Ciprofloxacin Dosage Guidelines
The recommended dosage of ciprofloxacin for treating bacterial infections varies by infection type, with standard adult dosing being 500 mg orally every 12 hours for most common infections, while more severe infections may require 750 mg every 12 hours or 400 mg IV every 8-12 hours. 1
Adult Dosing Recommendations
Oral Administration
- Uncomplicated infections: 250-500 mg every 12 hours
- Complicated infections: 500-750 mg every 12 hours
- Uncomplicated gonorrhea: Single 250 mg dose 2
- Anthrax post-exposure prophylaxis: 500 mg every 12 hours for 60 days 1
Intravenous Administration
- Standard dosing: 400 mg every 8-12 hours 3
- Severe infections: 400 mg every 8 hours 2
- Life-threatening infections: Initial loading dose of 600 mg every 12 hours on day 1, followed by 400 mg every 12 hours 3
Pediatric Dosing Recommendations
- Children aged ≥1 month to ≤17 years: 10 mg/kg every 8 or 12 hours IV or 15 mg/kg every 8 or 12 hours orally 2
- Maximum doses:
- IV: 400 mg/dose
- Oral: 500 mg/dose every 8 hours or 750 mg/dose every 12 hours 2
- Important note: Ciprofloxacin should only be used in children when benefits outweigh risks due to potential effects on developing joints/cartilage 1
Infection-Specific Dosing
Urinary Tract Infections
- Uncomplicated UTI: 100 mg twice daily for 3 days is the minimum effective dose 4
- Complicated UTI: 500 mg every 12 hours for 7-14 days 5
Respiratory Infections
- Standard dosing: 500-750 mg every 12 hours for 7-14 days 6
Skin and Soft Tissue Infections
- Standard dosing: 750 mg every 12 hours 6
Bone and Joint Infections
- IV therapy: 400 mg every 12 hours, followed by oral therapy 7
- Oral therapy: 500-750 mg every 12 hours for extended periods (often 6-8 weeks) 7
Plague Treatment
- Adults: 400 mg every 8 hours IV or 750 mg every 12 hours orally 2
Special Considerations
Renal Impairment
- Dosage adjustment required as ciprofloxacin is primarily eliminated by renal excretion 1
- For creatinine clearance <30 mL/min: reduce dose by 50%
Duration of Therapy
- Continue treatment for at least 2 days after signs and symptoms of infection have disappeared 1
- For most infections, 7-14 days is sufficient
- Certain infections (osteomyelitis, prostatitis) require longer treatment courses
Potential Pitfalls
- Inadequate dosing: May lead to treatment failure and promote antimicrobial resistance 1
- Drug interactions: Administration with products containing divalent cations (calcium, magnesium, aluminum) significantly reduces absorption; space doses by at least 2 hours 1
- Inappropriate use in children: Use only when benefits outweigh risks of potential joint/cartilage effects 1
- Inadequate duration: Stopping therapy too soon may lead to relapse 1
Administration Considerations
- Oral ciprofloxacin can be taken with or without food
- Maintain adequate hydration during therapy to prevent crystalluria
- IV infusion should be administered over 60 minutes to reduce the risk of vein irritation
The dosing recommendations above represent current guidelines based on clinical evidence, with the goal of achieving optimal therapeutic outcomes while minimizing adverse effects and antimicrobial resistance.