Cipro (ciprofloxacin) is a fluoroquinolone (i.e. 'quinolone') antibiotic that is effective in treating a broad range of bacterial infections, including urinary tract infections. Although effective, Cipro, as well as other medications in the fluoroquinolone class, are generally not recommended for first line therapy of UTIs due to the risk of adverse effects, as discussed below.


Cipro Dosing For A UTI (Urinary Tract Infection)

Acute, Uncomplicated UTI

As mentioned above, Cipro is not recommended for first line treatment of uncomplicated UTIs due to the risk for serious side effects. It should only be used in cases where alternative treatment options cannot be used or have failed.

Adult females: 250 mg by every 12 hours for 3 days.


Moderate To Severe UTI With Complications

Adults: 250 to 500 mg by mouth every 12 hours for 7 to 14 days.


A dose of 750 mg by mouth twice a day isn't typically recommended for UTI infections and is generally reserved for more serious infections such as chronic bronchitis and pneumonia. That's not to say it wouldn't work for treating UTIs, it simply would increase the risk of adverse effects.


Cipro Side Effects

As a class, quinolone antibiotics are associated with several rare, but serious side effects. These include:

  • Tendinitis
  • Tendon rupture
  • Peripheral neuropathy
  • Central nervous system effects
  • QT Prolongation


Tendon Rupture/Tendinitis

Quinolone antibiotics such as Cipro have been associated potentially irreversible tendinopathy, or disease of the tendons. This includes tendinitis and tendon rupture. If these occur, surgical repair may be necessary and could potentially result in disability. While uncommon, tendon problems can occur anywhere from hours to weeks after Cipro administration and data shows it has happened in individuals with no pre-existing conditions or risk factors.


If you do take a quinolone antibiotic and your notice any discomfort or tendon pain, it is important to discontinue immediately. While the tendon problems are typically associated with the Achilles Tendon specifically, problems with other tendons have been reported as well. The risk of tendon rupture is increased in certain individuals:

  • Over age 60
  • Concomitant steroid therapy
  • Organ transplant recpients


Central Nervous System Effects

Quinolones have been reported to cause serious and potentially irreversible neurotoxicity, resulting in:

  • Anxiety
  • Confusion
  • Convulsions
  • Depression
  • Hallucinations
  • Severe headaches
  • Nerve type pain

Therapy should be discontinued at the first signs or symptoms. The incidence of CNS effects appears to be low (less than 1%) but it is important to be aware of the potential adverse reactions.


QT Prolongation

Quinolones are associated with QT prolongation, a type of arrhythmia. The risk is greatly increased in those taking certain medications or are already taking anti-arrhythmic drugs. Drug interactions between quinolones and other medications is a common cause of QT prolongation.


Summary

While Cipro has a long list of potential side effects, it is an effective medication and beneficial when used in the right circumstances. It is generally recommend to not use Cipro for uncomplicated UTI cases due to the availability of other, potentially safer antibiotic choices.