【藥品性質提示】 根據 2019 AGS Beers Criteria，本藥品為【潛在不適當用藥 (PIM)】，腎功能不佳之老年人 (CrCl<30mL/min) 使用時須降低藥品劑量。

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

Antibiotic, Fluoroquinolone
Inhibits DNA-gyrase in susceptible organisms; inhibits relaxation of supercoiled DNA and promotes breakage of double-stranded DNA

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)

1. Hypersensitivity to ciprofloxacin, any component of the formulation, or other quinolones
2. Concurrent administration of tizanidine

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.

In general, quinolone antibiotics should be avoided in breastfeeding women if alternative agents are available.

Musculoskeletal and neurological signs and symptoms, skin rash, abdominal pain, diarrhea, nausea, vomiting, vulvovaginal candidiasis, injection site reactions, dizziness, headache, insomnia, nervousness, asthma, fever

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

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

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

There are no dosage adjustments provided in manufacturer's labeling. Use with caution in severe impairment.