Ciprofloxacin

• A quinolone antibiotic, similar to levofloxacin
• Usual adult dose: 250mg – 500mg bd orally, increased to 750mg bd for severe infections/Pseudomonas.
• Good bioavailability when given orally
• IV preparation is very expensive and the licensed dose is lower than the oral regime. IV ciprofloxacin is a restricted antibiotic at QMC.
• Dosage  reduction may be necessary in renal impairment.
• Use with caution in patients with epilepsy.
• Contra-indicated in pregnancy.
• High risk of Clostridium difficile antibiotic-associated diarrhoea.
• Use linked to increased colonisation with MRSA

Main indications: Oral

• Microbiology advice.
• Restricted agent - see list
• As ciprofloxacin can increase selection for C.difficile infection and MRSA colonisation/infection, all patients with previous MRSA/C.difficile  require documented microbiology approval regardless of indication.

Main indications: IV

• Microbiology advice only – restricted agent

Active against most strains of:

• Staphylococcus aureus (not MRSA)
• Neisseria gonorrhoea*
• Haemophilus influenzae
• Moraxella catarrhalis
• Escherichia coli
• Klebsiella sp
• Pseudomonas
• Legionella
• Salmonella
• Campylobacter

Not active against most strains of:

• MRSA
• Enterococci
• Anaerobes

Partial activity against Strep pneumoniae

*currently the resistance rates are ~20% therefore not suitable for first line empirical treatment of gonorrhoea.

Page last edited: 09/10/2009

Caution; the antibiotic doses recommended on this website are intended for adult patients with normal renal and liver function unless otherwise stated. Dosing advice for patients with renal impairment is available here.

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