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# Ciprofloxacin
## Overview
Ciprofloxacin is a synthetic fluoroquinolone antibiotic effective against a broad spectrum of Gram-positive and Gram-negative bacteria. It works by inhibiting bacterial DNA gyrase and topoisomerase IV, essential enzymes for DNA replication, transcription, repair, and recombination.
## Primary Indications
* Urinary tract infections (complicated and uncomplicated)
* Acute bacterial sinusitis
* Bone and joint infections
* Intra-abdominal infections
* Infectious diarrhea
* Pneumonia (nosocomial and community-acquired)
* Prostatitis
* Sexually transmitted infections (e.g., gonorrhea, chancroid)
* Anthrax (prophylaxis and treatment)
* Plague
## Adult Dosing
Dosing varies significantly by indication, severity of infection, and organism susceptibility.
* **Urinary Tract Infection (Uncomplicated):** 250 mg orally twice daily for 3 days.
* **Urinary Tract Infection (Complicated):** 500 mg orally twice daily for 7-14 days.
* **Acute Bacterial Exacerbation of Chronic Bronchitis:** 500 mg orally twice daily for 7 days.
* **Community-Acquired Pneumonia:** 500-750 mg orally or intravenously twice daily for 7-14 days.
* **Bone and Joint Infections:** 500-750 mg orally or intravenously twice daily for 4-12 weeks.
* **Anthrax (Inhalational, Treatment):** 500 mg orally or intravenously twice daily for 60 days.
* **Maximum Dose:** Generally 1500 mg per day orally or 1200 mg per day intravenously, though specific indications may have higher allowances or different maximums.
## Pediatric Dosing
Pediatric dosing is typically weight-based and reserved for specific indications where benefits outweigh risks, such as complicated urinary tract infections, urinary tract infections with pyelonephritis, and inhalational anthrax. Not generally recommended for children other than for these specific circumstances due to risk of arthropathy.
* **Urinary Tract Infections/Urinary Tract Infections with Pyelonephritis:** 10-20 mg/kg orally or intravenously every 12 hours.
* **Inhalational Anthrax:** 15 mg/kg orally or intravenously every 12 hours.
* **Maximum Dose:** Generally 1500 mg per day orally or 1200 mg per day intravenously. Specific pediatric dosing requires careful calculation and consultation with local protocols.
## Dose Adjustments
* **Renal Impairment:** Dose adjustment is necessary if creatinine clearance is less than 30 mL/min. Specific adjustments depend on the indication and route of administration.
* **CrCl > 30 mL/min:** No adjustment needed.
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