Ofloxacin (Oflox) Dosing Recommendations
The standard recommended dosing for ofloxacin is 200-400 mg orally every 12 hours, with specific dosages varying based on the type of infection being treated. 1
Infection-Specific Dosing
Sexually Transmitted Infections
- For nongonococcal cervicitis/urethritis due to C. trachomatis: 300 mg orally every 12 hours for 7 days 1
- For mixed infection of the urethra and cervix due to C. trachomatis and N. gonorrhoeae: 300 mg orally every 12 hours for 7 days 1
- For acute, uncomplicated urethral and cervical gonorrhea: 400 mg as a single dose 1
- For nongonococcal urethritis: 300 mg orally twice daily for 7 days (alternative regimen) 2
Pelvic Inflammatory Disease
- For acute pelvic inflammatory disease (oral treatment): 400 mg orally twice daily for 14 days 2
- For parenteral treatment: 400 mg IV every 12 hours, typically with metronidazole 500 mg IV every 8 hours 2
Urinary Tract Infections
- For uncomplicated cystitis due to E. coli or K. pneumoniae: 200 mg orally every 12 hours for 3 days 1
- For uncomplicated cystitis due to other approved pathogens: 200 mg orally every 12 hours for 7 days 1
- For complicated UTIs: 200 mg orally every 12 hours for 10 days 1
- For prostatitis due to E. coli: 300 mg orally every 12 hours for 6 weeks 1
Respiratory Infections
- For acute bacterial exacerbation of chronic bronchitis: 400 mg orally every 12 hours for 10 days 1
- For community-acquired pneumonia: 400 mg orally every 12 hours for 10 days 1
Skin and Skin Structure Infections
- For uncomplicated skin and skin structure infections: 400 mg orally every 12 hours for 10 days 1
Special Dosing Considerations
Renal Impairment
- For patients with creatinine clearance 20-50 mL/min: maintain usual dose but extend interval to every 24 hours 1
- For patients with creatinine clearance <20 mL/min: reduce dose by 50% and administer every 24 hours 1
Hepatic Impairment
- For patients with severe liver function disorders (e.g., cirrhosis with or without ascites): maximum daily dose should not exceed 400 mg 1
Administration Considerations
- Antacids containing calcium, magnesium, or aluminum; sucralfate; divalent or trivalent cations such as iron; multivitamins containing zinc; or didanosine should not be taken within 2 hours before or after taking ofloxacin 1
- Ofloxacin has almost complete bioavailability (95-100%), with peak serum concentrations of 2-3 mg/L after a 400mg oral dose 3
- The average half-life is 5-8 hours, with elimination highly dependent on renal clearance 3
Clinical Efficacy
- Ofloxacin has demonstrated efficacy in various infections with response rates ranging from 70-91% in clinical trials 4, 5
- For respiratory infections, efficacy rates of approximately 80.7% have been reported 6
- In complicated urinary tract infections, excellent to moderate responses were observed in 91% of patients after 14 days of treatment 4
Common Pitfalls and Caveats
- When treating PID, ofloxacin lacks adequate anaerobic coverage; consider adding metronidazole for complete coverage 2
- Resistance during therapy may develop, particularly with Pseudomonas aeruginosa (reported rate of 17.9%) 5
- Monitor for adverse effects, which may include gastrointestinal disturbances (4.5%), hypersensitivity reactions (0.5%), and central nervous system effects such as dizziness (2.3%) 6