Ciprofloxacin × Omeprazole

Ciprofloxacin absorbs better in acidic gastric environment. Omeprazole raises gastric pH — ciprofloxacin bioavailability drops by 20–30%. Clinically significant in infections with borderline pathogen sensitivity.

In severe infection: inadequate clinical response — persistent fever, symptoms, and inflammation markers 48–72 hours after antibiotic start.

On the combination, take ciprofloxacin 2 hours before or 6 hours after omeprazole. If dosing cannot be separated, alternative antibiotics: amoxicillin-clavulanate for respiratory infections, a cephalosporin for UTIs. In urinary infections, ciprofloxacin still reaches adequate urine concentrations regardless of bioavailability.