroquinolone

Pregnancy category: C

Average serum half life: 4 hours

Biliary penetration: Therapeutic

CSF penetration: Moderate

Lung penetration: Therapeutic

Urine penetration: Therapeutic

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