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.

Table 3. Adult Oral Fluoroquinolone Maximum Recommended Therapy Duration^1-9

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
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.

Table 4. Pediatric Oral Fluoroquinolone Maximum Recommended Therapy Duration^1-3,7

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