Penetration may be enhanced with meningeal inflammation. Use optimal doses.

CSF concentrations inadequate for streptococci. Ciprofloxacin may be useful for meningitis due to multi-resistant Gram negative organisms and as an alternative to β-lactams (ceftazidime, cefepime, meropenem) for P. aeruginosa meningitis, and moxifloxacin for M. tuberculosis CNS infections.