2. Duration of Therapy
Therapy duration for antibiotics like fluoroquinolones is based on the type and severity of infection. Recommendations for usual or documented therapy durations for adults are summarized in Table 3. However, severe or complicated infections may require prolonged therapy.
| Drug Name | Treatment Indication | Maximum Therapy Duration |
|---|---|---|
| ciprofloxacin, IR | acute sinusitis | 10 days |
| bone and joint infections | 4 to 8 weeks | |
| chronic bacterial prostatitis | 28 days | |
| complicated intra-abdominal infections (in combination with metronidazole) | 7 to 14 days | |
| complicated, uncomplicated skin/skin structure infections | 7 to 14 days | |
| infectious diarrhea | 5 to 7 days | |
| inhalational anthrax (post-exposure) | 60 days | |
| lower respiratory tract infections | 7 to 14 days | |
| ciprofloxacin, IR or ER | moderate, complicated UTI | 7 to 14 days |
| Ciprofloxacin, IR | typhoid fever | 10 days |
| uncomplicated cervical, urethral gonococcal infections* | single dose | |
| ciprofloxacin, IR or ER | uncomplicated UTI | 3 days |
| delafloxacin | acute bacterial skin/skin structure infections | 5-14 days |
| community acquired bacterial pneumonia (CABP) | 5-10 days | |
| gemifloxacin | chronic bronchitis (acute bacterial exacerbation) | 5 days |
| CAP | 5 to 7 days | |
| levofloxacin | acute bacterial sinusitis | 10 to 14 days (500 mg dose); 5 days (750 mg dose) |
| acute pyelonephritis | 10 days (250 mg dose); 5 days (750 mg dose) | |
| chronic bacterial prostatitis | 28 days | |
| chronic bronchitis (acute bacterial exacerbation) | 7 days | |
| CAP | 7 to 14 days (500 mg dose); 5 days (750 mg dose) | |
| complicated skin/skin structure infections | 7 to 14 days (750 mg dose) | |
| inhalational anthrax | 60 days+ | |
| mild/moderate complicated UTI | 10 days (250 mg dose); 5 days (750 mg dose) | |
| hospital acquired pneumonia | 7 to 14 days | |
| plague or plague prophylaxis | 10 to 14 days (500 mg dose; 750 mg dose considered if clinically warranted) | |
| uncomplicated skin/skin structure infections | 7 to 10 days (500 mg dose) | |
| uncomplicated UTI | 3 days (250 mg dose) | |
| moxifloxacin | acute bacterial sinusitis | 10 days (5 to 7 days IDSA guidelines) |
| chronic bronchitis (acute bacterial exacerbation) | 5 days | |
| CAP | 7 to 14 days | |
| complicated intra-abdominal infections | 5 to 14 days | |
| complicated skin/skin structure infections | 7 to 21 days | |
| plague or plague prophylaxis | 10 to 14 days | |
| uncomplicated skin/skin structure infections | 7 days | |
| ofloxacin | acute pelvic inflammatory disease (PID) | 10 to 14 days^ |
| acute, uncomplicated urethral, cervical gonorrhea* | (400 mg dose) 1 day | |
| chronic bronchitis (acute bacterial exacerbation) | 10 days | |
| CAP | 10 days | |
| complicated UTI | 10 days | |
| mixed infection of urethra, cervix due to C. trachomatis and N. gonorrhoeae* | 7 days | |
| nongonococcal cervicitis/urethritis due to Chlamydia trachomatis | 7 days | |
| prostatitis due to E. coli | 6 weeks | |
| uncomplicated cystitis due to E. coli or K. pneumoniae | 3 days | |
| uncomplicated cystitis due to other organisms | 7 days | |
| uncomplicated skin and skin structure infections | 10 days |
Legend:
- +Levofloxacin safety greater than 28 days in adults and greater than 14 days in pediatric patients to manage anthrax has not been studied; use for greater than 28 days in adults and greater than 14 days in pediatrics when benefits outweigh risks
- * CDC no longer recommends fluoroquinolones for treatment of infections due to N. gonorrhoeae
- ^CDC no longer recommends fluoroquinolones for treating PID; may be considered in combination with metronidazole if parenteral therapy not feasible
Fluoroquinolone therapy duration in pediatric patients is summarized in Table 4.
|
Drug Name |
Treatment Indication | Maximum Therapy Duration |
|---|---|---|
| ciprofloxacin | UTI, pyelonephritis | 10 to 21 days |
| inhalational anthrax (postexposure prophylaxis) | 60 days | |
| plague | 14 days | |
| levofloxacin | inhalational anthrax (postexposure prophylaxis) | 60 days+ |
| plague | 10 to 14 days |
Legend:
- UTI = urinary tract infection
- +Levofloxacin safety when used for longer than 14 days in pediatric patients has not been studied; use for greater than 14 days when benefit outweighs risk