Topical fluoroquinolone antibiotic (ophthalmic) Pregnancy: Use with caution — systemic quinolones avoided; topical exposure minimal but caution advised.

Ciprofloxacin 0.3% Eye Drops/Ointment (Ciloxan)

Brand names: Ciloxan

Adult dose

Dose: Bacterial conjunctivitis: 1–2 drops every 2 hours while awake for 2 days, then every 4 hours for 5 days. Corneal ulcer: 2 drops every 15 minutes for 6 hours, then every 30 minutes for rest of day 1; day 2 every hour; days 3–14 every 4 hours

Route: Ophthalmic (drops or ointment)

Frequency: Varies by indication — see notes

Max: Per protocol above

Bacterial conjunctivitis (mild-moderate): standard quinolone protocol. Bacterial keratitis / corneal ulcer: intensive dosing protocol — consider inpatient or close specialist supervision. Pseudomonas aeruginosa coverage is a key advantage over chloramphenicol. Discontinue if no improvement at 72 hours.

Paediatric dose

Route: Ophthalmic

Frequency: Same as adult

Max: Same as adult dosing protocol

Licensed from 1 year for conjunctivitis; from 1 year for corneal ulcers (specialist). Same dosing as adults.

Dose adjustments

Renal

No adjustment for ophthalmic use.

Hepatic

No adjustment for ophthalmic use.

Clinical pearls

First choice for contact lens-related keratitis (Pseudomonas coverage) — superior to chloramphenicol
White corneal precipitate during ulcer treatment is ciprofloxacin deposit — not treatment failure; continue
Intensive hourly dosing for corneal ulcers requires patient education and written schedule
Culture before starting for corneal ulcers — guides targeted therapy
Acanthamoeba keratitis: NOT treated with ciprofloxacin alone — requires specialist PHMB / chlorhexidine drops

Contraindications

Hypersensitivity to ciprofloxacin or other quinolones
Viral (herpetic) keratitis — will not treat and may worsen

Side effects

Ocular burning and discomfort
White crystalline precipitate in corneal ulcer (ciprofloxacin deposits — cosmetic, resolves)
Eyelid oedema
Photophobia
Taste disturbance (nasolacrimal drainage)
Corneal staining

Interactions

No significant systemic interactions at ophthalmic doses

Monitoring

Clinical response at 72 hours
Slit lamp at specialist review for corneal ulcers
Culture sensitivities

Reference: BNFc; BNF; RCOphth Corneal Infection Guidelines; Ciloxan SPC. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways