Ciprofloxacin instructions for administration

Instructions for administration
Adults Pediatrics
 * Dosage determination
 * Treatment duration
 * Dosage guidelines
 * Conversion of I.V. to oral dosing'''
 * Adults with impaired renal function
 * Dosage determination
 * Dosage guidelines
 * Complicated urinary tract or pyelonephritis
 * Inhalational anthrax (post-exposure)
 * Children with impaired renal function

Dosage determination
The determination of dosage for any particular patient must take into consideration the severity and nature of the infection, the susceptibility of the causative organism, the integrity of the patient's host-defense mechanisms, and the status of renal function and hepatic function. Return to top

Treatment duration
The duration of treatment depends upon the severity of infection. The usual duration is 7 to 14 days; however, for severe and complicated infections more prolonged therapy may be required. Ciprofloxacin should be administered at least 2 hours before or 6 hours after magnesium/aluminum antacids, or sucralfate, Videx® (didanosine) chewable/buffered tablets or pediatric powder for oral solution, other highly buffered drugs, or other products containing calcium, iron or zinc. Return to top

Dosage guidelines
Generally Ciprofloxacin should be continued for at least 2 days after the signs and symptoms of infection have disappeared, except for inhalational anthrax (post-exposure). Return to top

Acute uncomplicated urinary tract infection
100 mg or 250 mg every 12 h for 3 days. Return to top

Mild/Moderate urinary tract infection
250 mg every 12 h for 7 to 14 days. Return to top

Severe/Complicated urinary tract infection
500 mg every 12 h for 7 to 14 days. Return to top

Mild/Moderate chronic bacterial prostatitis infection
500 mg every 12 h for 28 days. Return to top

Mild/Moderate lower respiratory tract infection
500 mg every 12 h for 7 to 14 days. Return to top

Severe/Complicated lower respiratory tract infection
750 mg every 12 h for 7 to 14 days. Return to top

Mild/Moderate acute sinusitis infection
500 mg every 12 h for 10 days. Return to top

Mild/Moderate skin and skin structure infection
500 mg every 12 h for 7 to 14 days. Return to top

Severe/Complicated skin and skin structure infection
750 mg every 12 h for 7 to 14 days. Return to top

Mild/Moderate bone and joint infection
500 mg every 12 h for ≥ 4 to 6 weeks. Return to top

Severe/Complicated bone and joint infection
750 mg every 12 h for ≥ 4 to 6 weeks. Return to top

Complicated intra-abdominal infection
500 mg every 12 h for 7 to 14 days (used in conjunction with metronidazole). Return to top

Mild/Moderate/Severe infectious diarrhea
500 mg every 12 h for 5 to 7 days. Return to top

Mild/Moderate typhoid fever infection
500 mg every 12 h for 10 days. Return to top

Uncomplicated urethral and cervical gonococcal infections
Single dose of 250 mg. Return to top

Inhalational anthrax (post-exposure)
500 mg every 12 h for 60 days (drug administration should begin as soon as possible after suspected or confirmed exposure). Return to top

Conversion of I.V. to oral dosing
Patients whose therapy is started with Ciprofloxacin I.V. may be switched to Ciprofloxacin Tablets USP when clinically indicated at the discretion of the physician. Return to top

Adults with impaired renal function
Ciprofloxacin is eliminated primarily by renal excretion; however, the drug is also metabolized and partially cleared through the biliary system of the liver and through the intestine. These alternative pathways of drug elimination appear to compensate for the reduced renal excretion in patients with renal impairment. Nonetheless, some modification of dosage is recommended, particularly for patients with severe renal dysfunction. Return to top

Dosage determination
Dosing and initial route of therapy (i.e., I.V. or oral) for complicated urinary tract infection or pyelonephritis should be determined by the severity of the infection. In the clinical trial, pediatric patients with moderate to severe infection were initiated on 6 to 10 mg/kg I.V. every 8 hours and allowed to switch to oral therapy (10 to 20 mg/kg every 12 hours), at the discretion of the physician. Return to top

Complicated urinary tract or pyelonephritis
10 mg/kg to 20 mg/kg (maximum 750 mg per dose; not to be exceeded even in patients weighing > 51 kg) every 12 hours for a duration determined by the physician. Return to top

Inhalational anthrax (post-exposure)
15 mg/kg (maximum 500 mg per dose) 	Every 12 hours for 60 days. Return to top

Children with impaired renal function
Pediatric patients with moderate to severe renal insufficiency were excluded from the clinical trial of complicated urinary tract infection and pyelonephritis. No information is available on dosing adjustments necessary for pediatric patients with moderate to severe renal insufficiency (i.e., creatinine clearance of < 50 mL/min/1.73m2). Return to top