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Edina Avdic, Pharm.D., Paul A. Pham, Pharm.D.
Ciprofloxacin is a topic covered in the Johns Hopkins ABX Guide.

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  • Use of ciprofloxacin for acute sinusitis and acute uncomplicated UTIs should be avoided due recent FDA warning (Boxed warning) regarding serious and potentially permanent side effects (tendonitis and tendon rupture, peripheral neuropathy and CNS side effects). FDA safety warning regarding fluoroquinolone use.
  • Lower respiratory tract infections
  • Complicated intra-abdominal infections. Note: IDSA/SIS guidelines recommend ciprofloxacin in combination with metronidazole for community-acquired intra-abdominal infections and biliary tract infections. Due to high rates of E. coli resistance in many communities empiric use for health care-associated complicated infections is not recommended unless hospital surveillance indicates >90% susceptibility of E. coli to ciprofloxacin[3].
  • Infectious diarrhea
  • Uncomplicated cervical and urethral N. gonorrhoeae (note: high resistance rates make fluoroquinolones no longer recommended agent)
  • Typhoid fever
  • Lower respiratory tract infections
  • Complicated intra-abdominal infections
  • Infectious diarrhea
  • Chronic bacterial prostatitis
  • Skin and soft-tissue infections
  • Bone and joint infections
  • Complicated urinary tract infections and pyelonephritis in pediatric patients
  • Inhalational anthrax postexposure in adult and pediatric patients
  • Plague in adult and pediatric patients


  • Empiric therapy for neutropenic fever (in combination amoxicillin/clavulanate) in low-risk patients.
  • Meningitis caused by Gram-negative organisms in penicillin allergic patients.
  • Chron’s flare
  • Spontaneous bacterial peritonitis (SBP) prophylaxis

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Last updated: June 5, 2017


Avdic, Edina, and Paul A Pham. "Ciprofloxacin." Johns Hopkins ABX Guide, The Johns Hopkins University, 2017. Johns Hopkins Guide, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540128/all/Ciprofloxacin.
Avdic E, Pham PA. Ciprofloxacin. Johns Hopkins ABX Guide. The Johns Hopkins University; 2017. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540128/all/Ciprofloxacin. Accessed August 19, 2019.
Avdic, E., & Pham, P. A. (2017). Ciprofloxacin. In Johns Hopkins ABX Guide. Available from https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540128/all/Ciprofloxacin
Avdic E, Pham PA. Ciprofloxacin [Internet]. In: Johns Hopkins ABX Guide. The Johns Hopkins University; 2017. [cited 2019 August 19]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540128/all/Ciprofloxacin.
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TY - ELEC T1 - Ciprofloxacin ID - 540128 A1 - Avdic,Edina,Pharm.D. AU - Pham,Paul,Pharm.D. Y1 - 2017/06/05/ BT - Johns Hopkins ABX Guide UR - https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540128/all/Ciprofloxacin PB - The Johns Hopkins University DB - Johns Hopkins Guide DP - Unbound Medicine ER -