Ciprofloxacin dosing

Good afternoon,

Based on a few readings, I would like to ask your opinion on the renal dosing of ciprofloxacin.
In our hemodialysis/pre-dialysis population, we typically reduced the dosage to 250 mg q12h (carefully avoiding interactions with phosphate binders, oral iron supplements, etc.) However, adherence to the medication schedule is sometimes quite a challenge for our patients.
Although Bennett's Renal Dosing Handbook indicates to decrease the dosage by 50%, Lexi-Comp states varying dosage intervals (one example is 250-500 mg p.o. q24h after dialysis)
After discussing the article below with my nephrologists, we have semi-concluded to prescribe Cipro 500 mg q24h @HS. I have not mentioned the extended-release formulation (Cipro XL) to them as of yet, I would like to gather some feedback from the RPN first.

Any insight, such as how you currently dose ciprofloxacin in patients with ClCr < 25 ml/min, hemodialysis, peritoneal, pre-dialysis patients... would be appreciated!
Thanks in advance,
Beverly
Dr Georges L Dumont Hospital
Moncton, NB

Ref:
Dose adjustment of ciprofloxacin in renal failure: reduce the dose or prolong the administration interval?
Eur J Med Res. 2005 Apr 20;10(4):145-8.