Fluoroquinolone類抗生素
Urinary tract infection, acute uncomplicated cystitis in females, chronic bacterial prostatitis, bone and joint infections, complicated intra-abdominal infections (in combination with metronidazole), infectious diarrhea, typhoid fever, hospital-acquired pneumonia
藥理
Antibiotic, Fluoroquinolone
Inhibits DNA-gyrase in susceptible organisms; inhibits relaxation of supercoiled DNA and promotes breakage of double-stranded DNA
藥動學
Distribution:
Protein binding: 20-40% Metabolism:
1. Partially hepatic; forms 4 metabolites
2. Dialyzable: yes, <10% removed Excretion:
Urine (35% to 70% as unchanged drug); feces (15% to 35%; <1% as unchanged drug)
禁忌症
1. Hypersensitivity to ciprofloxacin, any component of the formulation, or other quinolones 2. Concurrent administration of tizanidine
懷孕分類
1. Ciprofloxacin is recommended for prophylaxis and treatment of pregnant women exposed to anthrax.
2. Alternative antibiotics are recommended in pregnant women for indications such as chancroid, meningococcal disease, or perianal disease and pouchitis in women with inflammatory bowel disease.
哺乳分類
In general, quinolone antibiotics should be avoided in breastfeeding women if alternative agents are available.
副作用
Musculoskeletal and neurological signs and symptoms, skin rash, abdominal pain, diarrhea, nausea, vomiting, vulvovaginal candidiasis, injection site reactions, dizziness, headache, insomnia, nervousness, asthma, fever
劑量和給藥方法
Anthrax:
400 mg every 12 hours for 42 to 60 days Intra-abdominal infection:
1. Acute Cholecystitis: 400 mg Q12H, continue for 1 day after gallbladder removal
2. Other intra-abdominal infections (eg, perforated appendix, diverticulitis, intra-abdominal abscess): 400 mg Q12H in combination with metronidazole, total duration 4-5 days Osteomyelitis:
400 mg every 12 hours; when treating P. aeruginosa, 400 mg Q8H for ≥6 weeks Plague (Yersinia pestis) infection:
400 mg Q8-12H Pneumonia (empiric therapy or for P. aeruginosa):
400 mg Q8H, typically 7 days GI infection (Salmonella species):
1. Typhoid fever: 500 mg Q12H for 7 to 10 days
2. Nontyphoidal bloodstream infection: 400 mg twice daily for 14 days Septic arthritis:
400 mg Q12H for 3-4 weeks Urinary tract infection:
400 mg Q12H for a total of 5-7 days
小兒調整劑量
Note: In pediatric patients, ciprofloxacin is not routinely first-line therapy, but after assessment of risks and benefits, can be considered a reasonable alternative.
Dose: 10-15 mg/kg/dose every 8 to 12 hours; maximum 400 mg/dose
腎功能調整劑量
1. CrCl 30-130 mL/min: 400 mg every 8-12 hours
2. CrCl <30 mL/min: 200-400 mg every 12-24 hours
3. Intermittent hemodialysis, peritoneal dialysis: 200-400 mg every 24 hours
肝功能調整劑量
There are no dosage adjustments provided in manufacturer's labeling. Use with caution in severe impairment.
安定性
Since the infusion solution is photosensitive, it should be removed from the box only immediately before use.
注射給藥指引
給藥途徑
IVD (靜脈滴注) (仿單)
靜脈輸注液
再生溶液:不需再生。稀釋溶液:NS、D5W、LR。
每瓶稀釋液體積
最終濃度1-2mg/mL (micromedex)
注射濃度
給藥速率
60分鐘以上 (仿單)
安定性
Since the infusion solution is photosensitive, it should be removed from the box only immediately before use.