From the Guidelines
Ciprofloxacin (Cipro) is not recommended as a first-line treatment for Ureaplasma infections. The preferred antibiotics for Ureaplasma are doxycycline (100 mg twice daily for 7 days) or azithromycin (1.0–1.5 g p.o. SD), as suggested by the European Association of Urology guidelines on urological infections 1. Ciprofloxacin has poor activity against Ureaplasma species because these organisms lack the DNA gyrase enzyme that ciprofloxacin targets.
Key Points to Consider
- The European Association of Urology guidelines on urological infections do not recommend ciprofloxacin as a treatment option for Ureaplasma infections 1.
- Doxycycline and azithromycin are the preferred treatment options for Ureaplasma infections, with dosages of 100 mg twice daily for 7 days and 1.0–1.5 g p.o. SD, respectively 1.
- Ciprofloxacin is not effective against Ureaplasma species due to its mechanism of action, which targets the DNA gyrase enzyme that is lacking in these organisms.
- Treatment success rates with ciprofloxacin are low, with high rates of persistence and recurrence of infection.
- Many Ureaplasma infections are asymptomatic and don't always require treatment, and testing and treatment should be guided by clinical symptoms and consultation with a healthcare provider.
From the Research
Cipro Dosing for Ureaplasma Treatment
- The recommended dosage of Cipro (ciprofloxacin) for treating Ureaplasma infections is not well established, but several studies provide some guidance 2, 3, 4.
- One study found that a dose of 500 mg administered every 12 hours (the course dose of 5 g) resulted in eradication of ureaplasma in 71.4% of patients with gonorrhea association with ureaplasmosis 2.
- Another study found that the dosage regimen of 500 mg orally twice a day for seven days was only partially effective against Ureaplasma urealyticum 3.
- A study comparing the efficacy of ciprofloxacin with doxycycline in the treatment of non-gonococcal urethritis found that ciprofloxacin given in a dosage of 1 g for seven days was not effective in the treatment of non-gonococcal urethritis, and Ureaplasma urealyticum was isolated from eight patients on day 21 4.
- In vitro studies have shown that ciprofloxacin has activity against Ureaplasma urealyticum, but other fluoroquinolones such as levofloxacin and gemifloxacin may be more active 5, 6.
- The MIC90 values for U. urealyticum were found to be 4 mg/L for ciprofloxacin, compared to 1 mg/L for levofloxacin and 0.1-0.25 mg/L for gemifloxacin 5, 6.