For ciprofloxacin when CrCl <30, what is typically recommended?

• A. Dosages used to treat common infections typically require reduction
• B. Increase dosage for efficacy
• C. No dosage change
• D. Ciprofloxacin is contraindicated entirely

Answer: (A)

When kidney function is reduced, drugs cleared by the kidneys need less frequent dosing or a smaller amount to prevent buildup. Ciprofloxacin is partly excreted by the kidneys, so with a CrCl below 30 mL/min, the drug can accumulate if given the usual dose. To maintain safety while still treating the infection, the dosing is typically reduced or the interval between doses is lengthened. That’s why the recommended approach for CrCl <30 is to adjust the dosage downward rather than increasing it or leaving it unchanged. Ciprofloxacin is not completely contraindicated in this setting, but careful dose adjustment is needed to avoid toxicity.