What are the typical doses of Ofloxacin for adults and pediatric patients?

Ofloxacin Dosing for Adults and Pediatric Patients

For adults, ofloxacin should be dosed at 400 mg orally every 12 hours, while pediatric patients should receive 7.5 mg/kg every 12 hours orally (maximum 400 mg per dose). 1

Adult Dosing

Ofloxacin dosing for adults varies by indication:

• Standard adult dose: 400 mg orally every 12 hours 2
• Specific indications:
  • Acute bacterial exacerbation of chronic bronchitis: 400 mg every 12 hours for 10 days
  • Community-acquired pneumonia: 400 mg every 12 hours for 10 days
  • Uncomplicated skin infections: 400 mg every 12 hours for 10 days
  • Acute uncomplicated gonorrhea: 400 mg as a single dose
  • Nongonococcal urethritis/cervicitis: 300 mg every 12 hours for 7 days
  • Pelvic inflammatory disease: 400 mg every 12 hours for 10-14 days
  • Uncomplicated cystitis: 200 mg every 12 hours for 3-7 days (depending on pathogen)
  • Prostatitis: 300 mg every 12 hours for 6 weeks 2

Pediatric Dosing

• Standard pediatric dose: 7.5 mg/kg every 12 hours orally (maximum 400 mg per dose) 1
• Important considerations:
  • Long-term use in children and adolescents requires careful evaluation due to concerns about effects on bone and cartilage growth
  • Generally used as an alternative agent when other options are not suitable
  • Not recommended for adolescents ≤17 years of age except in specific circumstances 3, 1

Dosage Adjustments for Special Populations

Renal Impairment

• Creatinine clearance 20-50 mL/min: Normal dose once daily
• Creatinine clearance <20 mL/min: Half the usual dose once daily 2

Hepatic Impairment

• Severe liver function disorders: Maximum dose should not exceed 400 mg per day 2

Administration Considerations

• Antacids containing calcium, magnesium, or aluminum; sucralfate; divalent or trivalent cations (iron, zinc); or didanosine should not be taken within 2 hours before or after ofloxacin 1, 2
• For pediatric patients requiring liquid formulation, alternative antibiotics should be considered as ofloxacin oral suspension is not widely available 1

Monitoring and Precautions

• Monitor for adverse effects including:
  • Gastrointestinal disturbances (nausea, bloating: 0.5-1.8% of patients)
  • Neurologic effects (dizziness, insomnia, tremulousness, headache: 0.5%)
  • Cutaneous reactions (rash, pruritus, photosensitivity: 0.2-0.4%) 3
• Ofloxacin should be avoided during pregnancy due to potential teratogenic effects 3
• The drug is not recommended for children except in cases of multidrug-resistant infections where benefits clearly outweigh risks 1

Clinical Pearls

• Ofloxacin penetrates CSF at 16-20% of serum concentration when meninges are inflamed 3
• The drug is primarily cleared by the kidney (80%), requiring dose adjustment in renal impairment 3
• For complicated urinary tract infections, some clinicians have used 200 mg three times daily (600 mg total daily dose) with good efficacy 4, though the FDA-approved dosing is 200 mg twice daily 2