What is the recommended dosage and treatment duration of Cipro (ciprofloxacin) for bacterial infections?

Ciprofloxacin Dosage and Treatment Duration for Bacterial Infections

For bacterial infections, ciprofloxacin should be administered at 250-750 mg orally twice daily for 7-14 days for most infections, with specific dosages and durations based on infection type and severity. 1

Standard Adult Dosing Regimens

Oral Administration

• Mild to Moderate Infections: 500 mg every 12 hours 1
• Severe/Complicated Infections: 750 mg every 12 hours 1

Intravenous Administration

• Severe Infections: 400 mg every 8-12 hours 2
• IV to Oral Conversion:
  • 200 mg IV q12h = 250 mg oral q12h
  • 400 mg IV q12h = 500 mg oral q12h
  • 400 mg IV q8h = 750 mg oral q12h 1

Infection-Specific Dosing

Infection Type	Severity	Dose	Frequency	Duration
Lower Respiratory Tract	Mild/Moderate	500 mg	q12h	7-14 days
Lower Respiratory Tract	Severe/Complicated	750 mg	q12h	7-14 days
Urinary Tract	Uncomplicated	250 mg	q12h	3 days
Urinary Tract	Complicated	500 mg	q12h	7-14 days
Skin/Skin Structure	Mild/Moderate	500 mg	q12h	7-14 days
Skin/Skin Structure	Severe/Complicated	750 mg	q12h	7-14 days
Bone and Joint	Mild/Moderate	500 mg	q12h	≥4-6 weeks
Bone and Joint	Severe/Complicated	750 mg	q12h	≥4-6 weeks
Intra-Abdominal*	Complicated	500 mg	q12h	7-14 days
Infectious Diarrhea	Mild/Moderate/Severe	500 mg	q12h	5-7 days
Typhoid Fever	Mild/Moderate	500 mg	q12h	10 days
Chronic Bacterial Prostatitis	Mild/Moderate	500 mg	q12h	28 days
Acute Sinusitis	Mild/Moderate	500 mg	q12h	10 days
Gonococcal Infections	Uncomplicated	250 mg	Single dose	Single dose
Inhalational Anthrax	Post-exposure	500 mg	q12h	60 days

*Used in conjunction with metronidazole 1

Pediatric Dosing

• Children (≥1 month to ≤17 years): 10-15 mg/kg every 12 hours orally (not to exceed 1 g/day) 2
• Intravenous: 10 mg/kg every 8 or 12 hours 2

Dosing in Renal Impairment

Creatinine Clearance	Recommended Dose
>50 mL/min	Standard dosage
30-50 mL/min	250-500 mg q12h
5-29 mL/min	250-500 mg q18h
Hemodialysis/Peritoneal dialysis	250-500 mg q24h (after dialysis)

1

Important Administration Guidelines

1. Administer at least 2 hours before or 6 hours after:

   • Magnesium/aluminum antacids
   • Sucralfate
   • Products containing calcium, iron, or zinc 1

2. Continue treatment for at least 2 days after signs and symptoms of infection have disappeared 1

Clinical Pearls and Pitfalls

• Oral Bioavailability: Oral ciprofloxacin is rapidly and well absorbed with maximum serum concentrations attained 1-2 hours after dosing 2
• Treatment Duration: Inadequate duration can lead to relapse; continue for at least 2 days after clinical improvement 1
• Special Populations:
  • Pregnancy: Not recommended during pregnancy unless benefits outweigh risks for life-threatening infections 3
  • Children: Use only when benefits outweigh risks due to potential effects on developing joints/cartilage 2
• Resistance Prevention: Inadequate dosing may lead to treatment failure and promote antimicrobial resistance 2

Evidence Quality Assessment

The FDA drug label 1 and CDC guidelines 2 provide the most authoritative and recent recommendations for ciprofloxacin dosing. These guidelines are consistent with clinical trial data showing efficacy of standard twice-daily dosing for most infections, with duration tailored to infection type and severity.