Combination Ciprofloxacin
Mechanism of Action
Inhibits bacterial DNA gyrase and topoisomerase IV, preventing DNA replication. Broad-spectrum bactericidal.
Indications
Combination formulation. Urinary tract infections, respiratory infections (non-first line), GI infections, skin infections, anthrax prophylaxis. Particularly valuable for Gram-negative infection coverage in lunar habitat.
Dosing
Standard (Earth)
See Combination prescribing information. 250-750 mg twice daily (oral) or 200-400 mg IV every 12 hours.
Lunar Protocol
Standard dosing. Important lunar consideration: fluoroquinolones may worsen tendon injury risk — already elevated in musculoskeletal-challenged lunar residents. Avoid in residents with active tendinopathy. Adequate hydration essential (renal stone risk in dehydrated lunar residents).
Storage
Standard
Room temperature.
Lunar (Radiation + Temperature)
Excellent stability at room temperature. Radiation shielded. 3-year expiry allows larger stock. Both oral and IV forms in lunar medical bay. IV form for critically ill patients where oral route not available.
Supply Chain & Lunar Pharmacy Notes
Essential broad-spectrum antibiotic. Alternative to amoxicillin for Gram-negative coverage. Reserve IV form for in-hospital use. Antibiotic stewardship: do not use for minor infections when narrower spectrum appropriate.
Drug Interactions
Antacids, calcium, iron (reduce absorption). Warfarin (increases INR). Methotrexate. QT-prolonging drugs.
Contraindications
Known hypersensitivity to fluoroquinolones. Avoid in children <18 (cartilage effects). History of fluoroquinolone-induced tendinopathy.
Side Effects
GI upset, CNS effects (insomnia, dizziness), tendon rupture, QT prolongation, photosensitivity.
Lunar Alternatives
Trimethoprim-sulfamethoxazole (UTI), levofloxacin (respiratory), ceftriaxone (severe infections).