Antimicrobials
Ciprofloxacin

Ciprofloxacin

Restricted

High
Excellent
PO:$ IV:$$

Spectrum of Activity

General Information

  • Dog bite/cat bite: Penicillin allergic patients
  • Human Bite: Penicillin allergic patients
  • Puncture would of foot (sneakers): Significant Beta-lactam allergy: Ciprofloxacin + Tobramycin
  • Perforated appendix/bowel PO stepdown in children 5 years and older: Ciprofloxacin PO + Metronidazole PO
  • Urinary Tract Infection: Beta-lactam allergy in >1 month of age: Ciprofloxacin
  • Cephalexin and Ciprofloxacin do not cover Enterococcus spp.

Limited Use Product (tablets)

  • QTc prolongation
  • Dysglycemia
  • CNS toxicity including confusion, psychosis
  • Tendinopathy and rupture
  • GI upset
  • Weakness exacerbation in myasthenia gravis
  • Rash
  • Retinal detachment

Monitor renal, hepatic, and hematopoietic function periodically; monitor number and type of stools/day for diarrhea

  • Strong CYP1A2 inhibitor and weak CYP3A4 inhibitor - Multiple interactions possible
  • QTc prolongation - Increased risk with other agents that prolong QTc
  • AVOID concomitant administration with antacids, multivitamin & mineral supplements. Space doses by 2 hours
  • Increased risk of tendon rupture with concomitant use of corticosteroids
  • Monitor INR with warfarin
  • Check for drug interactions prior to use
  • Avoid concurrent administration with antacids, iron

    • May decrease clearance of warfarin, tacrolimus, cyclosporine, other drugs
  • Use with caution in patients with seizure disorders

  • Monitor for arthralgias, tendonitis

  • Maintain adequate fluid intake to prevent crystalluria