Ciprofloxacin dosage

Cutaneous anthrax with signs of systemic involvement, extensive edema, or lesions of the head or neck require intravenous therapy, and a multidrug therapeutic approach ln children, ciprofloxacin dosage should not exceed 1 g/day... 

If intravenous ciprofloxacin is not available, oral ciprofloxacin may be acceptable because it is rapidly and well absorbed from the gastrointestinal tract with no substantial loss by first pass metabolism. Maximum serum concentrations are attained 1-2 h after oral dosing but may not be achieved if vomiting or ileus are present In children, ciprofloxacin dosage should not exceed 1 g d ... 

Other fluoroquinolones can be substituted at doses appropriate for age. Ciprofloxacin dosage should not exceed 1 g d" in children... 

There is an increased risk of CNS depression when tiie dopamine receptor agonists are administered witii otiier CNS depressants. When administered witii levodopa, the dopamine receptor agonists increase the effects of levodopa (a lower dosage of levodopa may be required). hi addition, when the dopamine receptor agonists are administered with levodopa, there is an increased risk of hallucinations. When administered witii ciprofloxacin, there is an increased effect of the dopamine receptor agonist. 

Clinicians should be aware that dosage regimens with the same drug maybe different depending on the infectious process. For example, ciprofloxacin, a fluoroquinolone, has various dosage regimens based on site of infection. The dosing for uncomplicated UTIs is 250 mg twice daily for 3 days. For complicated UTIs, the dose is 500 mg twice daily for 7 to... 

The WHO and CDC recommended treatment regimens are shown in Table 77-5.37 There has been some debate about a suitable dosage of ciprofloxacin in the treatment of chancroid. Though the CDC recommends 500 mg orally three times daily, the WHO supports a single 500-mg oral dose. Ciprofloxacin has demonstrated an acceptable cure rate for a single dose (92%) when compared to erythromycin (91%). 

Absorption of antimicrobial agents such as fluoroquinolones and tetracyclines that can be bound by divalent and trivalent cations potentially could be compromised by administration with EN formulas containing these cations. The fluoroquinolones (e.g., levofloxacin and ciprofloxacin) have been best studied in this regard, and results of studies are not consistent. Mechanisms for an interaction between fluoroquinolones and EN formulas other than chelation by cations have been postulated.40 Some institutions hold tube feedings for 30 to 60 minutes or more before and after enteral dosages of fluoroquinolones. Because ciprofloxacin absorption has been shown to be decreased with jejunal administration, this drug probably should not be given by jejunal tube.41... 

XR tabiets No dosage adjustment is required for patients with uncomplicated urinary tract infections receiving 500 mg ciprofloxacin XR. In patients with complicated urinary tract infections and acute uncomplicated pyelonephritis who have a Ccr of less than 30 mL/min, reduce the dose of XR tablets from... 

Equivalent AUC Dosing Regimens Ciprofloxacin oral dosage- Equivalent ciprofloxacin IV dosage... 

Sustained-release formulations can produce stable serum concentrations with once or twice daily dosage. Therapeutic effects occur at blood levels > 5 mg/1, and side effects increase considerably at levels > 15 mg/1. Smoking, alcohol, anticonvulsants, and rifampicin induce the drug-metabolizing enzyme system in liver and reduce the half-life of theophylline. On the other hand, heart and liver failure, sustained fever, old age and drugs such as cimeti-dine, ciprofloxacin, and oral contraceptives reduce theophylline clearance and thereby increase serum concentrations. 

The fed state, and the known ability to retain solid oral dose forms in this state, has been exploited using a relatively traditional approach of swelling tablets [32]. These dosage forms, based on the swelling of hydrocolloids such as hydroxypropylcellulose, are retained in the stomach for several hours and are capable of releasing ciprofloxacin or metformin over an extended period of time whereas the dosage forms are retained in the fed stomach [33]. 

Aly et al. [16] reported a rapid and sensitive chemiluminescence (CL) method for the determination of three fluoroquinolone derivatives, including ciprofloxacin, in both pharmaceutical dosage forms and in biological fluids. The method is based on the CL reaction of the drugs with tris(2,2 -bipyridyl)ruthenium(II) and cerium(IV) in sulfuric acid medium. The CL intensity was proportional to the concentration of ciprofloxacin in solution over the range 0.05-6 pg/mL, and the limit of detection was reported to be 26 nM. 

Renal clearance of ciprofloxacin averages 300 179 mL/min in adults with normal renal function, and the drug is 16-43% bound to serum protein in vitro. It crosses the placenta and is distributed into the amniotic fluid in humans. The usual human dosage has not revealed evidence of harm to the fetus. 

Ciprofloxacin, which is available in an aqueous 0.3% ophthalmic solution and an ointment farm, has a broad spectrum of action. Ciprofloxacin has been shown to be at least as successful in treating corneal ulceration as fortified antibiotics however, as mentioned earlier, there appears to be an increasing number of resistant strains since its introduction. The usual dosage of ciprofloxacin solution for the treatment of bacterial ulcers is two drops every 15 minutes for 6 hours, then two drops every 30 minutes for 18 hours, followed by two drops every hour for 24 hours. Ciprofloxacin is then used every 4 hours for the next 12 days. Ciprofloxacin ointment also is effective in the treatment of bacterial keratitis. It is applied every 1 to 2 hours in the first 2 days and then every 4 hours for the next 12 days. 

Ciprofloxacin can be associated with partial or complete tendinitis. Of 72 lung transplant recipients who received ciprofloxacin, 20 had Achilles tendon involvement (tendinitis 15, rupture 5) (49). Tendon rupture occurred at a lower dosage of ciprofloxacin than tendinitis and the mean recovery duration was significantly longer. 

The pharmacokinetics of intravenous ciprofloxacin have been studied in intensive care unit patients during continuous venovenous hemofiltration (n — 5) or hemo-diafiltration (n — 5) (67). Ciprofloxacin clearance was not altered. A dosage of 400 mg/day was sufficient to maintain effective drug plasma concentrations in patients undergoing continuous renal replacement therapy. 

Based on their predominant renal elimination, dosage adjustment is necessary in the presence of renal disease for ciprofloxacin, gatifloxacin, levofloxacin, and sitaflox-acin (124). 

Fluoroquinolones are potent inhibitors of hepatic cytochrome P450 isozymes (150). They inhibit theophylline metabolism, and accumulation of theophylline has led to seizures (151). Theophylline clearance is reduced by about 10% by norfloxacin, 30% by ciprofloxacin, and 70% by enoxacin (152-162). In a comparison of grepa-floxacin (400 and 600 mg/day) and ciprofloxacin, increased theophylline concentrations associated with clinical symptoms were found with both doses of grepa-floxacin but not in patients taking ciprofloxacin (17). The dosage of theophylline should be reduced when a quino-lone is given. 

A study of the pharmacokinetics of orally administered ciprofloxacin in elderly (63-76 years) and young volunteers (22-34 years) without renal impairment, revealed in the elderly group a decreased renal clearance of the quinolone with no differences detected in the terminal half-life (3.5 hours). This was accompanied, however, by a surprising increase in the absolute availability of the drug [226]. The authors cautioned about the need for a reduction of oral dosage of ciprofloxacin in the elderly population. 

Ciprofloxacin is available in oral dosage forms, both pills and suspension. It may also be administered intravenously. 

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