Ciprofloxacin
A fluoroquinolone. Resistance is high in Pakistan (including typhoid and Shigella), so use it only when culture shows sensitivity. Ciprofloxacin ear drops are useful for otitis externa and CSOM.
Common brands in Pakistan: Ciproxin. Brand availability changes; check with your pharmacy.
On this page
Uses
- Pyelonephritis and complicated UTI when sensitive.
- Prostatitis.
- Ear drops: otitis externa, CSOM (safe with a perforated drum).
- Not reliable for typhoid or Shigella in Pakistan because of resistance.
Adult dose
| Indication | Dose |
|---|---|
| Pyelonephritis | 500 mg orally twice daily for 7 days |
| Prostatitis | 500 mg twice daily for 14–28 days |
| IV | 400 mg every 8–12 hours |
| Ear drops (0.3%) | 3–4 drops twice daily for 7 days (2 weeks for CSOM) |
Children
Systemic use is generally avoided in children except where benefits outweigh risks (specialist advice). Ear drops are fine.
Kidney and liver
Creatinine clearance below 30: reduce dose (e.g. 250–500 mg every 12–24 hours).
Pregnancy and breastfeeding
Avoid systemic use in pregnancy if possible.
Side effects and cautions
- Tendon damage and rupture (elderly, steroids), nerve damage, low sugar, QT prolongation, C. difficile, seizures.
- Interacts with theophylline, warfarin; separate from antacids, iron and calcium.
Frequently asked questions
Why isn't ciprofloxacin used for typhoid in Pakistan?
Most typhoid in Pakistan is resistant to fluoroquinolones, including XDR strains.
Can ciprofloxacin ear drops be used with a perforated eardrum?
Yes. They are not ototoxic and are preferred in perforations.
Used in these guides
Sources
Doses on this page are typical doses from the sources above. Always confirm with a current drug reference, the product leaflet and your hospital protocol, especially in children, pregnancy and kidney or liver disease.
For FCPS Part 1
Revising for FCPS Part 1? Ciprofloxacin is covered in our textbook chapter Drug metabolism, with practice MCQs.