Summary
Ciprofloxacin has reached the approved stage (maximum clinical phase 4) for at least one indication, so its use in COPD would be drug repurposing rather than first-in-human development. This does not mean it is approved for COPD. ClinicalTrials.gov lists 8 registered trials linking Ciprofloxacin to COPD: 6 have completed; 2 are terminated, withdrawn, suspended or of unknown status. The most advanced is Phase 4 (NCT02171338). The largest enrolment is 304 participants (NCT00097773). Registration activity spans 2004 to 2020. The literature layer holds 6 publications for this pair: 1 Cochrane review and 5 clinical trial publications. Publication years run from 2010 to 2022. Because at least one synthesis-level source exists (systematic review, meta-analysis or Cochrane review), this pair has been assessed beyond single studies, although the synthesis may concern a different indication.
The RepurpOS disease-intelligence file for Chronic Obstructive Pulmonary Disease ranks 505 candidate therapeutics from Open Targets, ChEMBL, DGIdb and PubMed; only a minority carry direct clinical evidence, and this page covers one of those. Spontaneous remission context recorded for the condition: Effectively zero — airflow obstruction is irreversible by definition in COPD; FEV1 decline continues at 30-60 mL/year on standard care.
Evidence table
| Evidence tier | A · Strong |
|---|---|
| Evidence score | 59.5 (trials 24.5, literature 15.0, tier 15, approved bonus 5.0) |
| Registered trials | 8 total: 0 recruiting, 0 active / not yet recruiting, 6 completed, 2 other |
| Linked publications | 6 (5 clinical trial publications, 1 Cochrane review) |
| Agent type | Drug (Small molecule) |
| Development stage (any indication) | Approved |
| Mechanism / class | Not recorded |
| Data sources | Open Targets, ChEMBL |
| Linked via biomarker / target | ADCY5 |
How the evidence score is calculated
- Each registered trial scores by status (recruiting / active / enrolling 3, completed 2.5, not yet recruiting 2, unknown 1, terminated / withdrawn / suspended 0.5) plus a phase bonus (phase 3-4 +2, phase 2 +1, phase 1 +0.5). The trial component is capped at 30.
- Each literature item scores by design (Cochrane review 5, meta-analysis 4, systematic review 3, RCT 3, clinical trial publication 2, curated reference 1.5, other PubMed record 1). The literature component is capped at 30.
- The existing evidence tier adds 15 (A / Strong), 10 (B / Moderate), 5 (C / Preliminary) or 0 (D / Anecdotal).
- Agents approved for any indication (max clinical phase 4) add 5, because an approved agent has an established safety profile that lowers the barrier to repurposing trials.
- The score ranks what has been studied, not what works. It does not read effect sizes or directions of effect.
Registered clinical trials
| NCT ID | Title | Status | Phase | Enrolment |
|---|---|---|---|---|
| NCT03262142 | Targeted AntiBiotics for Chronic Pulmonary Diseases 2018 | terminated | Phase 4 | 51 |
| NCT02171338 | Procalcitonin as a Marker of Antibiotic Therapy in Patients With Lower Respiratory Tract Infections 2013 | status unknown | Phase 4 | 55 |
| NCT02300220 | Targeted Retreatment of COPD Exacerbations 2014 | completed | Phase 3 | 144 |
| NCT00097773 | Comparison of Two Treatment Regimens to Reduce PA Infection in Children With Cystic Fibrosis 2004 | completed | Phase 2 | 304 |
| NCT01072942 | To Evaluate the Safety, Tolerability, Pulmonary Deposition, Pharmacokinetics and Pharmacodynamics of Ciprofloxacin Inhale in Japanese Patients With Moderate to Severe Chronic Obstructive Pulmonary Disease (COPD, GOLD II-III) 2010 | completed | Phase 1 | 16 |
| NCT01052298 | Study to Evaluate the Safety and Pharmacokinetics of Inhaled Ciprofloxacin in Patients With Mild to Moderate Chronic Obstructive Pulmonary Disease (COPD) 2009 | completed | Phase 1 | 25 |
| NCT04879030 | Combination Antibiotic Therapy Compared to Monotherapy in the Treatment of Acute COPD 2020 | completed | PHASE2, PHASE3 | 170 |
| NCT00153634 | Standard vs. Biofilm Susceptibility Testing in Cystic Fibrosis (CF) 2004 | completed | Not applicable | 75 |
Published literature
- Clinical trial publication Targeted AntiBiotics for Chronic pulmonary diseases (TARGET ABC): can targeted antibiotic therapy improve the prognosis of Pseudomonas aeruginosa-infected patients with chronic pulmonary obstructive disease, non-cystic fibrosis bronchiectasis, and asthma? A multicenter, randomized, controlled, open-label trialEklöf J, Alispahic IA, Sivapalan P et al. · Trials · 2022 · PMID 36167555
- Clinical trial publication Targeted Retreatment of Incompletely Recovered Chronic Obstructive Pulmonary Disease Exacerbations with Ciprofloxacin. A Double-Blind, Randomized, Placebo-controlled, Multicenter, Phase III Clinical TrialRitchie AI, Brill SE, Vlies BH et al. · American journal of respiratory and critical care medicine · 2020 · PMID 32267724
- Clinical trial publication Ciprofloxacin Dry Powder for Inhalation in Patients with Non-Cystic Fibrosis Bronchiectasis or Chronic Obstructive Pulmonary Disease, and in Healthy VolunteersStass H, Nagelschmitz J, Kappeler D et al. · Journal of aerosol medicine and pulmonary drug delivery · 2017 · PMID 27448179
- Cochrane review Antibiotics for treatment of acute exacerbation of chronic obstructive pulmonary disease: a network meta-analysisZhang HL, Tan M, Qiu AM et al. · BMC pulmonary medicine · 2017 · PMID 29233130
- Clinical trial publication Echinacea purpurea along with zinc, selenium and vitamin C to alleviate exacerbations of chronic obstructive pulmonary disease: results from a randomized controlled trialIsbaniah F, Wiyono WH, Yunus F et al. · Journal of clinical pharmacy and therapeutics · 2011 · PMID 21062330
- Clinical trial publication Standard versus newer antibacterial agents in the treatment of severe acute exacerbation of chronic obstructive pulmonary disease: a randomized trial of trimethoprim-sulfamethoxazole versus ciprofloxacinNouira S, Marghli S, Besbes L et al. · Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2010 · PMID 20536364
Mechanism and notes
No mechanism of action is recorded for this pair in the source databases.
OSMF's existing evidence tier for this pair is A (Strong), derived from the strength of the disease association recorded in Open Targets and ChEMBL, in this case via the biomarker or target ADCY5. The tier describes how well the drug-disease link is documented, not how well the drug works.
Frequently asked questions
Is Ciprofloxacin approved for COPD?
Ciprofloxacin has reached the approved stage (maximum clinical phase 4) for at least one indication, so its use in COPD would be drug repurposing rather than first-in-human development. This does not mean it is approved for COPD. Approval status for the specific indication should always be confirmed with the relevant regulator and prescribing information.
Is Ciprofloxacin in clinical trials for COPD?
ClinicalTrials.gov lists 8 registered trials linking Ciprofloxacin to COPD: 6 have completed; 2 are terminated, withdrawn, suspended or of unknown status. The most advanced is Phase 4 (NCT02171338). The largest enrolment is 304 participants (NCT00097773). Registration activity spans 2004 to 2020.
What does the evidence show for Ciprofloxacin in COPD?
Ciprofloxacin has both completed registered trials and synthesis-level publications linked to COPD. That is the strongest profile in this database, but the summaries here do not extract effect sizes, so read the linked reviews for direction and magnitude of benefit. OSMF's existing evidence tier for this pair is A (Strong), derived from the strength of the disease association recorded in Open Targets and ChEMBL, in this case via the biomarker or target ADCY5. The tier describes how well the drug-disease link is documented, not how well the drug works.
Cite this page
Data: ClinicalTrials.gov, PubMed, Open Targets, ChEMBL, DGIdb and the OSMF therapeutic agent database. Last updated 2026-07-05. Page built 2026-10-07.