Pefloxacin

When ATH:
J01MA03

Characteristic.

Fluoroquinolone antibacterial agent II generation.

Pharmacological action.
Broad-spectrum antibacterial.

Application.

Treatment of infections, caused by susceptible microorganisms: respiratory and otolaryngology (middle ear, paranasal sinuses, throat, larynx), eye, kidney and urinary tract, GI (incl. salmonellosis, typhoid fever), oral, teeth, jaws, infection of the gallbladder and biliary tract (cholecystitis, kholangit, gallbladder empyema), pelvic (incl. adnexitis and prostatitis), epididymitis, gonorrhea, Chlamydia, chancroid, bone infections, joints, skin and soft tissue, intra-abdominal abscesses, peritonitis, sepsis, incl. septicemia, endokardit, meningoэncefalit; surgical and hospital infections, prevention of surgical infection.

Contraindications.

Hypersensitivity, gemoliticheskaya anemia, associated with lack of glucose-6-phosphate dehydrogenase, epilepsy, pregnancy, lactation, childhood (to 15 years).

Restrictions apply.

Cerebral atherosclerosis, cerebrovascular accident, organic CNS, convulsive disorder of unknown etiology.

Side effects.

From the nervous system and sensory organs: depression, headache, dizziness, fatigue, sleep disorders, increase convulsive, a feeling of anxiety, excitation, tremor, rarely convulsions.

Cardio-vascular system and blood (hematopoiesis, hemostasis): tachycardia, leukopenia, neutropenia, thrombocytopenia (at doses 1600 mg / day), agranulocytosis, eozinofilija.

From the digestive tract: nausea, vomiting, diarrhea, abdominal pain, anorexia, flatulence, psevdomembranoznыy colitis, transient increase in liver transaminases, cholestatic jaundice, hepatitis, hepatic necrosis.

With the genitourinary system: kristallurija, seldom-Glomerulonephritis, dizurija.

Allergic reactions: skin rash, itching, hives, dermahemia, photosensitivity, seldom-swelling kwinke, bronchospasm, arthralgia.

Other: myalgia, Tendinitis, tendon rupture, candidiasis; phlebitis at the injection site.

Cooperation.

Pefloksatsina potentiates the effect of anticoagulants, significantly reduces prothrombin index (patients, accepting indirect anticoagulants, requires constant monitoring of blood picture). Pefloksatsina reduces the metabolism of theophylline in the liver, which leads to increased concentrations of theophylline in plasma and CNS and elongation T_1/2 teofillina (theophylline dose should be reduced). Probenecid prolongs the excretion of pefloxacin. Histamine H₂-blockers extend T_1/2, reduce general and renal clearance pefloxacin.

Cimetidine and other inhibitors of microsomal oxidation increase T_1/2, reduce the total clearance, but do not affect the volume of distribution and renal clearance. Enveloping means slow absorption. Concomitant use of beta-lactam antibiotics can prevent the development of resistance during treatment of staphylococcal infections. Aminoglikozidy, piperacillin, azloцillin, ceftazidime increase antibacterial effect (incl. during infection, caused by Pseudomonas aeruginosa). Preparations, block tubular secretion, slow excretion of pefloxacin.

Overdose.

Symptoms: increased side effects.

Treatment: simptomaticheskaya therapy, If necessary, hemodialysis and peritoneal dialysis. Spetsificheskiy antidote unknown.

Dosing and Administration.

Inside, / drip. Dose selected individually, depending on the location and severity of the disease. Inside, in normal infections — on 400 mg 2 once a day, the average daily intake is 800 mg. B / drip (in infective endocarditis, sepsis, osteomielite, severe infections) -first dose 800 mg, then 400 mg every 12 no. Infusion was performed for 1 no. The solution for infusion is prepared time, the contents of sealed dissolved in 250 ml 5% glucose solution. The average duration is 1-2 weeks.

If abnormal liver function necessary correction mode: When minor violations of drug appointed dose of 400 mg / day, While more expressed violations — every 36 no, in severe liver disease interval between doses increased to 2 d. The course of treatment is not more than 30 days.

Patients at the kidney function (When Cl creatinine below 20 ml / min) single dose of 50% of medium (while maintaining a multiplicity of reception 2 once a day) or complete a single dose 1 once a day. Elderly patients to reduce the dose 1/3.

Precautions.

In renal and hepatic insufficiency should be reduced single dose and frequency of administration (in proportion to the extent of the damage function). During treatment, avoid contact with UV irradiation (due to the possible occurrence of photosensitivity), patients should receive plenty of fluids (to prevent crystalluria).

When mixed infections, when ruptured abdominal processes, infections pelvic pefloksatsina combined with drugs, active against anaerobes (metronidazol, klindamiцin). If there during treatment or after severe and prolonged diarrhea, It is necessary to exclude the development of pseudomembranous colitis. Upon confirmation of the diagnosis requires the immediate withdrawal of the drug and the appointment of appropriate treatment.

During treatment should refrain from activities potentially hazardous activities, require high concentration and speed of psychomotor reactions.

Cooperation