Ciprofloxacin

Restricted
Restricted

C. diff Risk

High

Oral Bioavailability

Excellent

Approximate Cost

Dosing

Adult

Reserved for Pediatrics

Pediatric

Fluoroquinolones should be avoided in pediatric patients whenever possible

Mild to moderate infections
10 mg/kg/dose PO every 12 hr (500 mg/dose max)

Severe infections
15-20 mg/kg/dose PO every 12 hr (750 mg/dose max)

10 mg/kg/dose IV every 8-12 hr (400 mg/dose max)

General Information

Common Usage

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

Drug Monitoring

Clinical

  • Monitor QTc in patients with increased risk

  • Increased INR (warfarin)

  • Hypersensitivity

  • GI effects

  • tendonitis

Adverse Effects

  • QTc prolongation

  • Dysglycemia

  • Tendinopathy and rupture

  • GI upset

  • Rash

  • Retinal detachment

  • CNS toxicity including confusion, psychosis

  • Weakness exacerbation in myasthenia gravis

Major Interactions

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

Pharmacology

Antimicrobial class: Fluoroquinolone

Pregnancy category: C

Average serum half life: 4 hours

Biliary penetration: Therapeutic

CSF penetration: Moderate

Lung penetration: Therapeutic

Urine penetration: Therapeutic