Criteria & Principles
Comparison of Fluoroquinolones:
FDA Black Box Warning: health care professionals should not prescribe systemic fluoroquinolones to patients who have other treatment options for acute bacterial sinusitis (ABS), acute bacterial exacerbation of chronic bronchitis (ABECB), and uncomplicated urinary tract infections (UTI) because the risks outweigh the benefits in these patients. Stop fluoroquinolone treatment immediately if a patient reports serious side effects, and switch to a non-fluoroquinolone antibacterial drug to complete the patient’s treatment course. These medicines are associated with disabling and potentially permanent side effects of the tendons, muscles, joints, nerves, and central nervous system (such as irreversible peripheral neuropathy) that can occur together in the same patient.
Usual Dose & Administration
Usual Adult Dose
250-750 mg q12h
Adjustment of Dose & Administration
Renal Adjustment
| Drug | Usual Dose | CrCl (mL/min) | ||
| >30 | 10-30 | <10, IHD | CRRT | |
| ciprofloxacin PO* | 250-500 mg q12h | 250-500 mg q24h | 250-500 mg q24h | 500 mg q12h |
| SBP prophylaxis | 500 mg q24h | 250 mg q24h | 250 mg q24h | 500 mg q24h |
|
Pseudomonas coverage Treatment of bone/joint infections** |
750 mg q12h | 750 mg q24h | 500 mg q24h | 750 mg q12h |
|
Non-TB Mycobacterium infection Non-Pseudomonal Bloodstream infection*** |
500-750 mg q12h | 500-750 mg q24h | 250-500 mg q24h | 500-750 mg q12h |
*250mg dose usually reserved for treatment of uncomplicated cystitis. Most other indications recommend 500 mg dose.
**ciprofloxacin 750mg dose used for osteomyelitis treatment to optimize bone penetration
***750 mg dose may be considered in obese patients and/or complicated bloodstream infections with an uncontrolled source of infection (e.g., liver abscess)
Drug-Specific Information
Separate this medication by 2 hours before or 6 hours after the oral form of iron products; antacids containing aluminum, magnesium, or calcium; multivitamins containing zinc; oral nutritional supplements; or tube feedings, all of which may bind with this medication.
Cost Index
$ (1-10)
General Notes
- Up-to-date cost information, click here
- IV antimicrobials outpatient (OPAT) dosing, click here
- Obesity dosing weight recommendations here
- Helpful drug-drug interaction check website here
- When dosing guidance is provided it is important to note the following:
Fixed (ie non weight-based) doses in adults are historically based on a 70 kg patient. Specific disease states or individual patients may warrant dosages that differ from the above recommendations. Since product-specific criteria for dose adjustment based on creatinine clearance exist, consult product information regarding specific recommendations for dosage adjustment based on estimated creatinine clearance.