Ciprofloxacin Dosing for Adults with Normal Renal Function
For adults with normal renal function, ciprofloxacin dosing ranges from 250-750 mg orally every 12 hours, with the specific dose determined by infection type and severity. 1
Standard Dosing by Infection Type
Urinary Tract Infections
- Uncomplicated UTI: 250 mg every 12 hours for 3 days (minimum effective dose) 2
- Complicated UTI/Pyelonephritis: 500 mg every 12 hours for 7-14 days 1
- The Infectious Diseases Society of America recommends 500 mg every 12 hours for 7 days (or 1000 mg extended-release daily) in areas where fluoroquinolone resistance is <10% 3
Respiratory Tract Infections
- Mild/Moderate lower respiratory tract infections: 500 mg every 12 hours for 7-14 days 1
- Severe/Complicated lower respiratory tract infections: 750 mg every 12 hours for 7-14 days 1
Skin and Soft Tissue Infections
- Mild/Moderate: 500 mg every 12 hours for 7-14 days 1
- Severe/Complicated: 750 mg every 12 hours for 7-14 days 1
Other Common Infections
- Acute sinusitis: 500 mg every 12 hours for 10 days 1
- Chronic bacterial prostatitis: 500 mg every 12 hours for 28 days 1
- Bone and joint infections (mild/moderate): 500 mg every 12 hours for ≥4-6 weeks 1
- Bone and joint infections (severe/complicated): 750 mg every 12 hours for ≥4-6 weeks 1
- Infectious diarrhea: 500 mg every 12 hours for 5-7 days 1
- Typhoid fever: 500 mg every 12 hours for 10 days 1
- Intra-abdominal infections (complicated): 500 mg every 12 hours for 7-14 days (used with metronidazole) 1
Special Situations
- Uncomplicated gonorrhea: 250 mg single dose 1
- Inhalational anthrax (post-exposure): 500 mg every 12 hours for 60 days 1
- Meningococcal prophylaxis: 500 mg single dose orally to eliminate throat carriage 4
Important Administration Guidelines
Ciprofloxacin must be administered at least 2 hours before or 6 hours after antacids containing magnesium/aluminum, sucralfate, or products containing calcium, iron, or zinc to avoid significant reduction in absorption 1. This is a common pitfall that can lead to treatment failure.
Duration Considerations
Treatment should generally continue for at least 2 days after signs and symptoms of infection have disappeared, with the usual duration being 7-14 days 1. However, severe and complicated infections may require more prolonged therapy 1.
Critical Clinical Caveats
- Avoid empirical use if local fluoroquinolone resistance exceeds 10% for pyelonephritis; consider initial parenteral therapy with ceftriaxone or aminoglycoside instead 3
- Reserve fluoroquinolones as alternative agents for acute cystitis when other UTI antimicrobials cannot be used, due to collateral damage concerns and the need to preserve these agents for more serious infections 3
Monitoring Requirements
- ECG monitoring at baseline and at 2 weeks due to QTc prolongation risk 3, 5
- Blood glucose monitoring regularly in diabetic patients due to hypoglycemia risk 3, 5
- CBC, renal function, and liver function tests should be checked intermittently throughout treatment 3, 5
- Monitor for CNS adverse effects (dizziness, headache, insomnia), which may indicate drug accumulation 3