Cipro Dosage

Generic name: ciprofloxacin (oral)
Drug class: Quinolones

Medically reviewed by  A Ras MD.

 

Recommended Adult Dosing

Dosage forms:  TAB: 250 mg, 500 mg; SUSP: 250 mg per 5 mL, 500 mg per 5 mL; INJ: various

Infections, bacterial

[PO route]

Dose: 250-750 mg PO q12h; Info: dose, duration varies w/ infection type, severity

[IV route]

Dose: 200-400 mg IV q12h; Alt: 400 mg IV q8h for severe/complicated infection; Info: dose, duration varies w/ infection type, severity

UTI

[uncomplicated cystitis]

Dose: 250 mg PO q12h x3 days; Info: for pts w/ no alternative tx options; refer to IDSA guidelines

[uncomplicated pyelonephritis]

Dose: 500 mg PO q12h x7 days; Alt: 400 mg IV x1, then 500 mg PO q12h x7 days total; 400 mg IV q12h x7 days; Info: may give w/ ceftriaxone or gentamicin; refer to IDSA guidelines

[complicated]

Dose: 500 mg PO q12h x7-14 days; Alt: 400 mg IV q12h x7-14 days

Intra-abdominal infections, complicated

[500 mg PO q12h x7-14 days]

Alt: 400 mg IV q12h x7-14 days; Info: part of multi-drug regimen

Bone/joint infections

[500-750 mg PO q12h x4-8wk]

Alt: 400 mg IV q8-12h x4-8wk

Prostatitis, chronic bacterial

[500 mg PO q12h x28 days]

Pneumonia, hospital-acquired or ventilator-assoc.

[400 mg IV q8h x7 days]

Info: may extend duration based on clinical response; refer to IDSA guidelines

Anthrax

[systemic]

Dose: 400 mg IV q8h for at least 2wk; Info: 1st-line agent; part of multi-drug regimen; may use as 1st-line agent in pregnant women; switch to PO abx for post-exposure prophylaxis if inhalational exposure

[cutaneous]

Dose: 500 mg PO q12h x7-10 days; Info: for non-systemic infection; 1st-line agent; may use as 1st-line agent in pregnant women; use extended duration for post-exposure prophylaxis if bioterrorism suspected

[post-exposure prophylaxis]

Dose: 500 mg PO q12h x60 days; Info: 1st-line agent; give in combo w/ anthrax vaccine; may use as 1st-line agent in pregnant women; may give x42 days or x14 days after last vaccine dose in immunocompetent pts 18-65 yo if anthrax vaccine regimen completed

Typhoid fever

[500 mg PO q12h x2wk]

Plague

[500-750 mg PO q12h x2wk]

Info: for prophylaxis and tx

Chancroid

[500 mg PO q12h x3 days]

Salmonellosis, acute

[500-750 mg PO q12h x3-7 days]

Info: may extend tx x1wk if immunocompromised

Salmonella, chronic carrier

[750 mg PO q12h x1mo]

Shigellosis, severe

[500-750 mg PO q12h]

Info: duration varies w/ infection severity; refer to CDC guidance

Febrile neutropenia, chemo-induced

[500-750 mg PO q12h]

Info: for empiric tx in low-risk pts not on fluoroquinolone prophylaxis; give w/ amoxicillin/clavulanate

Meningococcal prophylaxis

[500 mg PO x1]

Info: for asymptomatic meningococcal carriers

Infection prophylaxis, surgical

[400 mg IV x1]

Start: 120min preop; Info: refer to ASHP/IDSA guidelines

Renal dosing

[PO route]

CrCl 30-50: 250-500 mg PO q12h; CrCl <30: 250-500 mg PO q24h; Info: may give 750 mg/dose if serious infection w/ severe renal impairment

HD: 250-500 mg PO q24h, on dialysis days admin. after dialysis; no supplement; PD: 250-500 mg PO q24h; no supplement; Info: may give 750 mg/dose if serious infection

[IV route]

CrCl <30: 400 mg IV q24h

HD: 200-400 mg IV q24h, on dialysis days admin. after dialysis; no supplement; PD: 200-400 mg IV q24h; no supplement

Hepatic dosing

[not defined]

hepatic impairment: caution advised

Recommended Peds Dosing

Dosage forms:  TAB: 250 mg, 500 mg; SUSP: 250 mg per 5 mL, 500 mg per 5 mL; INJ: various

UTI

[1-17 yo]

Dose: 18-30 mg/kg/day IV divided q8h x10-21 days; Max: 400 mg/dose IV; 750 mg/dose PO; Alt: 20-40 mg/kg/day PO divided q12h; Info: for complicated UTI or pyelonephritis; not 1st-line agent

Anthrax, systemic

[neonates >32 wk gestation]

Dose: 20-30 mg/kg/day IV divided q12h for at least 2wk; Info: 1st-line agent; part of multi-drug regimen; dose depends on gestational and post-natal age; switch to PO abx x60 days total if inhalational exposure

[1 mo and older]

Dose: 30 mg/kg/day IV divided q8h for at least 2wk; Max: 400 mg/dose; Info: 1st-line agent; part of multi-drug regimen; switch to PO abx x60 days total if inhalational exposure

Anthrax, cutaneous

[neonates >32 wk gestation]

Dose: 20-30 mg/kg/day PO divided q12h x7-10 days; Info: for non-systemic infection; 1st-line agent; dose depends on gestational and post-natal age; give abx x60 days total if bioterrorism suspected

[1 mo and older]

Dose: 30 mg/kg/day PO divided q12h x7-10 days; Max: 500 mg/dose; Info: for non-systemic infection; 1st-line agent; give abx x60 days total if bioterrorism suspected

Anthrax, post-exposure prophylaxis

[neonates >32 wk gestation]

Dose: 20-30 mg/kg/day PO divided q12h x60 days; Info: 1st-line agent; dose depends on gestational and post-natal age

[1 mo and older]

Dose: 30 mg/kg/day PO divided q12h x60 days; Max: 500 mg/dose; Info: 1st-line agent

Plague

[15 mg/kg/dose PO q8-12h x14 days]

Max: 500 mg/dose; Info: for prophylaxis and tx

Infections, bacterial

[20-30 mg/kg/day PO divided q12h]

Alt: 15-30 mg/kg/day IV divided q8-12h; Max: 750 mg/dose PO; 400 mg/dose IV

Resp. infections, cystic fibrosis pts

[40 mg/kg/day PO divided q12h]

Alt: 30 mg/kg/day IV divided q8h; Max: 750 mg/dose PO; 400 mg/dose IV

Community-acquired pneumonia, mod-severe bacterial

[>3 mo]

Dose: 30 mg/kg/day IV divided q12h x10 days; Info: may switch to PO regimen when possible to complete course

Salmonellosis, acute

[20-30 mg/kg/day PO divided q12h x3-7 days]

Max: 750 mg/dose; Info: may extend tx x1wk if immunocompromised

Salmonella, chronic carrier

[20-30 mg/kg/day PO divided q12h x1mo]

Max: 750 mg/dose

Shigellosis, severe

[1 mo and older]

Dose: 30 mg/kg/day PO divided q12h; Max: 500 mg/dose; Info: duration varies w/ infection severity; refer to CDC guidance

Typhoid fever

[30 mg/kg/day PO/IV divided q12h x1-2wk]

Max: 500 mg/dose

Chancroid

[preadolescents >45 kg and adolescents]

Dose: 500 mg PO q12h x3 days

Febrile neutropenia, chemo-induced

[20-40 mg/kg/day PO divided q12h]

Max: 750 mg/dose; Info: for empiric tx in low-risk pts not on fluoroquinolone prophylaxis; give w/ amoxicillin/clavulanate

Meningococcal prophylaxis

[1 mo and older]

Dose: 20 mg/kg/dose PO x1; Info: for asymptomatic meningococcal carriers

Infection prophylaxis, surgical

[1 yo and older]

Dose: 10 mg/kg/dose IV x1; Start: 120min preop; Info: refer to ASHP/IDSA guidelines

Renal dosing

[adjust dose frequency]

CrCl 10-29: give usually divided dose q18h; CrCl <10: give usually divided dose q24h

HD: give usual divided dose q24h, on dialysis days admin. after dialysis; no supplement; PD: give usually divided dose q24h; no supplement

Hepatic dosing

[not defined]

hepatic impairment: caution advised

 

SRC: NLM .