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- Discussion:
    - broad spectrum quinolone against gm pos & neg organisms;
    - poor Activity against: enterococci, non entero strep, anaerobes;
    - adult:
          - PO: 250, 500, or 750 mg PO q12 hr;
          - IV: 200-400 mg IV q12 hr;

- Cautions:
    - at present sucralfate should not be used if fluoroquinolone antibiotics are required;
    - watch for hallucinations;
    - will incr levels of theophyllin;
    - antacids (Mg & Al) and ferrous sulfate will decr levels of Cipro, while probeneicid will incr Cipro levels;
    - will increase PT times in patients taking coumadin;
    - may affect phenytoin levels;
    - equivocal evidence for Achilles tendon rupture in rare cases;
    - contra-indicated in children: 
    - may be toxic to immature cartilage (evidence in puppies), but has been used to treat pulmonary infections in children w/ CF will no apparent ill effects; 
    - note: good diffusion from blood into CSF only w/ inflammation; ratio of CSF to blood level (%): normal meninges: 5; inflammed meninges: 5-37;
    - dosing regimens for patients with renal insufficiency:
          - dose for 70kg Adult (gm/dosing interval in hrs)
          - PO: CrCl: >80: 0.5-.75/12; CrCl:50-79:0.5-.75/8; CrCl:30-49: 0.5-.75/12; CrCl:10-29: 0.5-.75/18-24;
          - IV: CrCl: >80: 0.2-.4/12; CrCl:50-79:0.2-.4/8; CrCl:30-49: 0.2-.4/12; CrCl: 10-29: 0.5-.75/18-24;
          - 40-50 % of dose will be excreted in urine (w/ nl R F(x))

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Oral ciprofloxacin compared with parenteral antibiotics in the treatment of osteomyelitis.

Oral ciprofloxacin compared with standard parenteral antibiotic therapy for chronic osteomyelitis in adults.

Oral ciprofloxacin compared with parenteral antibiotics in the treatment of osteomyelitis.

Oral ciprofloxacin treatment of Pseudomonas aeruginosa osteomyelitis.

Ciprofloxacin Inhibition of Experimental Fracture-Healing.

The Effect of Fluoroquinolone Antibiotics on Growing Cartilage in the Lamb Model   

Fluoroquinolones Impair Tendon Healing in a Rat Rotator Cuff Repair Model