From the Guidelines
Ciprofloxacin eye drops should be administered every hour for the treatment of bacterial keratitis, particularly for central or severe cases.
Key Considerations
- The frequency of administration may vary depending on the severity of the infection, with a loading dose of every 5 to 15 minutes possible in severe cases 1.
- Ciprofloxacin 0.3% is an approved treatment for bacterial keratitis, with efficacy comparable to other fluoroquinolones such as ofloxacin and levofloxacin 1.
- It is essential to note that the prevalence of resistance to fluoroquinolones, including ciprofloxacin, appears to be increasing, with individual risk factors such as recent fluoroquinolone use and hospitalization 1.
- In general, antibiotic eye drops should not be tapered below 3 to 4 times a day to minimize the risk of developing antibiotic resistance 2.
- The treatment regimen should be guided by the severity of the infection, the presence of virulent organisms, and the patient's immune status.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION Corneal Ulcers: The recommended dosage regimen for the treatment of corneal ulcersis two drops into the affected eye every 15 minutes for the first six hours and then two drops into the affected eye every 30 minutes for the remainder of the first day. On the second day, instill two drops in the affected eye hourly On the third through the fourteenth day, place two drops in the affected eye every four hours. Bacterial Conjunctivitis: The recommended dosage regimen for the treatment of bacterial conjunctivitisis one or two drops instilled into the conjunctival sac(s) every two hours while awake for two days and one or two drops every four hours while awake for the next five days.
The recommended frequency for Ciprofloxacin (ciprofloxacin) eye drops is:
- Corneal Ulcers:
- Every 15 minutes for the first 6 hours
- Every 30 minutes for the remainder of the first day
- Hourly on the second day
- Every 4 hours on the third through fourteenth day
- Bacterial Conjunctivitis:
- Every 2 hours while awake for the first 2 days
- Every 4 hours while awake for the next 5 days 3
From the Research
Recommended Frequency for Ciprofloxacin Eye Drops
The recommended frequency for ciprofloxacin eye drops can be determined based on the available studies.
- The study 4 found that the dose frequency for 0.3% ciprofloxacin has a pharmacodynamic basis, which is related to the required Minimum Inhibitory Concentration90 (MIC90) of commonly encountered isolates in bacterial keratitis.
- The study 5 used a dosing schedule of 1 to 2 drops of ciprofloxacin every 30 minutes for 6 hours, then hourly for the remainder of day 1, and found that ciprofloxacin monotherapy is equivalent clinically and statistically to the standard therapy regimen of fortified antibiotics.
- The study 6 derived evidence-based clinically applicable minimum drop-regimes for the treatment of bacterial keratitis on Day-1, and found that lower numbers of drops of ciprofloxacin on Day-1 were significantly associated with increased treatment failure rates.
- The study 6 also found that the derived minimum number of drops on Day-1 for ciprofloxacin was 47 drops.
- The study 7 focused on the pharmacokinetics of ciprofloxacin in the human eye, and did not provide information on the recommended frequency for ciprofloxacin eye drops.
- The study 8 discussed the safety of oral ciprofloxacin, and did not provide information on the recommended frequency for ciprofloxacin eye drops.
Key Findings
- Ciprofloxacin eye drops should be used at a frequency that takes into account the required MIC90 of commonly encountered isolates in bacterial keratitis 4.
- A dosing schedule of 1 to 2 drops of ciprofloxacin every 30 minutes for 6 hours, then hourly for the remainder of day 1, has been used in clinical studies 5.
- Lower numbers of drops of ciprofloxacin on Day-1 are associated with increased treatment failure rates 6.
- The minimum number of drops on Day-1 for ciprofloxacin is 47 drops 6.