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Ciprofloxacin

Urinary tract infections, Intra-abdominal infections (with metronidazole), Pyelonephritis

Indications

  • Urinary tract infections
  • Intra-abdominal infections (with metronidazole)
  • Pyelonephritis

Adult dosing

  • uti: dose: 500; unit: mg PO BID; route: PO; interval: BID x 7 days; fixed: true; iv: dose: 400; unit: mg IV; route: IV; interval: q12h; fixed: true; severe: dose: 400; unit: mg IV; route: IV; interval: q8h; fixed: true

Pediatric dosing

  • standard: dose: 10; unit: mg/kg; maxDose: 400; maxDoseAbsolute: true; route: IV; interval: q12h; weightBased: true; pedNote: Generally avoid in children <18 years — cartilage toxicity risk; use only when no alternative

Contraindications

  • Concurrent tizanidine
  • QT prolongation risk
  • Tendon rupture history with fluoroquinolones

Clinical pearls

  • FDA black box: risk of tendon rupture, peripheral neuropathy, CNS effects
  • Avoid in patients on theophylline — significant interaction
  • Excellent gram-negative coverage but does NOT cover anaerobes
  • Pair with metronidazole for intra-abdominal infections

Source and review

  • IDSA UTI Guidelines; Sanford Guide. Last reviewed: 2024-11-01