Levofloxacin is a highly effective drug for the treatment of infectious diseases. Levofloxacin for cystitis Method of administration of levofloxacin, doses
Levofloxacin is an antibacterial drug from the group of fluoroquinolones. A broad-spectrum drug is active against many pathogenic and opportunistic bacteria that excite infectious and inflammatory processes in the human body. The use of Levofloxacin is advisable in the treatment of diseases of the ENT organs (otitis media, sinusitis), respiratory tract (pneumonia, bronchitis), urinary system (cystitis, urethritis, pyelonephritis), genital organs (chlamydia, prostatitis), as well as soft tissues (boils and abscesses) .
Instructions for use
Below is the medication Levofloxacin - instructions for use are provided for informational purposes only. It is necessary to consult a doctor to prescribe the exact dosage of the medicine.
pharmachologic effect
The antibiotic Levofloxacin has a bactericidal effect. The drug blocks the work of enzymes that are necessary for the synthesis of DNA of pathogenic bacteria; without these enzymes, microorganisms cannot reproduce. When the active substance of the drug blocks DNA synthesis, changes occur in the bacterial cell wall, they are not compatible with the normal life and functioning of microbial cells. Thus, the main effect of the drug is bactericidal, first of all it destroys bacteria, and only secondly, does not allow them to multiply.
Levofloxacin is active against most Gram-positive, Gram-negative and anaerobic infectious agents. inflammatory diseases.
Composition and form of release
The drug Levofloxacin is available in the form of tablets. The tablets are film-coated, yellow, round, biconvex, 2 layers are visible on the cross section.
One tablet contains the active substance levofloxacin in the amount of 250 milligrams.
Auxiliary components: calcium stearate, microcrystalline cellulose, hypromellose, primellose.
Shell composition: hypromellose, titanium dioxide, talc, macrogol 4000, iron dye yellow oxide.
The drug Levofloxacin is also produced with a content of 500 mg of the active ingredient in 1 tablet.
Indications
Indications for the use of Levofloxacin:
- acute sinusitis;
- exacerbation of chronic bronchitis;
- community-acquired pneumonia;
- complicated urinary tract infections, including pyelonephritis;
- uncomplicated urinary tract infections - cystitis, urethritis;
- infectious prostatitis;
- infections of the skin and soft tissues;
- septicemia, bacteremia;
- intra-abdominal infection.
Contraindications
Contraindications to taking the drug Levofloxacin:
- renal failure (with creatinine clearance less than 20 ml / min);
- epilepsy;
- tendon lesions in previous treatment with quinolones;
- age up to 18 years;
- pregnancy and lactation;
- hypersensitivity to levofloxacin and other quinolones.
The drug Levofloxacin should be used with caution in the elderly, as there is a high possibility of reduced kidney function. Caution is also recommended for patients with glucose-6-phosphate dehydrogenase deficiency.
Dosage and method of application
Levofloxacin tablets are intended for internal use, as a rule, 1 or 2 doses are prescribed per day. Tablets should not be chewed, they must be swallowed with a sufficient amount of water - from 0.5 to 1 glass, can be taken before meals or between meals. The dosage is determined by the doctor, taking into account the nature and degree of development of the infection, as well as the presence of concomitant diseases.
For patients with normal or moderately reduced kidney function with a creatinine clearance of more than 50 ml / min, the following dosages are prescribed:
- with sinusitis - 500 mg 1 time per day, the course of treatment lasts from 10 to 14 days;
- with exacerbation of chronic bronchitis - 250-500 mg 1 time per day for 7-10 days;
- with community-acquired pneumonia - 500 mg once or twice a day for 7-14 days;
- with uncomplicated urinary tract infections (cystitis, urethritis) - 250 mg 1 time per day for three days;
- with prostatitis - 500 mg 1 time per day, the course of treatment is 28 days;
- with complicated urinary tract infections, including pyelonephritis - 250 milligrams once a day, the duration of the course of treatment is 7-10 days;
- for infectious diseases of the skin and soft tissues - 250-500 mg 1 time per day for 7-14 days;
- with septicemia, bacteremia - 250-500 mg once or twice a day for 10-14 days;
- with intra-abdominal infection - 250-500 mg of the drug once a day, a long-term therapeutic course - 7-14 days.
Patients undergoing hemodialysis or continuous ambulatory peritoneal dialysis do not require additional doses.
For patients with impaired liver function, a special selection of dosages is not carried out, since levofloxacin breaks down into metabolites in the liver only in small quantities.
As with other antibacterial drugs, treatment with Levofloxacin should be continued for at least 48-78 hours after normalization of body temperature or after positive results analyses.
Overdose
An overdose of Levofloxacin drugs includes manifestations at the level of the central nervous system, the following symptoms occur:
- dizziness;
- confusion;
- disturbances of consciousness and convulsive seizures by the type of epileptic seizures.
Disorders of the gastrointestinal tract may also occur - attacks of nausea and vomiting, erosive lesions of the mucous membranes, prolongation of the QT interval.
Treatment of overdose is symptomatic. Levofloxacin is eliminated by dialysis. There is no specific antidote.
Side effects
When taking the drug Levofloxacin, the development of side effects is possible:
- From the gastrointestinal tract - attacks of nausea and vomiting, diarrhea, increased activity of liver enzymes, lack of appetite, pain in the abdomen, digestive disorders, in rare cases, diarrhea with blood impurities may appear.
- From the side of the central nervous system - headaches, dizziness, numbness, drowsiness, sleep disturbances, in rare cases, patients may develop paresthesia in the hands, a feeling of anxiety, psychotic reactions in the form of depression and hallucinations, agitation, convulsions and confusion, extremely rarely there are visual and hearing impairments, impaired sense of smell and taste sensitivity decrease tactile sensitivity.
- From the side of the cardiovascular system - tachycardia, lowering blood pressure, in rare cases, vascular collapse is likely, prolongation of the QT interval.
- On the part of the urinary system - an increase in the level of bilirubin and creatinine in the blood serum, in rare cases, deterioration in kidney function up to acute renal failure, interstitial nephritis.
- On the part of the musculoskeletal system - damage to the tendons, including tendonitis, pain in the joints and muscles, in rare cases, tendon rupture, muscle weakness, muscle damage - rhabdomyolysis.
- On the part of the hematopoietic organs - an increase in the number of eosinophils, a decrease in the number of leukocytes, in rare cases, neutropenia, thrombocytopenia develops, which is accompanied by increased bleeding, agranulocytosis, the development of severe infections, in some cases - pancytopenia, hemolytic anemia.
- On the part of metabolism - in rare cases, it is possible to reduce the level of glucose in the blood, exacerbation of porphyria in patients suffering from this pathology.
- Allergic reactions - itching and redness of the skin, in rare cases - general hypersensitivity reactions, urticaria, bronchial constriction (possibly severe suffocation), swelling of the skin and mucous membranes, a sharp decrease in blood pressure and shock, hypersensitivity to sunshine And ultraviolet radiation, allergic pneumonitis, vasculitis, severe skin rash with blistering, toxic epidermal necrolysis, exudative erythema multiforme.
- Others - general weakness, in rare cases, fever is possible.
Taking any antibacterial drugs often causes changes in the microflora, which is normally present in every person. For this reason, there is an increased reproduction of bacteria and fungi that are resistant to the antibiotic used. In rare cases, these side effects may require additional treatment.
drug interaction
The simultaneous use of quinolones, including Levofloxacin, together with substances that can lower the cerebral seizure threshold, can provoke an excessive decrease in this threshold. A similar effect is observed when Levofloxacin and theophylline are taken together.
The effect of taking an antibiotic can be reduced by the combined use of sucralfate, magnesium-containing antacids and aluminum-containing antacids, as well as iron salts. In this case, Levofloxacin must be taken at least two hours before taking such drugs or two hours after taking them.
Simultaneous administration of Levofloxacin and vitamin K antagonists requires monitoring of the level of blood clotting.
The excretion of Levofloxacin by the kidneys may be slightly slowed down by the action of probenecid and cimetidine. It should be noted that such an interaction has practically no clinical significance. However, with the simultaneous use of drugs such as probenecid and cimetidine, which block a specific route of excretion, treatment medicine Levofloxacin should be used with caution. First of all, such caution is important for patients with limited kidney function.
Levofloxacin slightly increases the half-life of drugs containing cyclosporine.
Taking glucocorticosteroids increases the risk of tendon rupture.
Terms and conditions of storage
Keep out of the reach of children, dry and protected from light, at a temperature not exceeding 25 degrees.
Shelf life - two years. Do not use after the expiration date.
special instructions
You can not use the Antibiotic Levofloxacin for the treatment of children and adolescents, as there is a high probability of damage to the articular cartilage.
When treating elderly patients with Levofloxacin, it should be understood that this category of people often has impaired renal function.
In severe pneumonia caused by pneumococci, the drug Levofloxacin may not have a positive effect. therapeutic effect. Hospital infections in some cases may require combined treatment.
During the period of treatment with Levofloxacin, seizures may develop in patients with previous brain damage, which is caused by severe trauma or stroke.
Symptoms of photosensitivity when taking Levofloxacin are quite rare, but patients are still advised not to be exposed to strong sunlight and ultraviolet light without special need.
If pseudomembranous colitis is suspected, Levofloxacin should be discontinued immediately and the necessary treatment initiated. In such situations, you can not use medications that inhibit intestinal motility.
Terms of dispensing from pharmacies
The drug is dispensed by prescription.
Price
The price of the drug Levofloxacin varies from 350 to 550 rubles, depending on the specific pharmacy and region.
Analogues
Medicine analogues:
- Levofloxacin-Teva;
- Remedia;
- Elefloks;
- Glevo.
You can leave your review about Levofloxacin below!
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 the inflammatory process in 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. When manifested negative reactions 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 caused 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 used if, after laboratory tests of urine, it is revealed that the disease is provoked by the activity of pathogenic microorganisms.
Antibiotic therapy is prescribed in 9 out of 10 cases of diagnosing cystitis in patients. You can do without them only in cases where the disease is provoked by:
- prolonged hypothermia;
- allergic reactions (to personal hygiene products, contraceptives, fabric, etc.);
- active sexual intercourse;
- the beginning of the menstrual cycle;
- pregnancy;
- eating spicy foods and alcoholic beverages.
It is not advisable to solve any of the above causes with the help of drugs aimed at combating pathogenic microorganisms. Problems of this kind are treated with the help of diuretics, uroseptics, compliance with the drinking regimen of the day, diet and other non-medical practices.
Pathogenic microorganisms against which Levofloxacin is used:
- fungi of Candida and other species;
- Pseudomonas aeruginosa and Escherichia coli;
- proteus;
- staphylococcus;
- ischerechias;
- mycoplasmas and ureaplasmas;
- chlamydia;
- Klebsiella, etc.
Acute and chronic cystitis and other complicated or uncomplicated urinary tract infections are one of the main indications for treatment with the antibiotic Levofloxacin. Its active substance will disrupt the DNA synthesis of microorganism cells, thereby preventing them from multiplying, growing and eating. Gradually, during treatment, acute symptoms will go away and a full recovery will come.
Depending on the patient's condition, his age and the degree of neglect of the disease, the drug can be prescribed in the form of:
- pills containing 250, 500 and 750 mg of the active substance;
- solution for intramuscular and intravenous infusions at a dosage of 500 mg per 100 ml of liquid.
Instructions for use
The first thing to remember for patients who are faced with manifestations of cystitis is that self-medication is dangerous to health. Antibiotic therapy can only be prescribed by a doctor, to who needs to be contacted immediately at the first symptoms, including include:
- false urge to urinate with a frequency of up to 30 times per day;
- difficulty in the release of fluid (small drops), accompanied by pain and pain in the urethra;
- pain above the pubis and in the lower back;
- change in the color and smell of urine (color is cloudy and dark, the smell is sharp and unpleasant);
- the presence of bloody impurities and clots in the urine;
- lack of feeling of emptiness of the urea after visiting the toilet;
- general malaise, manifested in loss of appetite, headache and subfebrile body temperature.
The dosage and form of the antibiotic is determined by the urologist . Tablets are the preferred dosage form because infusions are given to people in more severe conditions who have cystitis as a concomitant disease.
Taking Levofloxacin tablets 1-2 pieces per day drinking big amount water.
Daily dosage should equal 250 mg for both uncomplicated and complicated urinary tract infections.
It is not necessary to tie the use of medicine to meals.
For patients suffering from liver problems, no special selection of daily dosage is made, since levofloxacin does not have negative impact to the organ. For people undergoing outpatient or single hemodialysis, additional doses are not administered.
Duration of admission
Often a course of antibiotics does not exceed 7–10 days. It is important to remember that even after the onset of visible relief and normalization of body temperature, you should not stop taking it. Even after receiving positive results of laboratory tests, treatment is recommended to continue for another 24-48 hours.
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- Fast and effective treatment of cystitis with folk methods;
Price
The cost of the drug is quite democratic, which allows people from different segments of the population to purchase it for the treatment of cystitis. An Indian-made pharmaceutical product costs about 150 rubles (10 tablets). Domestic Levofloxacin is a little more expensive - 350 rubles (5 tablets).
Contraindications
The first ban on use is the age of patients under 12 years of age. Further, the list of contraindications includes:
- pregnancy and lactation period;
- kidney failure;
- convulsive and fainting conditions caused by epileptic seizures;
- allergic reactions to fluoroquinolone antibiotics;
- allergic reactions to individual components of the drug;
- tendon damage due to the use of quinolones.
The last of the points is one of the main side effects that can be observed during treatment with Levofloxacin. In addition, the manifestations are not uncommon:
- digestive disorders;
- headache;
- skin rashes and itching;
- thrush.
Similar drugs
Levolet 
Among the drugs that are similar in composition and principle of action are:
- « Levolet". An antimicrobial agent with a bactericidal effect, Levolet is taken orally, topically and intramuscularly. For cystitis, take 250 mg once a day for 7-10 days. Price: 360 rubles for 10 tablets.
- "". The composition of this medication contains norfloxacin, to which most bacteria are sensitive. The course of treatment of urinary tract infections takes from 3 to 5 days, in which 400 mg are taken 2 times a day.
Thank you
The site provides background information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!
medicinal product Levofloxacin represents antibiotic wide spectrum of action. This means that the drug has a detrimental effect on a wide range of pathogenic and opportunistic microorganisms that are the causative agents of infectious and inflammatory processes. Since each infectious and inflammatory pathology is caused by certain types of microbes and is localized in specific organs or systems, antibiotics that are detrimental to this group of microorganisms are most effective in treating the diseases they cause in the same organs.Thus, the antibiotic Levofloxacin is effective for the treatment of infectious and inflammatory diseases of the upper respiratory tract (for example, sinusitis, otitis media), respiratory tract (for example, bronchitis or pneumonia), urinary organs (for example, pyelonephritis), genital organs (for example, prostatitis, chlamydia) or soft tissues (eg, abscesses, boils).
Release form
To date, the antibiotic Levofloxacin is available in the following dosage forms:1. Tablets 250 mg and 500 mg.
2. Eye drops 0.5%.
3. Solution for infusion 0.5%.
Levofloxacin tablets, depending on the content of the antibiotic, are often referred to as "Levofloxacin 250" and "Levofloxacin 500", where the numbers 250 and 500 show the amount of their own antibacterial component. They are dyed in yellow, have a round biconvex shape. On the section of the tablet, two layers can be clearly distinguished. Tablets of 250 mg and 500 mg are available in packs of 5 or 10 pieces.
Eye drops are a homogeneous solution, transparent, practically uncolored. Produced in bottles of 5 ml or 10 ml, equipped with a cap of a special design in the form of a dropper.
The solution for infusion is available in 100 ml bottles. One milliliter of the solution contains 5 mg of the antibiotic. A full bottle of solution for infusion (100 ml) contains 500 mg of an antibiotic intended for intravenous administration.
Levofloxacin - group
According to the type of action, Levofloxacin belongs to bactericidal drugs. This means that the antibiotic kills pathogens by acting on them at any stage. But bacteriostatic antibiotics can only stop the reproduction of bacteria, that is, they can only affect dividing cells. It is precisely because of the bactericidal type of action that Levofloxacin is a very powerful antibiotic that destroys both growing, resting, and dividing cells.According to the mechanism of action, Levofloxacin belongs to the group systemic quinolones, or fluoroquinolones. The group of antibacterial agents belonging to systemic quinolones is used very widely, since it has high efficiency and a wide range of activities. Systemic quinolones, in addition to Levofloxacin, include such well-known drugs as Ciprofloxacin, Lomefloxacin, etc. All fluoroquinolones disrupt the process of synthesis of the genetic material of microorganisms, preventing them from multiplying, and thereby leading to their death.
Levofloxacin - manufacturer
Levofloxacin is produced by various pharmaceutical concerns, both domestic and foreign. In the domestic pharmaceutical market, Levofloxacin preparations from the following manufacturers are most often sold:- CJSC "Vertex";
- RUE "Belmedpreparaty";
- CJSC "Tavanik";
- Concern Teva;
- JSC "Nizhpharm", etc.
Doses and composition
Tablets, eye drops and solution for infusions Levofloxacin contain the same name as an active ingredient. Chemical substance – levofloxacin. Tablets contain 250 mg or 500 mg of levofloxacin. And eye drops and solution for infusion contain levofloxacin 5 mg per 1 ml, that is, the concentration of the active substance is 0.5%. Eye drops and solution for infusion as auxiliary components contain the following substances:
- sodium chloride;
- disodium edetate dihydrate;
- deionized water.
- microcrystalline cellulose;
- hypromellose;
- primellose;
- calcium stearate;
- macrogol;
- titanium dioxide;
- iron oxide yellow.
Spectrum of action and therapeutic effects
Levofloxacin is an antibiotic with a bactericidal type of action. The drug blocks the work of enzymes that are necessary for the synthesis of DNA of microorganisms, without which they are not able to reproduce. As a result of the blockage of DNA synthesis in the cell wall of bacteria, changes occur that are incompatible with the normal life and functioning of microbial cells. Such a mechanism of action on bacteria is bactericidal, since microorganisms die, and not only lose their ability to multiply. Levofloxacin destroys pathogenic bacteria that cause inflammation in certain organs. As a result, the cause of inflammation is eliminated, and as a result of the use of an antibiotic, recovery occurs. Levofloxacin is able to cure inflammation in any organ caused by susceptible microorganisms. That is, if cystitis, pyelonephritis or bronchitis is caused by bacteria that Levofloxacin has a detrimental effect on, then all these inflammations in different organs can be cured with an antibiotic.
Levofloxacin has a detrimental effect on a wide range of gram-positive, gram-negative and anaerobic microbes, a list of which is presented in the table:
| Gram-positive bacteria | Gram-negative bacteria | anaerobic bacteria | Protozoa |
| Corynebacterium diphtheriae | Actinobacillus actinomycetemcomitans | Bacteroides fragilis | Mycobacterium spp. |
| Enterococcus faecalis | Acinetobacter spp. | Bifidobacterium spp. | Bartonella spp. |
| Staphylococcus spp. | Bordetella pertussis | Clostridium perfringens | Legionella spp. |
| Streptococci pyogenic, agalactose and pneumonia, groups C, G | Enterobacter spp. | Fusobacterium spp. | Chlamydia pneumoniae, psittaci, trachomatis |
| Virids from the group of streptococci | Citrobacter freundii, diversus | Peptostreptococcus | Mycoplasma pneumoniae |
| Eikenella corrodens | Propionibacterium spp. | Rickettsia spp. | |
| Escherichia coli | Veillonella spp. | Ureaplasma urealyticum | |
| Gardnerella vaginalis | |||
| Haemophilus ducreyi, influenzae, parainfluenzae | |||
| Helicobacter pylori | |||
| Klebsiella spp. | |||
| Moraxella catarrhalis | |||
| Morganella morganii | |||
| Neisseria meningitidis | |||
| Pasteurella spp. | |||
| Proteus mirabilis, vulgaris | |||
| Providence spp. | |||
| Pseudomonas spp. | |||
| Salmonella spp. |
Indications for use
Eye drops are used for a narrow range of inflammatory diseases that are associated with the visual analyzer. And tablets and solution for infusions are used for a wide range of infectious and inflammatory diseases of various organs and systems. Levofloxacin can be used to treat any infection caused by microorganisms that the antibiotic has a detrimental effect on. Indications for the use of drops, solution and tablets for convenience are shown in the table:| Indications for the use of eye drops | Indications for the use of tablets | Indications for use of solution for infusion |
| Superficial eye infections of bacterial origin | Sinusitis | Sepsis (blood poisoning) |
| Otitis media | anthrax | |
| Exacerbations of chronic bronchitis | Tuberculosis resistant to other antibiotics | |
| Pneumonia | Complicated prostatitis | |
| Urinary tract infections (pyelonephritis, cystitis, etc.) | Complicated pneumonia with the release of a large number of bacteria into the blood | |
| Genital infections, including chlamydia | ||
| Acute or chronic prostatitis of bacterial origin | panniculitis | |
| Atheroma | Impetigo | |
| Abscesses | pyoderma | |
| Furuncles | ||
| Intra-abdominal infection |
Levofloxacin - instructions for use
Features of the use of tablets, drops and solution are different, so it would be advisable to consider the intricacies of using each dosage form separately.Levofloxacin tablets (500 and 250)
Tablets are taken once or twice a day before meals. You can take the tablets between meals. The tablet should be swallowed whole, without chewing, but with a glass of clean water. If necessary, the Levofloxacin tablet can be broken in half along the dividing strip. The duration of the course of treatment with Levofloxacin tablets and dosage depend on the severity of the infection and its nature. So, the following courses and dosages of the drug are recommended for the treatment of various diseases:
- Sinusitis - take 500 mg (1 tablet) 1 time per day for 10-14 days.
- Exacerbation of chronic bronchitis - take 250 mg (1 tablet) or 500 mg (1 tablet) 1 time per day for 7 to 10 days.
- Pneumonia - take 500 mg (1 tablet) 2 times a day for 1 to 2 weeks.
- Infections of the skin and soft tissues (boils, abscesses, pyoderma, etc.) - take 500 mg (1 tablet) 2 times a day for 1-2 weeks.
- Complicated urinary tract infections (pyelonephritis, urethritis, cystitis, etc.) - take 500 mg (1 tablet) 2 times a day for 3 days.
- Uncomplicated urinary tract infections - take 250 mg (1 tablet) 1 time per day for 7 to 10 days.
- Prostatitis - take 500 mg (1 tablet) 1 time per day for 4 weeks.
- Intra-abdominal infection - take 500 mg (1 tablet) 1 time per day for 10-14 days.
- Sepsis - take 500 mg (1 tablet) 2 times a day for 10-14 days.
Solution for infusion Levofloxacin
The solution for infusion is administered once or twice a day. Levofloxacin must be administered only by drip, and 100 ml of the solution is dripped no faster than 1 hour. The solution can be replaced with tablets in exactly the same daily dosage. Levofloxacin can be combined with the following infusion solutions:
1.
saline.
2.
5% dextrose solution.
3.
2.5% Ringer's solution with dextrose.
4.
solutions for parenteral nutrition.
Duration intravenous use antibiotic should not exceed 2 weeks. It is recommended to administer Levofloxacin all the time while the person is sick, plus two more days after the temperature returns to normal.
Dosages and duration of use of Levofloxacin infusion solution for the treatment of various pathologies are as follows:
- Acute sinusitis- administer 500 mg (1 bottle of 100 ml) 1 time per day for 10-14 days.
- Exacerbation of chronic bronchitis - administer 500 mg (1 bottle of 100 ml) 1 time per day for 7-10 days.
- Pneumonia
- Prostatitis- administer 500 mg (1 bottle of 100 ml) 1 time per day for 2 weeks. Then they switch to taking 500 mg tablets once a day for another 2 weeks.
- Acute pyelonephritis - administer 500 mg (1 bottle of 100 ml) 1 time per day for 3-10 days.
- Biliary tract infections - administer 500 mg (1 bottle of 100 ml) 1 time per day.
- Skin infections- administer 500 mg (1 bottle of 100 ml) 2 times a day for 1 to 2 weeks.
- Anthrax - administer 500 mg (1 bottle of 100 ml) 1 time per day. After stabilization of the person's condition, transfer to taking Levofloxacin tablets. Take 500 mg tablets once a day for 8 weeks.
- Sepsis- administer 500 mg (1 bottle of 100 ml) 1-2 times a day for 1-2 weeks.
- Abdominal infection - administer 500 mg (1 bottle of 100 ml) 1 time per day for 1 to 2 weeks.
- Tuberculosis - administer 500 mg (1 bottle of 100 ml) 1-2 times a day for 3 months.
Tablets and solution
The following features and recommendations for the use of Levofloxacin apply to tablets and solution for infusion.Reception of Levofloxacin should not be stopped in advance, and the next dose of the drug should be skipped. Therefore, if you miss another tablet or infusion, you should immediately take it, and then continue using Levofloxacin in the recommended regimen.
People suffering from severe renal impairment, in which CC is less than 50 ml / min, you need to take the drug according to a certain scheme during the entire course of treatment. Levofloxacin is taken, depending on the QC, according to the following schemes:
1.
CC above 20 ml / min and below 50 ml / min - the first dosage is 250 or 500 mg, then take half of the primary, that is, 125 mg or 250 mg every 24 hours.
2.
CC above 10 ml / min and below 19 ml / min - the first dosage is 250 mg or 500 mg, then take half of the primary, that is, 125 mg or 250 mg once every 48 hours.
In rare cases, Levofloxacin can lead to inflammation of the tendons - tendonitis, which is fraught with ruptures. If tendinitis is suspected, the use of the drug should be discontinued, and therapy of the inflamed tendon should be started urgently.
Levofloxacin can lead to hemolysis of red blood cells in people suffering from hereditary deficiency of glucose-6-phosphate dehydrogenase. Therefore, antibiotics should be used in this category of patients with caution, constantly monitoring bilirubin and hemoglobin.
The antibiotic negatively affects the speed of psychomotor reactions, as well as concentration. Therefore, during treatment with Levofloxacin, all activities that require a good concentration of attention and a high speed of reactions, including driving a car or servicing various mechanisms, should be abandoned.
Overdose
An overdose of Levofloxacin is possible, and is manifested by the following symptoms: - confused mind;
- dizziness;
- nausea;
- erosion of the mucous membranes;
- changes on the cardiogram.
Interaction with other drugs
The combined use of Levofloxacin with Fenbufen, non-steroidal anti-inflammatory drugs (for example, Aspirin, Paracetamol, Ibuprofen, Nimesulide, etc.) and theophylline enhances the readiness of the central nervous system for convulsions.The effectiveness of Levofloxacin is reduced when used simultaneously with Sucralfate, antacids (for example, Almagel, Renia, Phosphalugel, etc.) and iron salts. In order to neutralize the effect of the listed drugs on Levofloxacin, their intake should be separated by 2 hours.
The combined use of Levofloxacin and glucocorticoids (for example, hydrocortisone, prednisolone, methylprednisolone, dexamethasone, betamethasone, etc.) leads to an increased risk of tendon ruptures.
Taking alcoholic beverages together with Levofloxacin leads to an increase in side effects developing from the central nervous system (dizziness, drowsiness, visual impairment, loss of concentration and weak reaction).
Eye drops Levofloxacin
Drops are used exclusively locally for the treatment of inflammation of the outer membranes of the eye. In this case, adhere to the following scheme for the use of antibiotics:1. During the first two days, apply 1-2 drops into the eye every two hours, during the entire period of wakefulness. You can bury your eyes up to 8 times a day.
2. From the third to the fifth day, apply 1-2 drops to the eyes 4 times a day.
Levofloxacin drops are used for 5 days.
Levofloxacin for children
Levofloxacin should not be used to treat various pathological conditions in children and adolescents under 18 years of age, since the antibiotic negatively affects cartilage tissue. During the period of active growth of children, the use of Levofloxacin can provoke damage to the articular cartilage, which is fraught with disruptions in the normal functioning of the joints.Application for the treatment of ureaplasma
Ureaplasma affects the genitals and urinary tract in men and women, causing infectious and inflammatory processes in them. Treatment of ureaplasmosis requires some effort. Levofloxacin is detrimental to ureaplasma, therefore it is successfully used to treat infections caused by this microorganism. So, for the treatment of ureaplasmosis, uncomplicated by other pathologies, it is enough to take Levofloxacin in tablets of 250 mg 1 time per day for 3 days. If the infectious process is delayed, then the antibiotic is taken at 250 mg (1 tablet) 1 time per day, for 7 to 10 days.
Treatment of prostatitis
Levofloxacin is able to effectively cure prostatitis caused by various pathogenic bacteria. Prostatitis can be treated with Levofloxacin tablets or infusion solution. At severe course prostatitis, it is better to start therapy with an infusion of an antibiotic 500 mg (1 bottle of 100 ml) 1 time per day. Intravenous administration of Levofloxacin is continued for 7-10 days. After that, it is necessary to switch to taking an antibiotic in tablets, which they drink 500 mg (1 piece) 1 time per day. Tablets should be taken for another 18 to 21 days. General course treatment with Levofloxacin should be 28 days. Therefore, after several days of intravenous administration of the antibiotic, the rest of the time up to 28 days, you need to drink tablets.
Prostatitis can only be treated with Levofloxacin tablets. In this case, the man should take the drug 500 mg (1 tablet) 1 time per day for 4 weeks.
Levofloxacin and alcohol
Alcohol and Levofloxacin are incompatible with each other. During the treatment period, you should stop drinking alcoholic beverages. If a person needs to drink a certain amount of alcohol, then it should be borne in mind that Levofloxacin will increase the effect of drinks on the central nervous system, that is, intoxication will be stronger than usual. The antibiotic aggravates the dizziness, nausea, confusion, reaction rate and concentration impairment caused by alcohol.Contraindications
Tablets and solutions for infusion Levofloxacin- hypersensitivity, allergy or intolerance to the components of the drug, including levofloxacin or other quinolones;
- renal failure with CC less than 20 ml / min;
- the presence of inflammation of the tendon in the past in the treatment of any drugs from the group of quinolones;
- age under 18;
- pregnancy;
- breast-feeding.
Relative contraindications to the use of Levofloxacin tablets and solution are severe renal dysfunction and deficiency of glucose-6-phosphate dehydrogenase. in such cases, the drug should be taken under close medical supervision of the person's condition.
Eye drops Levofloxacin contraindicated for use in the following cases:
- sensitivity or allergy to any drugs from the quinolone group;
- age less than 1 year.
Side effects
Side effects of Levofloxacin are quite numerous, and they develop from various organs and systems. All side effects of the antibiotic are divided according to the frequency of development:1. Often - observed in 1 - 10 people out of 100.
2. Sometimes - observed in less than 1 person out of 100.
3. Rare - occurs in less than 1 in 1,000 people.
4. Very rare - occurs in less than 1 in 1,000 people.
All side effects of tablets and solution for infusion, depending on the frequency of occurrence, are shown in the table:
| often | Side effects encountered Sometimes | Side effects encountered rarely | Side effects encountered very rarely | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Diarrhea | Itching | Anaphylactic reactions | Edema on the face and throat | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Nausea | Skin redness | Hives | Shock | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Increased activity of liver enzymes (AST, ALT) | Loss of appetite | Bronchospasm, up to severe suffocation | A sharp drop in blood pressure | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Digestive disorders (belching, heartburn, etc.) | Diarrhea with some blood | Hypersensitivity to sunbeams and ultraviolet | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Vomit | Exacerbation of porphyria | Pneumonitis | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Stomach ache | Anxiety | Vasculitis | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Headache | body shaking | blisters on the skin | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| dizziness | Paresthesias on the hands (sensation of "goosebumps") | Toxic epidermal necrolysis | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| torpor | hallucinations | Exudative erythema multiforme | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Drowsiness | Depression | Decrease in blood glucose concentration | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Sleep disorders | Excitation | visual impairment | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| An increase in the number of blood eosinophils | convulsions | taste disorder | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Decrease in the total number of blood leukocytes | Confused mind | Decreased ability to distinguish odors | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| General weakness | heartbeat | Decreased tactile sensitivity (sensation of touch) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| pressure drop | Vascular collapse | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Tendinitis | tendon rupture | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Pain in the muscles | muscle weakness | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
, as well as increased reproduction headache ; Levofloxacin - synonyms The antibiotic Levofloxacin has synonymous drugs. Levofloxacin is synonymous with drugs that also contain the antibiotic levofloxacin as an active ingredient. Levofloxacin eye drops have the following synonymous drugs:
Levofloxacin tablets and solution for infusions have the following synonyms in the domestic pharmaceutical market:
AnaloguesAnalogues of Levofloxacin are drugs that contain as an active ingredient another antibiotic with a similar spectrum of antibacterial activity. For convenience, analogues of eye drops, tablets and infusion solution are shown in the table:
urinary tract infection(IMP) is one of the most actual problems 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 UTIs is significant event and draws the attention of physicians. 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. Research recent years 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 frequently occurring 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 significantly more low level 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, 3 patients complained of nausea, long time suffering from chronic gastritis. 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 trial effectiveness of 10-day LF therapy, it can be concluded that levofloxacin is effective and safe means 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. Loran O.B., Pushkar D.Yu., Tevlin K.P. |
