Ciprofloxacin

C. diff Risk

High

Oral Bioavailability

Excellent

Approximate Cost

IV:$
PO:$

Dosing

Adult

PO: 500-750mg PO q12h

IV: 400mg IV q8-12h

General Information

Common Usage

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

Drug Monitoring

Laboratory

  • Consider periodic Cr and LFTs with prolonged use

Clinical

  • Hypersensitivity

  • GI effects

  • Drug interactions (warfarin),

  • Prolongation of QT interval (amiodarone),

  • CNS effects,

  • Photosensitivity

Adverse Effects

  • GI effects

  • Arthropathy (especially in pediatric patients)

  • Tendon rupture

  • Prolongation of QT interval

  • CNS effects

Major Interactions

CYP inhibitor - multiple interactions possible

QTc prolongation - Increased risk with other agents that prolong QTc

Di- & 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

Additional Information

Ciprofloxacin is associated with arthropathy and histological changes in weight-bearing joints of juvenile animals and is currently not FDA approved for pediatric use.

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