Levofloxacin in the treatment of urinary tract infections. Levofloxacin for cystitis
Levofloxacin is a pharmacological bactericidal drug with an extensive spectrum of action.
The composition of the drug includes fluorocarboxyquinolone.
The drug is a white crystalline powder with a yellowish tint, soluble in liquid.
pharmachologic effect
Levofloxacin is an antibiotic. The main active ingredient is hemihydrate, which is an isomer of ofloxacin.
A distinctive characteristic of the drug is the increased effectiveness of the action, which is explained by the levorotatory formula of the substance.
It is used as an antibacterial drug of synthetic origin.
The bioavailability of the drug in the form of tablets is about 99%.
The absorption of the substance by the gastrointestinal tract is carried out within a short period of time.
The drug can be used regardless of meals, due to the fact that in this case there is no significant effect on the duration of absorption.
After taking the drug, it actively spreads throughout the body, and quickly penetrates into the tissues, including the tissues of the respiratory organs.
It is characterized by stability, being in the blood and during excretion through the urine, without forming toxic decomposition products for the body.
The composition of the drug (with a volume of 100 ml) includes 500 mg of Levofloxacin in its pure form, as well as excipients: sodium chloride, chlorous acid, sodium edetate.
Mechanism of action
The drug has an effect on most microorganisms that have an aerobic metabolism.
Among them are strains sensitive to the influence of ampicillin, methicillin.
The action of the drug occurs by blocking the work of enzymes, due to which the synthesis of DNA molecules occurs.
In turn, this leads to the fact that pathological microorganisms are not able to divide, and their spread stops.
The use of drugs in medicine
Indications for the use of Levofloxacin:
Restrictions and contraindications
Contraindications for use:
- individual intolerance to the substances that make up the drug;
- diseases of ligaments and tendons caused by the use of drugs from the group of fluoroquinolones;
- during pregnancy and during breastfeeding;
- epileptic seizures;
- age limit (children under the age of 18);
- (in the elderly).
Forms of release of the drug
Levofloxacin is available in the following forms:
- infusions for intravenous administration, distributed in vials of 0.5 g of active ingredient for every 100 mg of solution;
- tablets - 250m, packs of 10 pieces of 0.25g;
- tablets - 500 mg, packs of 10 pcs. by 0.5g.
Based on the instructions for use and feedback from practitioners, the following doses of Levofloxacin are recommended, depending on the disease and its severity:
The drug should be taken in accordance with the required dosage. With a daily dose of 0.5 g of the drug, one tablet of 0.5 g or two tablets of 0.25 g should be taken.
Intravenous infusion for drip injection into a vein is used twice a day - 0.5 g of the active substance.
Cases of overdose
An overdose of the drug is possible even with a slight excess of the recommended dosage.
Overdose symptoms:
- nausea, vomiting;
- headache;
- disturbances of consciousness;
- excessive sleepiness;
- slurred speech;
- trembling and weakness in the body.
A lethal outcome is possible with a single use of a dose exceeding 0.25 g of the active substance per kg of body weight.
This is important to remember!
When interacting with drugs, which include antacids and suralphates, the effectiveness of the drug is sharply reduced.
In the presence of renal insufficiency, taking the drug in combination with other pharmaceuticals may have a negative effect.
When using drugs to strengthen joints and tendons, the simultaneous use of Levoflaxacin leads to an increase in the likelihood of their ruptures.
In addition, the drug is contraindicated during pregnancy, as well as during breastfeeding. Taking medication by children under 18 years of age is also contraindicated.
Medical opinion
Reviews of doctors about Levofloxacin are offered below.
The medication was prescribed to a patient with a diagnosis of acute pyelonephritis. Admission was accompanied by side effects in the form of constant nausea, vomiting, weakness.
After five days of administration, there were practically no side effects, and the patient was discharged 13 days after the start of administration.
Urologist, Konstantin Evgenievich
He prescribed Levofloxacin intravenously at 0.5 g. The patient had complications with cystitis. After a short-term intake (about 9 days), the patient's condition improved, and with virtually no side effects.
Intern Valery
A very powerful drug. Even despite the large number of side effects, it allows you to get rid of infectious diseases in the shortest possible period of time.
Kirill Antonovich
What do patients think?
Short excerpts from patient reviews about Levofloxacin, which were collected on various forums:
- It perfectly performs the function of an antibiotic, but it falls short as a modern medicine due to the large number of side effects. Already on the first day of admission, he suffered from candidiasis, as well as diarrhea.
- The antibiotic is very powerful, but after one tablet, severe headaches began. The pressure is all right, I'm 23 years old. I can imagine how older people feel when they take this drug. After the second tablet there was a constant desire to sleep.
- He took Levofloxacin for 5 days, at first he had a headache, he could not think hard, his stomach was twisting. In the last two days of admission, there were pains in the shoulder. The list of side effects indicates that you can not take if the tendons are damaged, most likely I encountered this.
- Saw to get rid of cystitis. No side effects, but after 2 weeks the infection returned in an even more severe form.
- The antibiotic may affect the head. Got a mental breakdown.
Patient Admission Tips:
- Before taking medication, the day before it is recommended to take about 10 tablets of activated charcoal in order to reduce the likelihood of intoxication of the body. The same should be done after the end of the course of admission.
- It is best to drink tablets with plenty of plain boiled water.. Despite the fact that antibiotic intake does not depend on meals, it is recommended to take it after meals.
- During the reception it is recommended to limit the physical and stress load on the body.
Most of the negative reviews from patients are due solely to side effects from taking Levofloxacin.
Pros and cons of the drug
The advantages of the drug: 
- a wide spectrum of action (diseases of the urinary system, skin of the body, respiratory tract, diseases of the prostate, etc.);
- convenient form of reception;
- high efficiency;
- low cost and availability.
Disadvantages of the drug:
- many side effects;
- the risk of intoxication of the body;
- the possibility of death in case of severe overdose;
- mental impact;
- a large number of contraindications.
Despite the large number of side effects and other disadvantages, Levofloxacin is an effective drug that is actively used to treat various infectious diseases.
Buying and storing medication
Price of Levofloxacin tablets:
- 0.5g (5 pcs.) - 270-460 r;
- 0.5g (10 pcs.) - 510-613 r;
- 0.5g (14 pcs.) - 615 - 690 r;
- 0.25g (5 pcs.) - 290 - 300 r;
- 0.25g (10pcs) - 305-480 r;
- solution - 0.5 g (100 ml) - 170-890 r;
- eye drops 1 ml - 30-45 r, 5 ml - 110 - 140 r.
The medicine must be stored at a temperature not exceeding 25 degrees, preferably in a dark place, protected from direct sunlight.
It is unacceptable to store the drug in places accessible to children. The release of the drug in the pharmacy is carried out according to the prescription.
Drug analogues
There are many drugs with a similar composition, and also have general indications and contraindications, but many of which are cheaper than Levofloxacin.
Common analogues:
The use of analogues is permissible only after prior consultation with the attending physician, who must prescribe the course of treatment and the correct dosage.
urinary tract infection(UTI) is one of the most urgent problems of modern urology. Inadequate therapy of this condition often leads to bacteremia and sepsis. In the US, UTIs cause 7 million visits to a doctor each year and 1 million hospitalizations.
Treatment of urinary tract infection implies the implementation of effective and timely antibiotic therapy, subject to the restoration of normal urodynamics, and aims to prevent urosepsis and the occurrence of relapses. Antibacterial drugs of the fluoroquinolone group are the drugs of choice for the treatment of UTIs worldwide.
An additional problem that significantly complicates the treatment of UTIs is the high resistance of microorganisms to most antibacterial drugs that have been used for a long time in urological practice. Hospitalism, inadequately long courses of treatment, and incorrect prescription of drugs often lead to the emergence of antibiotic-resistant strains. The emergence of a new effective drug for the treatment of UTI is a significant event and attracts close attention of doctors.
Levofloxacin (LF)- a new antimicrobial drug of the quinolone group - is the L-isomer of ofloxacin. Since levofloxacin accounts for almost all of the antimicrobial activity in the racemic mixture of isomers, its in vitro activity is twice that of ofloxacin. Both drugs show a similar level of toxicity in animal experiments, which suggests that levofloxacin is more effective due to the lower level of side effects. LF is intended for the treatment of infectious and inflammatory processes caused by microorganisms sensitive to LF. Recent studies have demonstrated good efficacy of LF in the treatment of complicated and uncomplicated urogenital infections. The pharmacokinetics of LF is similar to that of ofloxacin: the half-life is approximately 6-7 hours, and the maximum concentration in blood serum is reached 1.5 hours after ingestion. The mechanism of action of LF is similar to that of all fluoroquinolones and consists in the inhibition of bacterial topoisomerase-4 and DNA gyrase, enzymes responsible for replication, transcription and recombination of microbial DNA.
LF has a wide spectrum of antimicrobial activity. LF acts in vitro on the following infectious agents:
aerobic gram-positive: Streptococcus agalactiae, Staphylococcus aureus and saprophyticus, Enterococcus faecalis, Streptococcus pneumoniae, Streptococcus pyogenes;
aerobic gram-negative: Enterobacter cloacae, Escherichia coli, Haemophilus influenzae, Haemophilus parainfluenzae, Klebsiella pneumoniae, Legionella pneumophila, Moraxella catarrhalis, Proteus mirabilis, Pseudomonas aeruginosa;
other microorganisms: Chlamydia pneumoniae, Mycoplasma pneumoniae.
Resistance to LF associated with spontaneous mutations is relatively rare in vitro. Despite the presence of cross-resistance between Lf and other fluoroquinolones, some microorganisms resistant to quinolones may be sensitive to Lf.
LF is contraindicated in persons with hypersensitivity to LF or other quinolone drugs (their components). At present, the effect of LF on children, adolescents, pregnant and lactating mothers has not been studied.
The most commonly reported side effects are nausea (1.3%), diarrhea (1.1%), dizziness (0.4%) and insomnia (0.3%). All of the above effects are dose-dependent and quickly disappear after dose reduction or drug withdrawal.
The ease of use of LF - once a day - is another advantage of this drug. An analysis of scientific publications devoted to studies of the efficacy and tolerability of LF makes it possible to more clearly present its differences from other quinolones.
G. Richard et al. studied the efficacy and safety of LF 250 mg once daily versus ciprofloxacin 500 mg twice daily for 10 days in the treatment of 385 patients suffering from UTI symptoms in a randomized, double-blind, multicenter study. Before treatment, all patients underwent a bacteriological examination of urine, according to which all patients showed an increase in pathogenic microflora and the microbial count was 105 microbial bodies in 1 ml of urine. Clinical recovery was observed in 92% of patients treated with LF, and 88% of patients treated with ciprofloxacin. Side effects were noted in 4 and 3% of patients, respectively. The authors conclude that the efficacy and safety of LF therapy is comparable to that of ciprofloxacin.
Y. Kawada et al. compared the efficacy of LF at a dose of 100 mg twice a day (135 patients) and ofloxacin at a dose of 200 mg twice a day (126 patients) in the treatment of patients with complicated urinary infection. A positive clinical result was obtained in 83.7% of patients in the LF group and in 79.4% of patients in the ofloxacin group. These differences were not statistically significant. Side effects were noted in 4.9% of patients in the ofloxacin group. In the LF group, no such effects were noted, which, according to the authors, indicates a better tolerability of the drug.
No significant difference was found in the efficacy and tolerability of LF and other quinolones in a randomized, double-blind study by G. Richard et al. They used LF 250 mg once daily and ofloxacin 200 mg twice daily in 581 patients with uncomplicated UTI. Clinical improvement or cure was observed in 98.1% of patients in the LF group and in 97% of patients in the ofloxacin group.
In another study by G. Richard, I. Klimberg et al. compared the efficacy and tolerability of LF, ciprofloxacin and lomefloxacin in the treatment of 259 patients with acute pyelonephritis for 10 days. With the same efficiency, the authors note a significantly lower level of side effects in the treatment of LF compared with other drugs (gastrointestinal disorders in 2 patients and vaginitis in 1).
An interesting, in our opinion, study was performed by I. Klimberg et.al. They studied the efficacy and tolerability of LF and lomefloxacin in the treatment of complicated urinary infections. After randomization, patients received therapy with these drugs at a standard dosage for 7-10 days. At the same time, safety was assessed in 461 patients and microbiological efficacy in 336 of them. The average level of elimination of pathogens in the LF group was 95.5%, and in the lomefloxacin group - 91.7%. Side effects were noted, respectively, in 2.6 and 5.2% of patients. At the same time, photosensitivity and dizziness were more common in the lomefloxacin group, and nausea was more common in the LF group. Six patients in each group experienced various gastrointestinal disorders. The authors claim that the effectiveness of LF is approximately the same as other quinolones, while the tolerability of LF is somewhat better.
Thus, levofloxacin is a new antimicrobial drug used to treat infectious and inflammatory processes in the upper and lower urinary tract. Despite the fact that the effectiveness of the drug is close to that of other quinolones, the obvious advantages of LF are the low level of side effects and the possibility of a single dose per day. The existence of an intravenous form of the drug allows it to be more effectively used in the treatment of complicated urinary infections.
Materials and methods
We have undertaken a study of the effectiveness of LF in patients with complicated urinary tract infection. LF was administered to 20 patients (19 women and 1 man) aged 24 to 56 years (mean age 41.3 years) with complicated UTI observed at the Department of Urology of the Moscow State Medical University and in the CDC City Clinical Hospital No. 50. In 19 patients, there was an exacerbation of chronic pyelonephritis and chronic cystitis. One patient was prescribed the drug after contact ureterolithotripsy due to the development of infectious and inflammatory complications. LF was prescribed at a dose of 250 mg per day for 10 days.
The study included patients with UTIs in the initial stages of the development of inflammation, who had not taken antibacterial drugs before the start of the study.
The inclusion criterion was the presence of at least one clinical symptom (chills, pain in the lumbar region, dysuria, pain in the suprapubic region, nausea, vomiting) in combination with microbiological criteria:
the number of leukocytes in the urine is more than 10 in the field of view;
the number of colony-forming units of the pathogen> 104;
sensitivity to LF according to the sample with disks.
Prior to taking the drug, all patients underwent a routine urological examination, including urine culture for flora with determination of sensitivity to antibiotics, general urinalysis, clinical and biochemical blood tests, ultrasonographic monitoring (ultrasound), X-ray urological examination. None of the examined had signs of impaired passage of urine through the upper urinary tract.
The analysis of the results was carried out on the basis of a subjective assessment of the effectiveness of treatment by patients and a doctor, as well as the dynamics of objective studies: blood and urine tests, ultrasound images, urine cultures performed before the start of treatment, on the 3rd, 10th and 17th days of treatment.
No clinical benefit from treatment was defined as persistence or worsening of clinical symptoms at any time after 3 days of treatment.
The comparison group consisted of 23 patients (mean age 38.7 years) with acute pyelonephritis who were treated with ciprofloxacin 1.0 g per day.
results
In 90% of patients, the effectiveness of LF therapy was considered very good, and in 10% - good. Tolerability of the drug was very good in 55% of patients, good in 40% and moderate in 5% of patients.
In the ciprofloxacin group, 70% of patients showed very good treatment efficacy, 18% - good. In 3 patients (12%), ciprofloxacin therapy was ineffective, which was expressed in the preservation of severe hyperthermia and local pain in the lumbar region. Two of them were operated on due to the development of purulent inflammation: they underwent a kidney revision, decapsulation and nephrostomy.
The main complaints of the patients were pain in the lumbar region from the affected organ, chills, frequent painful urination, weakness - all these complaints were associated with an active inflammatory process in the upper and lower urinary tract. By the end of treatment, all patients treated with levofloxacin and 88% of patients treated with ciprofloxacin felt satisfactory and had no complaints.
Ultrasound monitoring of the size of the kidneys and the thickness of the renal parenchyma, carried out throughout the study in the main group, recorded a positive trend: an increase in the size of the kidney affected by the inflammatory process and local thickening of the parenchyma regressed by 10-17 days of treatment in all patients.
Pain on palpation of the lumbar region on the side of the lesion also regressed in all patients by the end of the study.
Monitoring of the culture study of urine against the background of LF therapy revealed a positive trend, expressed in a progressive decrease in the degree of bacteriuria, and by the 10-17th day of therapy, the urine culture was sterile. In the treatment of LF, inflammatory changes in the peripheral blood regressed. This was reflected in the normalization of the number of leukocytes and the disappearance of the stab shift in the blood formula.
Against the background of LF treatment, on the 3-10th day from the start of treatment, 6 patients (30%) experienced adverse reactions in the form of nausea, and 3 of them (15%) had episodes of diarrhea. It should be noted that these phenomena were insignificant. By the end of the study, complaints of nausea were made by 3 patients suffering from chronic gastritis for a long time. None of the patients required special treatment due to the above adverse reactions, and none of them refused therapy.
In the ciprofloxacin group, adverse reactions in the form of nausea and diarrhea that did not require discontinuation of the drug were noted in 18% of patients.
Discussion
According to our data, the efficacy and safety of LF treatment were found to be good to very good in 95% of patients. Similar results are given in their works by G. Richard, C. DeAbate et.al., who used the drug according to a similar scheme and received a clinical effect in 98.1% of patients. Kondo K. et al. report a 100% success rate for treatment with levofloxacin. Such high results are explained by the short duration of the use of levofloxacin in urological practice, which determines the absence of strains of microorganisms resistant to its action. It should be noted that resistance to drugs of this pharmacological group, associated with spontaneous mutations in vitro, is extremely rare.
The effectiveness of levofloxacin therapy in patients with acute pyelonephritis in the study by G. Richard et al. was 92%, while in the comparison group, where treatment with ciprofloxacin was carried out, it was slightly lower and equaled 88%. At the same time, the number of side effects recorded during treatment and expressed in various intensities of dyspeptic symptoms was 2% in the levofloxacin group, and 8% in the ciprofloxacin group.
According to our data, bacteriological examination of urine on the 10th day of admission and 7 days after discontinuation of treatment showed the absence of bacteriuria in all patients included in the study. I. Klimberg et al. studied the microbiological efficacy of levofloxacin in 171 patients. The course of treatment was 10 days. The drug was taken in the standard dosage - 250 mg once a day. The average level of elimination of pathogenic agents in the group was 95.5%.
Fu K.P. et.al., examining the safety of levofloxacin therapy, concluded that the most common side effects were nausea (1.3%) and diarrhea (1.1%). Dizziness (0.4%) and insomnia (0.3%) are somewhat less common. In our patients, sleep disorders and dizziness were not observed, which is probably due to the small number of patients in the group compared to Fu K.P., however, diarrhea and nausea were also quite common in our patients.
Based on our clinical study of the effectiveness of 10-day LF therapy, we can conclude that levofloxacin is an effective and safe agent for the treatment of patients with complicated urinary tract infection.
Literature:
1 Stratton C.W. A practical approach to diagnosing and treating urinary tract infections in adults // Antimicrob. inf. Dis, 1996; 15:37-40.
2. Davis R., Bryson H.M. Levofloxacin: a review of its antibacterial activity, pharmacokinetics and therapeutic efficasy // Drugs, 1994; 47:677-700.
3. George A. Richard., Stacy Childs., Cynthia Fowler et. al. A comparison of Levofloxacin and Ciprofloxacin for the treatment of urinary tract infections // Clin. Infect. Dis, 1996; 23:914, abs 293.
4. Y. Kawada., Y. Aso., S. Kamidono et.al. Comparative study of DR-3355 and Ofloxacin in complicated urinary tract infections. 31st Intersci Conf Antimicrob Agents Chemother. Chicago, Sept-Oct 1991 In: Programm and Abstracts, 1991: abs. 884.
5. Richard G., DeAbate C., Ruoff G. et.al. Short-course levofloxacin (250 mg qd) vs ofloxacin (200 mg bid) in uncomplicated UTI: a double-blind, randomized trial. 6th Int. Symp. on new Quinolones. Denver (Nov 1998) In: Abstracts, 1998: abs 126.
6. Richard G. A., Klimberg I. N., Fowler C. L., Callery-D'Amico S., Kim S. S. Levofloxacin versus ciprofloxacin versus lomefloxacin in acute pyelonephritis// Urology, 1998; 52:51-5.
7. Ira W. Klimberg, Clair E. Cox, Cynthia L. Fowler et.al. A controlled trial of levofloxacin and lomefloxacin in the treatment of complicated UTI // Urology, 1998; 51:610-5.
8. Kondo K., Akaeda T., Shidahara K., Nakayama Y. Usefullness of single-dose levofloxacin therapy for female acute uncomplicated cystitis // Jpn J Chemother, 1998; 46:195-203.
9. Fu K.P., Lafredo S.C., Foleno B. Et.al. In vitro and in vivo antibacterial activities of levofloxacin, an optically active ofloxacin // Antimicrob. Agents Chemother, 1992; 36:860-6.
Loran O.B., Pushkar D.Yu., Tevlin K.P.
MGMSU
An antibiotic is a drug that has a direct effect on bacteria and their reproduction process. The pharmacological group of fluoroquinolones includes Levofloxacin. It contains the active substance of the same name, which affects the structure of the pathogens of cystitis. The drug quickly destroys the DNA of microbes.
If a woman or a man complains of cystitis, a fluoroquinol with a bactericidal effect is prescribed. It blocks the enzymes necessary for the vital activity of pathogens of inflammation. Against the background of changes occurring in the walls of bacteria, the process of their reproduction is disrupted.
Levofloxacin is often prescribed for cystitis, as its primary effect is to kill bacteria, and the secondary effect is to prevent their increase in numbers.
Description of the drug
The release form of the drug to eliminate inflammation in the urinary system and prostate is tablets. They are covered with a shell with a yellow tint. The main component is levofloxacin, and calcium stearate and cellulose are isolated from additional substances.
The top layer consists of macrogol, talc, titanium dioxide. Levofloxacin is often prescribed for cystitis, as its primary effect is to kill bacteria, and its secondary effect is to prevent their reproduction.
The drug is produced in tablets, the dose of which is 250 and 500 mg. They are supplied in packs of 10 pieces. Drops are used to eliminate the infection that occurs in the organs of vision. Intensive treatment is carried out with an injection solution.
What else is being treated with the drug
The doctor may prescribe the drug in question not only for the treatment of an inflammatory process in the bladder. The drug has a wide spectrum of action and is often prescribed in the presence of the following pathologies:
The medication is prescribed for oral administration 1-2 times a day. It cannot be chewed up. The tablet is swallowed with a glass of water. The doctor allows you to drink Levofloxacin before meals or between meals. The dosage is also determined by the urologist. Previously, he considers the nature of the symptoms manifested, diagnosing the degree of development of the process. Comprehensive examination reveals concomitant diseases.
A mild form of the infectious process is eliminated by 250 mg of the drug. This dosage is kept for 3 days. If cystitis with prostatitis is confirmed, take 500 mg of the drug for a month. Pyelonephritis and other complicated infections occurring in the urinary system together with cystitis are treated with 250 mg for no longer than 10 days.
A patient with impaired liver function does not need a special dose selection. This decision is explained by the breakdown of levofloxacin into metabolites in small quantities. Urologists do not recommend drinking the medicine earlier than 48 hours after normalization of the condition. Negative results of laboratory tests indicate the need to extend the therapeutic course.
In what cases is admission prohibited?
If the prostate is inflamed in a man in old age, Levofloxacin is taken with caution. The drug may receive a negative review due to a decrease in kidney function. It is dangerous to prescribe a remedy to patients who suffer from a lack of glucose.
Levofloxacin should not be taken if the following diagnosis is made:
What threatens the excess concentration of the active substance in the body
Due to the overdose received, patients leave negative reviews about Levofloxacin for cystitis. Excessive use of the drug disrupts the central nervous system, causing dizziness, confusion, convulsions, epileptic seizures. Less often, the work of the gastrointestinal tract is upset, against which the patient feels sick.
Gag reflexes become permanent. Additionally, erosions appear on the gastric mucosa, the QT interval is lengthened. If the above-described clinic manifests itself, it is treated symptomatically. Dialysis is indicated for the withdrawal of Levofloxacin. There is no specific antidote.
List of negative effects on the body
The use of the drug provokes side effects. They are especially strong when the permissible dose is exceeded.
Against the background of taking the drug, the microflora changes, which contributes to the increased reproduction of fungi and bacteria that are resistant to this antibiotic. Rarely, side effects require urgent treatment. If negative reactions occur, an analogue of Levofloxacin is prescribed, the doctor prescribes a new therapy regimen.
How to combine with other drugs
The interaction of the drug with substances that lower the cerebral threshold enhances their effect. Such a clinical picture is observed with the joint treatment of Levofloxacin with Theophylline.
The therapeutic effect that the agent under consideration has decreases when it is used in combination with sucralfate, magnesium. A similar reaction is observed due to iron salts, an aluminum-containing antacid. With this action, Levofloxacin is taken 2 hours before the above drugs or 120 minutes after them.
With simultaneous therapy of the agent under consideration with a vitamin K antagonist, the doctor should monitor the level of blood clotting. The excretion of substances by the kidneys slows down under the influence of cimetidine, probenecid. This reaction has no clinical significance. But with the complex use of medications that block a specific route of excretion, Levofloxacin therapy is carried out with caution. The risk group includes patients who have a limited functionality of the kidneys.
The drug slightly increases the half-life of drugs with cyclosporine. Complex reception with a glucocorticosteroid increases the likelihood of tendon rupture.
It is forbidden to take an antibiotic for therapy for children and adolescents, since it is characterized by a high degree of damage to cartilage and joints. If treatment is indicated for elderly patients, the internal organs are preliminarily examined. Particular attention is paid to the performance and functions of the kidneys. The risk group includes people over 60 who have similar disorders.
During the use of the drug, the development of seizures in patients with a previously affected brain is allowed, which is due to severe trauma, stroke. Signs of photosensitivity during treatment are rare. But before therapy, doctors advise to exclude strong solar radiation, as well as exposure to ultraviolet light.
Modern doctors believe that "Levofloxacin" in rare cases can cause pseudomembranous colitis. With this phenomenon, the withdrawal of the drug and the appointment of a new remedy are indicated. It is forbidden to drink drugs that depress gastrointestinal motility.
Replacement drugs
The cost of "Levofloxacin" is low, which depends on the territorial factor and dosage, so it is often included in the treatment regimen for cystitis and other infectious diseases. Minus the antibiotic: it is dispensed at the pharmacy by prescription of the attending physician.
If the drug provoked a side effect or there are indications for its cancellation, the patient is prescribed an analogue:
- "Glevo". The drug is included in the group of fluoroquinolines. Its active substance is levofloxacin. It is effective in combating infectious diseases caused by bacteria resistant to penicillins and cephalosporins.
- "Elefloks". An Indian drug with a wide spectrum of effects and the active ingredient - levofloxacin. Against the background of its intake, bacterial enzymes that are involved in DNA synthesis are deactivated.
- "Remedia". An antimicrobial drug indicated for use in infectious and inflammatory diseases. It is based on the active substance - levofloxacin. "Remedia" is administered intravenously.
What opinion did the drug leave about itself in people after treatment
Reviews of men about "Levofloxacin", used for prostatitis, are usually positive if the prostate gland is inflamed due to the activity of gram-negative microorganisms. Patients and doctors unanimously note that taking the medication reduces the manifestation of symptoms of acute cystitis already on the 4th day of treatment. At the same time, not only the number of urges to the restroom is reduced, but also the pain syndrome is reduced.
Side effects appear if Levofloxacin is taken for more than one week. The risk group includes patients suffering from stomach ulcers.
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The use of "Levofloxacin" for the fight against prostatitis 
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Levofloxacin is the main active ingredient of antibacterial drugs called Novox, Leflox, Floxium, Levo, Tigeron, Levoksimed, etc., produced by various pharmaceutical companies. Levofloxacin is a systemic antibiotic that, together with sparfloxacin, belongs to the group of third-generation fluoroquinolones, which means it has a wide spectrum of action.
Various strains of bacteria, such as: enterococci, staphylococci, streptococci, mycoplasmas, chdamydia, etc., are not resistant to levofloxacin. The only exceptions are spirochetes. Thus, for diseases of an infectious breed, the doctor may prescribe treatment with a drug whose active ingredient is levofloxacin.
Release form
The drug levofloxacin is produced in the form of tablets for internal use at a dosage of 250, 500 and 750 mg, in the form of a solution for infusion (dosage 500 mg per 100 ml) and eye drops for topical use (5 mg per 1 ml).
Indications for the use of levofloxacin
- Acute sinusitis.
- Exacerbation of chronic bronchitis.
- community-acquired pneumonia.
- Skin and soft tissue infections.
- intra-abdominal infection.
- Infectious prostatitis.
- Uncomplicated and complicated urinary tract infections - cystitis, urethritis, pyelonephritis.
The principle of action of levofloxacin in cystitis
Cystitis is an inflammation of the mucous membrane of the bladder, which is often caused by infection (in most cases, E. coli, enterococci), as well as viruses and fungi, and is characterized by a number of symptoms:
- Discomfort and pain in the lower abdomen.
- Frequent urge to urinate.
- Urine is cloudy in color, possibly with an admixture of blood, and an unpleasant odor.
- Cutting pain during urination, sometimes extending to the rectum.
- Sensation of an incompletely emptied bladder.
- Subfebrile temperature (up to 37.5)
- General malaise.
If a person has at least a few of these symptoms, you should consult a doctor (urologist, andrologist, gynecologist). After conducting an examination and examination of the patient, passing the necessary tests, and confirming the diagnosis of cystitis in the clinical picture, the doctor prescribes a comprehensive treatment. This is, first of all, antibiotic therapy plus uroprotectors, antifungal agents, antispasmodics, and probiotics. As for antibacterial agents, both in acute and chronic forms of the course of the disease, levofloxacin has shown its effectiveness in practice.
Violating the synthesis of DNA of a microbial cell, the drug has bactericidal effect, destroying pathogenic microorganisms and preventing them from multiplying. This will be followed by a healing process - the pain will subside, the urine will become clearer, the frequent urge to urinate will stop.
If the inflammation does not respond to treatment, and there is no improvement in well-being, then you need to be examined further and find out the cause in order to differentiate cystitis from other diseases. In other words, if the diagnosis is correct, and it is cystitis, then the patient will appreciate the effect of levofloxacin in complex therapy.
Indications and contraindications for cystitis
Cystitis in the primary, acute form has symptoms in which the patient simply needs bed rest. It is also prescribed to drink plenty of clean water, cranberry juice, herbal decoctions, special kidney fees. During treatment, the patient is shown a diet that excludes spicy, heavy, salty and fatty foods. To relieve pain, in addition to antispasmodics, physiotherapy, warming, herbal douching or baths can be prescribed.
With an exacerbation of chronic cystitis, the indications coincide with the treatment of the primary attack. And in the remission stage, the patient needs to direct his actions to eliminate all foci of infection in the body, for example, once untreated pharyngitis, tonsillitis, caries, etc.
In addition, women in whom this diagnosis is made much more often than men, due to the structure of the genitourinary system, should be regularly examined by a gynecologist. It is also desirable to adhere to proper nutrition, physical activity; monitor hygiene, and periodically drink uroprotective herbal remedies and vitamins to strengthen immunity.
Contraindications for cystitis are:
- Products that irritate the bladder mucosa: alcohol, caffeinated and carbonated drinks, sweets, fatty, spicy foods.
- Hypothermia of any scale.
- Wearing synthetic underwear.
- Sexual contact and physical activity during an attack.
- Self-treatment.
Method of application of levofloxacin, doses
Antibiotic therapy of cystitis with levofloxacin, again, should be prescribed only by the attending physician. It is the specialist who will take into account all the features of the course of the disease and prescribe the necessary treatment regimen. The drug is indicated for people over 12 years of age. It must be understood that if the patient is able to drink a pill, then this is much better for the body than infusions. Parenteral antibiotic therapy is prescribed in more severe human conditions.
Often, in cystitis patients with normal kidney function, levofloxacin is prescribed at a dosage of 250 or 500 mg once a day, regardless of food intake. The duration of treatment is from 3 to 14 days. In case of renal failure, the doctor corrects the scheme.
Contraindications and side effects
Like all drugs, levofloxacin has its contraindications for use. This:
- Hypersensitivity to the components of the drug, as well as to other fluoroquinolones.
- Epilepsy (convulsions and fainting)
- Renal failure.
- During pregnancy and breastfeeding.
- Damage or inflammation of the tendons as a result of taking other quinolones.
The latter is one of the side effects of levofloxacin. Sometimes therapy with such a powerful drug leads to a number of side effects affecting various systems of the human body. These are dizziness, fainting, nausea, diarrhea, vomiting, dyspepsia, headache, loss of some senses (taste, vision, for example), hypersensitivity reactions, angioedema, various changes in the composition of the blood, tachycardia, arrhythmia, shortness of breath, hepatitis, rash, hyperhidrosis , scabies, candidiasis, etc. Therefore, one should not neglect the instructions and allow an overdose of levofloxacin, because the possibility of manifestation of all of the above side symptoms increases. To avoid dysbacteriosis, probiotics are prescribed in combination with an antibiotic. For the prevention of thrush, antifungal agents are included in the treatment.
Analogues
As for analogues of levofloxacin, we have already determined above that there are many of them. And it is not so important what name the medicine will have (“Levofloks”, “Levalet”, “Novox”, “Tigeron”, etc.); it is important that the main active ingredient of this drug is levofloxacin in the dosage you need.
Expiration date and conditions for dispensing from pharmacies
The drug is valid for 3 years from the date of issue under proper storage conditions. Released by prescription.
The only remedy for CYSTITIS and its prevention, recommended by our subscribers!
Cystitis is an unpleasant disease that is quite common in women. One of the drugs widely used to treat cystitis is Levofloxacin. What is this medicine, what is its principle of action and how to take it correctly for cystitis - we will consider these issues in detail in this article.
What is Levofloxacin?
Levofloxacin is a drug belonging to the group of antibiotics and has a wide range of effects. In pharmacies, the drug is dispensed only by prescription.
The drug is available in the form of tablets of 250 and 500 milligrams of the active enzyme. The composition of the drug includes the active single-phase substance levofloxacin.
The mechanism of the drug is aimed at blocking the formation of the genetic apparatus of bacterial tissues (their DNA), which subsequently leads to their rapid death.
Levofloxacin is effective against such microbes:
- rickettsia;
- proteas;
- enterococci;
- ureaplasma;
- mycobacteria;
- mycoplasma;
- salmonella;
- chlamydia;
- listeria;
- staphylococci, etc.
The use of Levofloxacin for cystitis
Many appreciated the effect of Levofloxacin in the treatment of cystitis at its true worth.
Levofloxacin is used for the following types of cystitis:
- acute and chronic, of an infectious nature;
- post-traumatic - if the flora is highly vulnerable and sensitive;
- postoperative.
In the treatment of cystitis, Levofloxacin is prescribed 1 tablet of 250 milligrams of active enzyme per day. The duration of treatment is from a week to two weeks: it all depends on the stage, intensity, form and localization, as well as on laboratory changes in the tests. As a rule, 7 days after therapy, you need to re-examine to find out how effective the treatment is.
Levofloxacin: indications and contraindications
Consider the cases in which Levofloxacin is indicated. It affects almost all organs, so treatment with it is considered quite effective.
Indications for the use of Levofloxacin:
- sepsis;
- peritonitis;
- soft tissue and skin infections, erysipelas;
- furunculosis;
- bedsores;
- osteomyelitis;
- urethritis;
- cystitis;
- angina;
- bronchitis;
- gonorrhea;
- pyelonephritis;
- prostatitis;
- microplasmosis;
- otitis;
- sinusitis, etc.
Of course, Levofloxacin, like any other drug, has its own contraindications:
- lactation period;
- convulsions of any kind;
- epilepsy;
- allergy to components, their intolerance;
- age up to 18 years;
- adverse reactions to similar drugs associated with tendons;
- pregnancy.
It should be remembered that antibiotics negatively affect the speed of psychomotor reactions and concentration of attention. Hallucinations, confusion and impaired coordination may occur. Therefore, if you are taking Levofloxacin, you must give up work or activities that require a clear concentration. It is also recommended to avoid direct sunlight, visits to baths, saunas and solariums.
Adverse reactions during drug treatment
- Allergic reactions: flushing, itching, necrolysis, swelling of the face, Stevens-Jones syndrome, pressure, urticaria, chest pain, weakness, headache, excessive sweating, hand peresthesia, convulsions, diarrhea, nausea and problems with the gastrointestinal tract
- Cardiovascular system: neutropenia, leukopenia, thrombocytopenia, zosinophelia, tachycardia, vascular collapse.
- Extremely rare: elevated levels of bilirubin in the blood, bleeding in the gastrointestinal tract, hepatitis, cholelithiasis.
Tendinitis may develop - damage to the tendons, joints, a manifestation of muscle weakness. Very rarely, but there is a rupture of the tendons, deterioration of the kidneys, kidney failure and nephritis. Also fever, pneumonitis, in females - vaginitis.
If adverse reactions appear, then they do gastric lavage, immediately give sorbents, prescribe forced diuresis - drug-enhanced urination, as well as symptomatic therapy.
Application features
The instructions that come with the drug indicate that it can be taken with or without food.
As a rule, Levofloxacin is prescribed in the amount of 1-2 tablets of 250-500 milligrams 1 time per day, in severe cases - 2 times. The doctor must prescribe the dosage and duration of admission - he draws up an individual treatment regimen, taking into account the stage, form, localization and intensity of the disease.
The course of therapy can vary from one week to two; with prostatitis, treatment lasts a month.
Compatibility with other drugs
Also, you can not combine an antibiotic with non-steroidal drugs with anti-inflammatory properties: Imet, Aspirin, Ibuprofen, Paracetamol. Simultaneous administration of Levofloxacin with Theophylline and Fenbufen increases the risk of seizures.
The effectiveness of the drug is reduced when combined with Almagel, Rhenium, as well as iron salts. It is recommended to observe a three-hour interval in the use of these drugs.
The combined use of an antibiotic and Betamethasone, Dexamethasone, Prednisolone can lead to damage to the tendons.
You can not take the drug during pregnancy and during the lactation period, since the effect of the drug on the body of the mother and fetus has not been established.
Until the age of 18, the use of this antibiotic is prohibited, since it negatively affects the development of bones.
Drug analogues:
- Lefloc;
- Levomak;
- Tigeron;
- Levobaks;
- Flexid;
- Glevo;
- Lebel;
- Maklevo.
The rules of admission, dosage and course of treatment are indicated in the instructions attached to the drug.
Remember that self-medication can harm your health. Therefore, before you start taking medications, be sure to consult your doctor: he will prescribe you an effective and appropriate therapy.
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