Ciprofloxacin

제한된
0
C. difficile 위험도
High
경구생체이용률
Excellent

Dosing

Mild or moderate UTISevere UTIMild or moderate pneumoniaSevere or complicated pneumoniaHAPMild or moderate SSTISevere or complicated SSTIMild or moderate bone & joint infectionSevere or complicated bone & joint infectionComplicated intraabdominal infectionAcute bacterial sinusitisChronic bacterial prostatitis200 mg IV q12h x7-14d400 mg IV q8-12h x7-14d400 mg IV q12h x7-14d400 mg IV q8h x7-14d400 mg IV q8h x10-14d400 mg IV q12h x7-14d400 mg IV q8h x7-14d400 mg IV q12h x≥4-6w400 mg IV q8h x≥4-6w400 mg IV q12h x7-14d400 mg IV q12h x10d400 mg IV q12h x4w

CystitisMild or moderate UTISevere or complicated UTIChronic bacterial prostatitisMild or moderate pneumoniaSevere or complicated pneumoniaAcute bacterial sinusitisMild or moderate SSTISevere or complicated SSTIMild or moderate bone & joint infectionSevere or complicated bone & joint infectionComplicated intraabdominal infectionInfectious diarrheaMild or moderate typhoid feverGonococcal urethritis, cervicitisInhalation anthrax PEP250 mg PO q12h x3d250 mg PO q12h x7-14d500 mg PO q12h x7-14d500 mg PO q12h x4w500 mg PO q12h x7-14d750 mg PO q12h x7-14d500 mg PO q12h x10d500 mg PO q12h x7-14d750 mg PO q12h x7-14d500 mg PO q12h x≥4-6w750 mg PO q12h x≥4-6w500 mg PO q12h x7-14d500 mg PO q12h x5-7d500 mg PO q12h x10d250 mg PO 1 dose500 mg PO q12h x60d

Complicated UTIInhalation anthrax PEPSafety and efficacy in pediatric patients <18y of age have not been established

Ciprofloxacin should be used as an alternative option for complicated UTI in pediatric patients aged 1-17y and for inhalation anthrax PEP6-10 mg/kg IV q8h x10-21d (max 400 mg/dose) 10 mg/kg IV q12h x60d (max 400 mg/dose)

Complicated UTIInhalation anthrax PEP10-20 mg/kg PO q12h x10-21d (max 750 mg/dose)15 mg/kg PO q12h x60d (max 500 mg/dose)

No dose adjustment

CrCl >30CrCl 5-29HDCRRTNo dose adjustment200-400 mg IV q18-24h400 mg q24h (dose AD on dialysis days)200-400 mg q12h

CrCl >50CrCl 30-50CrCl 5-29CAPDNo dose adjustment250-500 mg PO q12h250-500 mg PO q18h250-500 mg PO q24h

General Information

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

Black Box Warning: Fluoroquinolones, including ciprofloxacin, are associated with disabling and potentially irreversible serious adverse reactions, including tendinitis and tendon rupture, peripheral neuropathy, and CNS effects; discontinue and avoid use if adverse reactions occur. Avoid use in patients with known history of myasthenia gravis.

Monitor QTc in patients with increased risk.

Perform culture and susceptibility tests prior to and during therapy.

Monitor renal funcion and signs of hypersensitivity.

  • 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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