Ofloxacin Dosage

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Usual Adult Dose for Inhalation Bacillus anthracis

Mass casualty treatment or prophylaxis of inhalational anthrax: 400 mg orally every 12 hours for 60 days

In case of intentional anthrax release as a biological weapon, the Working Group on Civilian Biodefense has suggested that, based on in vitro studies, ofloxacin could be used for postexposure prophylaxis or treatment of inhalational anthrax if ciprofloxacin and doxycycline are unavailable.

Usual Adult Dose for Anthrax Prophylaxis

Mass casualty treatment or prophylaxis of inhalational anthrax: 400 mg orally every 12 hours for 60 days

In case of intentional anthrax release as a biological weapon, the Working Group on Civilian Biodefense has suggested that, based on in vitro studies, ofloxacin could be used for postexposure prophylaxis or treatment of inhalational anthrax if ciprofloxacin and doxycycline are unavailable.

Usual Adult Dose for Bronchitis

400 mg orally every 12 hours for 10 days

Usual Adult Dose for Campylobacter Gastroenteritis

400 mg orally every 12 hours

Therapy should be continued for approximately 3 days. However, most cases are self-limited, and prudent withholding of antibiotics in mild cases does not appear to slow recovery in most patients.

Usual Adult Dose for Cervicitis

Due to Chlamydia trachomatis and/or Neisseria gonorrhoeae: 300 mg orally every 12 hours for 7 days

The patient's sexual partner(s) should also be evaluated/treated.

Due to high rates of resistance, the Centers for Disease Control and Prevention (CDC) do not recommend fluoroquinolones for treatment of gonococcal infections in the United States or for infections acquired in Asia, the Pacific Islands, England, and Wales. Ceftriaxone or oral cefixime are recommended as first-line treatment of gonorrhea in the United States or acquired in these areas. Antimicrobial susceptibility patterns should be monitored. The CDC recommends fluoroquinolones as alternative therapy only when gonococcal culture proves susceptibility.

Usual Adult Dose for Chancroid

400 mg orally every 12 hours for 3 days, depending on the nature and severity of the infection

The patient's sexual partner(s) should also be evaluated/treated.

Usual Adult Dose for Chlamydia Infection

300 mg orally twice daily for 7 days

The patient's sexual partner(s) should also be evaluated/treated.

Usual Adult Dose for Cystitis

Uncomplicated: 200 mg orally every 12 hours
Duration: 3 days for infections due to Escherichia coli or Klebsiella pneumoniae; 7 days for infections due to other organisms

Usual Adult Dose for Epididymitis - Non-Specific

200 to 400 mg orally every 12 hours for 10 days

Usual Adult Dose for Epididymitis - Sexually Transmitted

300 mg orally every 12 hours for 10 days

The patient's sexual partner(s) should also be evaluated/treated.

Ofloxacin is recommended by the CDC for nongonococcal epididymitis in patients over 35 years old, for infections due to enteric organisms, or as an alternate agent for nongonococcal infections in patients with hypersensitivity to ceftriaxone or doxycycline.

Due to high rates of resistance, the CDC do not recommend fluoroquinolones for treatment of gonococcal infections in the United States or for infections acquired in Asia, the Pacific Islands, England, and Wales. Ceftriaxone is recommended as first-line treatment of gonococcal infections in the United States or acquired in these areas. Antimicrobial susceptibility patterns should be monitored. The CDC recommends fluoroquinolones as alternative therapy only when gonococcal culture proves susceptibility.

Usual Adult Dose for Gonococcal Infection - Disseminated

400 mg orally every 12 hours

Due to high rates of resistance, the CDC does not recommend fluoroquinolones for treatment of gonococcal infections in the United States or for infections acquired in Asia, the Pacific Islands, England, and Wales. Antimicrobial susceptibility patterns should be monitored. The CDC recommends fluoroquinolones as alternative therapy only when culture proves susceptibility.

The CDC currently recommends initial hospitalization and injectable antimicrobials (i.e., ceftriaxone, cefotaxime, ceftizoxime) for the treatment of disseminated gonococcal infection. Twenty-four to forty-eight hours after improvement begins, the patient can be switched to oral cefixime or cefpodoxime for a total course of at least 1 week.

Doxycycline therapy for 7 days (if not pregnant) or single dose azithromycin is also recommended to treat possible concurrent chlamydial infection.

The patient's sexual partner(s) should also be evaluated/treated.

Usual Adult Dose for Gonococcal Infection - Uncomplicated

Uncomplicated urethral/cervical gonococcal infections: 400 mg orally one time

Due to high rates of resistance, the CDC does not recommend fluoroquinolones for treatment of gonococcal infections in the United States or for infections acquired in Asia, the Pacific Islands, England, and Wales. Ceftriaxone or oral cefixime are recommended as first-line treatment of gonorrhea in the United States or acquired in these areas. Antimicrobial susceptibility patterns should be monitored. The CDC recommends fluoroquinolones as alternative therapy only when culture proves susceptibility.

Doxycycline therapy for 7 days (if not pregnant) or single dose azithromycin is also recommended to treat possible concurrent chlamydial infection.

The patient's sexual partner(s) should also be evaluated/treated.

Usual Adult Dose for Joint Infection

Mild to moderate: 400 mg orally every 12 hours

Therapy should be continued for approximately 3 to 4 weeks, depending on the nature and severity of the infection. Longer therapy, 6 weeks or more, may be required for prosthetic joint infections. In addition, removal of the prosthesis is usually required to cure the infection.

Usual Adult Dose for Mycobacterium avium-intracellulare - Treatment

400 mg orally every 12 hours

The treatment of disseminated MAI infection in immunocompromised patients consists of either clarithromycin or azithromycin and 1 to 3 other drugs such as ethambutol, ciprofloxacin, ofloxacin, rifampin, rifabutin or amikacin. The optimal combination of drugs is not known. As long as a clinical and microbiological response is documented, therapy should be continued for life.

Usual Adult Dose for Nongonococcal Urethritis

300 mg orally every 12 hours for 7 days

The patient's sexual partner(s) should also be evaluated/treated.

Usual Adult Dose for Osteomyelitis

Mild to moderate: 400 mg orally every 12 hours

Therapy should be continued for approximately 4 to 6 weeks, depending on the nature and severity of the infection. Chronic osteomyelitis may require one to two months of additional antibiotic therapy and may benefit from surgical debridement.

Usual Adult Dose for Pelvic Inflammatory Disease

400 mg orally every 12 hours

Therapy should be continued for approximately 14 days, depending on the nature and severity of the infection. The patient should be reevaluated and switched to parenteral antibiotics if she does not respond to oral therapy within 72 hours.

Due to high rates of resistance, the CDC does not recommend fluoroquinolones for treatment of gonococcal infections in the United States or for infections acquired in Asia, the Pacific Islands, England, and Wales. A parenteral cephalosporin is recommended as first-line treatment of gonococcal infections in the United States or acquired in these areas. Antimicrobial susceptibility patterns should be monitored. The CDC recommends fluoroquinolones as alternative therapy only when gonococcal culture proves susceptibility.

Usual Adult Dose for Plague

Postexposure prophylaxis: 400 mg orally every 12 hours for 7 days
Treatment: 400 mg orally every 12 hours for 10 days

In case of intentional plague release as a biological weapon, the Working Group on Civilian Biodefense has suggested ofloxacin as an alternative agent to ciprofloxacin or doxycycline for treatment or postexposure prophylaxis of plague in a mass-casualty setting.

Usual Adult Dose for Pneumonia

400 mg orally every 12 hours for 10 to 21 days

Usual Adult Dose for Prostatitis

300 mg orally every 12 hours for 6 weeks

Usual Adult Dose for Pyelonephritis

Uncomplicated: 400 mg orally every 12 hours for 14 days

Usual Adult Dose for Salmonella Enteric Fever

200 to 400 mg orally every 12 hours for 7 to 14 days

Usual Adult Dose for Salmonella Gastroenteritis

200 to 400 mg orally every 12 hours

Therapy should be continued for approximately 3 days. However, most cases are self-limited, and prudent withholding of antibiotics does not appear to slow recovery in most patients.

Usual Adult Dose for Shigellosis

200 to 400 mg orally every 12 hours

Therapy should be continued for approximately 3 to 5 days in severely ill patients.

Usual Adult Dose for Skin or Soft Tissue Infection

Uncomplicated: 400 mg orally every 12 hours

Therapy should be continued for approximately 7 to 10 days, or for 3 days after acute inflammation disappears, depending on the nature and severity of the infection. For more severe infections, such as diabetic soft tissue infections, 14 to 21 days of therapy may be required.

Usual Adult Dose for Traveler's Diarrhea

300 mg orally every 12 hours

Therapy should be continued for approximately 3 days. However, most cases are self-limited, and prudent withholding of antibiotics in mild cases does not appear to slow recovery in most patients.

Usual Adult Dose for Tuberculosis - Active

300 mg to 400 mg orally or IV every 12 hours

May be given in combination with at least 3 other active drugs for treatment of multi-drug resistant TB, or when the patient is intolerant of first-line agents. AFB smear and culture should be monitored monthly.

Duration: Treatment for TB should generally continue for 18 to 24 months, or for 12 to 18 months after culture results are negative.

Usual Adult Dose for Urinary Tract Infection

Uncomplicated: 200 mg orally every 12 hours
Duration: 3 days for infections due to Escherichia coli or Klebsiella pneumoniae; 7 days for infections due to other organisms

Complicated: 200 mg orally every 12 hours for 10 days

Renal Dose Adjustments

CrCl 20 to 50 mL/min: After a normal initial dose, the usual recommended dose every 24 hours
CrCl 19 mL/min or less: After a normal initial dose, one-half the usual recommended dose every 24 hours

Liver Dose Adjustments

Patients with severe liver function disorders should not exceed a maximum dose of 400 mg/day.

Precautions

Consult WARNINGS section for dosing related precautions.

Dialysis

Ofloxacin is slightly removed during hemodialysis. Therefore, the dose should follow dialysis if given on a day the patient is dialyzed.

Clearance may be significantly increased in patients undergoing continuous renal replacement therapy. The dose should be individualized and based on calculated ofloxacin clearance during CRRT.

Other Comments

Iron-, zinc-, aluminum-, or magnesium-containing compounds (e.g., antacids, sucralfate, mineral supplements, buffered didanosine) should be taken either 2 hours before or 2 hours after ofloxacin. Patients should be well hydrated or instructed to drink plenty of water to avoid crystalluria.

The manufacturer's Medication Guide should be dispensed with each new and refill prescription.

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