From the Research
The recommended meningeal dose of ciprofloxacin (Cipro) is 400 mg intravenously every 8 hours for adults, as this dose has been shown to achieve adequate cerebrospinal fluid (CSF) levels and effectively treat gram-negative bacillary meningitis 1.
Key Considerations
- The dose of 400 mg every 8 hours is preferred for severe infections or immunocompromised patients, as it provides higher peak concentrations and better coverage against less susceptible pathogens 2.
- Ciprofloxacin should be administered as a slow infusion over 60 minutes to minimize vascular irritation.
- The duration of therapy typically ranges from 10-14 days, depending on the causative organism and clinical response.
- Renal function should be monitored, and dosage adjustments may be necessary in patients with impaired kidney function, as higher doses may be required to achieve adequate target attainment in patients with high renal clearance 3.
Mechanism of Action
- Ciprofloxacin works by inhibiting bacterial DNA gyrase and topoisomerase IV, which are essential for bacterial DNA replication.
Important Notes
- Ciprofloxacin is not considered first-line therapy for most cases of bacterial meningitis; it's typically used when the causative organism is known to be susceptible to fluoroquinolones or in cases of allergy or resistance to standard therapies like ceftriaxone and vancomycin.
- The use of ciprofloxacin for meningococcal disease prophylaxis has been evaluated, and it has been shown to be effective in eradicating N. meningitidis, but its use should be considered in the context of local resistance patterns and treatment guidelines 4.