Ciprofloxacin

C difficile risk
High
Oral Bioavailability
Excellent
Cost
Oral: <$1/day IV: $4-7/day

Dosing

CrCl <10CrCl 10 - 29400mg IV q24h

500mg PO q24h400mg IV q12-24h

500-750mg PO q24h

400mg IV or 500mg PO q24h

Dose after HD on dialysis days

400mg IV q12h

PO: 500-750mg po q12h

IV: 400mg IV q8-12h

Note: to cover Pseudomonas use max dosing (oral 750 mg po q12 or intravenous 400 mg q8h)

Standard dosing PO: 30-40 mg/kg/day divided q12h IV: 30 mg/kg/day divided q8-12h

Cystic Fibrosis PO: 40 mg/kg/day divided q12h IV: 30 mg/kg/day divided q8h

General Information

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

Monitor QTc in patients with increased risk

  • QTc prolongation

  • Dysglycemia

  • Tendinopathy and rupture

  • GI upset

  • Rash

  • Retinal detachment

  • CNS toxicity including confusion, psychosis

  • Weakness exacerbation in myasthenia gravis

CYP1A2 inhibitor - Multiple interactions possible.

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

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

Cyclosporine - Increased levels of cyclosporine

Warfarin - Increased INR

Methadone - Lowered seizure threshold

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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