The ciprofloxacin QTc alarm: What every hospitalist needs to know

Fluoroquinolones are widely used antibiotics, however, concerns about QTc prolongation often limit their use in inpatient care. Ciprofloxacin, despite demonstrating minimal QTc effects and the lowest arrhythmic risk within its class, is frequently avoided due to non-specific electronic medical record warnings. This perspective reviews pharmacologic and real-world data to understand the real QTc risk, emphasizing ciprofloxacin's favorable cardiac safety profile. Aligning evidence with clinical practice may reduce unnecessary hospitalization, avoid prolonged intravenous therapy, and support safer transitions to oral antibiotics.