Ciprofloxacin is a synthetic chemotherapeutic antibiotic from the fluoroquinolone drug class.

It was
first patented by Bayer A. G. in 1983 and was approved by the Food and Drug Administration in 1987.
Common brand names of Ciprofloxacin are Alcipro, Bacipro, Baxolyn, Baycip, Ciclodin, Cidrolex,
Ciflodal, Cifloxin, Ciloxan, Ciprobay, Ciprobiotic, Ciprotor, Flosicron, Floxil, Holdestin, Hyprocel,
Iprobac, Iprolan, Proseloc, Proquin, Qinosyn, Xipro, and Zyflox. Ciprofloxacin is classified as a
Fluoroquinolone and an Anti-infective.

Indication for Ciprofloxacin

Ciprofloxacin is used in the treatment of chronic bacterial prostatitis. It is also used in the treatment of
skin or skin structure, GI tract, bone or joint, lower respiratory tract, and urinary tract infections.
Ciprofloxacin is also used in the treatment of chancroid.
Ciprofloxacin is also used in the treatment of infectious diarrhea, uncomplicated gonorrhea, empiric
treatment of febrile neutropenia, and acute sinusitis. It can also be used for conjunctival keratitis,
keratoconjunctivitis, corneal ulcers, blepharitis, dacrocystitis, blepharoconjunctivitis, and acute
meibomianitis.

Routes and Dosage of Ciprofloxacin

Mild to Moderate Urinary Tract Infections
PO: ADULTS, ELDERLY: 250mg every 12 hours.
IV: ADULTS, ELDERLY: 200mg every 12 hours.

Complicated Urinary Tract, Mild to Moderate Respiratory Tract, Skin or Skin

Structure, Bones, Joint Infections, Infectious Diarrhea
PO: ADULTS, ELDERLY: 500mg every 12 hours.
IV: ADULTS, ELDERLY: 400mg every 12 hours.

Severe, Complicated Infections

PO: ADULTS, ELDERLY: 750 mg every 12 hours.
PO: ADULTS, ELDERLY: 400mg every 12 hours.

Prostatitis
PO: ADULTS, ELDERLY: 500mg every 12 hours for 28 days.

Uncomplicated Bladder Infections

PO: ADULTS: 100mg 2 times a day for 3 days.

Acute Sinusitis
PO: ADULTS, 500mg every 12 hours.
Uncomplicated Gonorrhea
PO: ADULTS: 250mg as single dose.

Usual Dosage for Children

PO: 20-30 mg/kg/day in 2 divided doses. Maximum: 1.5 g per day.
IV: 20-30 mg/kg/day in 2 divided doses every 12 hours. Maximum: 800mg per day.

Dosage in Renal Impairment

Dose and frequency is modified in patients based on severity of infection, degree of renal impairment.
Hemodialysis and peritoneal dialysis, 250-500mg every 24 hours after dialysis.

Usual Opthalmic Dose

Corneal Ulcer: ADULTS, ELDERLY: 2 drops every 15 minutes for 6 hours, then 2 drops ever 30
minutes for remainder of first day; 2 drops every 1 hour for second day; then 2 drops every 4 hours in
days 3-14.
Conjuctivitis: ADULTS, ELDERLY: 1-2 drops every 2 hours for 2 days, then 2 drops every 4 hours in
the next 5 days.

Action of Ciprofloxacin
Ciprofloxacin inhibits DNA enzyme in susceptible microorganisms. It interferes with bacterial DNA
replication. Ciprofloxacin is also bactericidal.

Side Effects and Adverse Reactions of Ciprofloxacin

Side Effects of Ciprofloxacin
• Nausea
• Diarrhea
• Dyspepsia
• Vomiting
• Constipation
• Flatulence
• Confusion
• Crystalluria
• Burning
• Crusting in the corner of eye
• Abdominal pain or discomfort
• Headache
• Rash
• Bad taste
• Redness of the eyelid
• Confusion
• Hallucination
• Hypersensitivity reaction
 • Insomnia
• Dry mouth
• Paresthesia

Adverse Reactions of Ciprofloxacin

• Superinfection (especially enterococcal and fungal)
• Nephropathy
• Cardiopulmonary arrest
• Cerebral thrombosis may occur
• Arthropathy may occur if given to children <18 years.
• Sensitization may contraindicate later systemic use of Ciprofloxacin

Nursing Considerations for Clients Taking Ciprofloxacin

• Question for history of hypersensitivity to Ciprofloxacin or Quinolones.
• May be given without regards to meals. Preferred dosing time 2 hours after meals.
• Do not administer antacids within 2 hours of Ciprofloxacin.
• Encourage cranberry juice or citrus fruits.
• Evaluate food tolerance.
• Determine pattern of bowel activity.
• Check for dizziness, headache, visual difficulties, and tremors.
• Observe therapeutic response.

Patient Teachings for Clients Taking Ciprofloxacin

• Do not skip doses, take full course of therapy.
• Take with 8 oz water, drink several glasses of water between meals.
• Eat or drink high sources of ascorbic acid, like cranberry juice or citrus fruits, to prevent
crystalluria.
• Do not take antacids.
• Shake suspension well before using.
• Do not chew microcapsules in suspension.
• Sugarless gum or hard candy may relieve bad taste.
• Opthalmic: A crystal precipitate may form but usually resolves in 1-7 days.