Ciprofloxacin
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Trade Name
Cipro, Cipro XR (extended-release); generic ciprofloxacin
Classification
Fluoroquinolone antibiotic
Dosage/Route
- * Dosage:
- – Tablets: 250 mg, 500 mg, 750 mg
- – Extended-release (XR): 500 mg, 1000 mg
- – Suspension: 250 mg/5 mL, 500 mg/5 mL
- – IV: 200 mg, 400 mg vials
- * Route: Oral (PO), intravenous (IV)
Usual Dosage
- * Adults:
- – Urinary Tract Infection (UTI): 250-500 mg PO BID or 500 mg XR daily; 3-7 days
- – Respiratory/Skin Infections: 500-750 mg PO BID or 400 mg IV BID; 7-14 days
- – Complicated Infections (e.g., intra-abdominal): 750 mg PO BID or 400 mg IV BID; 7-14 days
- * Children (limited use): 10-20 mg/kg PO/IV BID; max 750 mg/dose (e.g., anthrax, cystic fibrosis)
- * Renal Impairment: Reduce dose if CrCl <50 mL/min (e.g., 250-500 mg daily)
Mechanism of Action
Inhibits bacterial DNA gyrase and topoisomerase IV, preventing DNA replication and transcription. Bactericidal against gram-negative (e.g., E. coli, Pseudomonas) and some gram-positive bacteria (e.g., S. aureus); broad-spectrum
Side Effects & Adverse Effects
- * Side Effects: Nausea, diarrhea, headache, dizziness
- * Adverse Effects:
- – Tendonitis/tendon rupture (boxed warning; esp. >60 yrs, steroids)
- – QT prolongation (arrhythmias)
- – Clostridioides difficile-associated diarrhea (CDAD)
- – Neurotoxicity (seizures, confusion; boxed warning)
- – Photosensitivity, hepatotoxicity (rare)
Nursing Management (Implications & Teachings)
- * Implications:
- – Monitor tendon pain (esp. Achilles), neuro status (confusion), ECG (QT risk)
- – Assess GI symptoms (CDAD) and renal function (dose adjust)
- – IV: Infuse over 60 min in 100-200 mL NS/D5W; avoid rapid push
- – PO: Give 2 hr before/after antacids, iron, dairy (reduce absorption)
- * Teachings:
- – Finish full course; take consistently (e.g., 8 AM/8 PM)
- – Report joint pain, palpitations, or severe diarrhea
- – Avoid sun exposure; use sunscreen
- – Take with water, not milk; shake suspension well
Indication for This Patient
- * Bacterial infections:
- – UTI (complicated/uncomplicated)
- – Respiratory (e.g., pneumonia, bronchitis)
- – Skin, bone, intra-abdominal infections
- * Anthrax (treatment/prophylaxis)
- * Pseudomonas infections (e.g., cystic fibrosis)
Time
- * Timing: PO: BID or daily (XR); IV: BID
- * Onset: Symptom relief in 1-3 days
- * Duration: 3-14 days (infection-specific)
