What is the age-specific dosing for ciprofloxacin (fluoroquinolone antibiotic)?

Age-Specific Dosing for Ciprofloxacin

The recommended dosage of ciprofloxacin for children is 10-15 mg/kg every 12 hours orally or 10 mg/kg every 8-12 hours intravenously, not to exceed 1 g per day. 1, 2

Pediatric Dosing

• For neonates, the American Academy of Pediatrics recommends 15 mg/kg twice daily 1
• For children, the standard dosage is 20-30 mg/kg/day divided every 12 hours 3
• For children with complicated urinary tract infections, 15-20 mg/kg orally every 12 hours is recommended 4
• For intravenous administration in children, 10-15 mg/kg every 8-12 hours is appropriate 2

Adult Dosing

• Standard adult dosing ranges from 250-750 mg orally every 12 hours, depending on infection severity 5
• For uncomplicated urinary tract infections in adults, short-course therapy of 500 mg once daily for 3 days is effective 6
• For complicated infections in critically ill adults, dosing should be based on renal function and pathogen susceptibility 7

Dosing Considerations by Age Group

Neonates and Infants (0-3 months)

• 15 mg/kg twice daily 1, 2
• Careful monitoring of renal and hepatic function is essential 2

Children (3 months-12 years)

• 10-15 mg/kg every 12 hours orally 1, 2
• 20-30 mg/kg/day total daily dose 3
• Maximum daily dose: 1 g regardless of weight 2

Adolescents (13+ years)

• Can use adult dosing guidelines if weight appropriate 3
• 500-750 mg twice daily for most infections 5

Special Considerations

• Renal function adjustment: Fat-free mass and glomerular filtration rate are significant factors affecting ciprofloxacin clearance 4
• For Pseudomonas aeruginosa infections, higher doses may be required (at least 20 mg/kg orally in children) 4
• For severe infections with poor clinical response, therapeutic drug monitoring should be considered 1
• Target serum levels for 500 mg twice daily: trough level 1 mg/L, peak level 3 mg/L 1

Monitoring Recommendations

• ECG monitoring at baseline, 2 weeks, and after addition of any new medication known to prolong QT interval 1
• Blood glucose monitoring in diabetic patients due to risk of hypoglycemia 1
• Regular monitoring of hepatic and renal function throughout treatment 1, 2

Common Adverse Effects

• Gastrointestinal symptoms: nausea, vomiting, diarrhea, abdominal pain (4.9% incidence) 8
• Central nervous system effects: headache, dizziness (1.5% incidence) 8
• Dermatological reactions: rash, photosensitivity (1.1% incidence) 8
• Most adverse reactions are mild to moderate in severity (94%) 8

Important Cautions

• Consultation with a pediatric infectious disease specialist is recommended before initiating ciprofloxacin in young children 2
• Treatment discontinuation due to side effects occurs in approximately 1.5% of patients, primarily due to gastrointestinal reactions 8
• QT prolongation is a serious potential adverse effect requiring monitoring 1