Ciprofloxacin Dosage and Treatment Duration Guidelines
The standard adult dosage for ciprofloxacin is 500 mg orally twice daily for 7-14 days for most infections, with specific durations and dosages varying by infection type and severity. 1
Adult Dosing Guidelines by Infection Type
Urinary Tract Infections
- For uncomplicated UTIs: 250-500 mg twice daily for 3 days 2, 3
- For complicated UTIs: 500 mg twice daily for 7-14 days 1
- For acute pyelonephritis: 500 mg twice daily for 7 days, with or without an initial 400 mg IV dose 2
Respiratory Tract Infections
- Mild/Moderate: 500 mg twice daily for 7-14 days 1
- Severe/Complicated: 750 mg twice daily for 7-14 days 1
Skin and Skin Structure Infections
- Mild/Moderate: 500 mg twice daily for 7-14 days 1
- Severe/Complicated: 750 mg twice daily for 7-14 days 1
Bone and Joint Infections
- Mild/Moderate: 500 mg twice daily for ≥4-6 weeks 1
- Severe/Complicated: 750 mg twice daily for ≥4-6 weeks 1, 2
Gastrointestinal Infections
- Infectious Diarrhea: 500 mg twice daily for 5-7 days 1
- Typhoid Fever: 500 mg twice daily for 10 days 1
Sexually Transmitted Infections
Special Situations
- Anthrax (post-exposure): 500 mg twice daily for 60 days 2
- Chronic Bacterial Prostatitis: 500 mg twice daily for 28 days 1
Pediatric Dosing
- 10-15 mg/kg every 12 hours (not to exceed 1 g per day) 2
- For anthrax exposure in children: 10-15 mg/kg every 12 hours for 60 days 2
Dosing in Renal Impairment
- CrCl >50 mL/min: Standard dosing 1
- CrCl 30-50 mL/min: 250-500 mg every 12 hours 1
- CrCl 5-29 mL/min: 250-500 mg every 18 hours 1
- Hemodialysis/Peritoneal dialysis: 250-500 mg every 24 hours (after dialysis) 1
Administration Considerations
- Take at least 2 hours before or 6 hours after antacids, sucralfate, or products containing calcium, iron, or zinc 1
- Can be taken with or without food, though taking with food may minimize gastrointestinal discomfort 4
- If IV administration is needed initially, can switch to oral therapy when clinically appropriate 1, 5
Important Cautions
- Fluoroquinolones should be reserved for infections where other antibiotics cannot be used due to concerns about resistance development 2
- Monitor for adverse effects including tendinitis, tendon rupture, peripheral neuropathy, and CNS effects 6
- Use with caution in children due to potential effects on developing cartilage, though benefit may outweigh risk in serious infections 2
Conversion from IV to Oral Therapy
- 250 mg oral tablet q12h is equivalent to 200 mg IV q12h 1
- 500 mg oral tablet q12h is equivalent to 400 mg IV q12h 1
- 750 mg oral tablet q12h is equivalent to 400 mg IV q8h 1
Remember that ciprofloxacin is rapidly and well absorbed from the gastrointestinal tract, making oral therapy an effective option once the patient is stable 2, 5.