Levofloxacin - instructions for use, dosage, side effects, contraindications

Levofloxacin is a left-handed isomer of ofloxacin. The broad-spectrum antibacterial drug inhibits the synthesis of DNA by blocking DNA gyre, disrupting the cross-linking of DNA gaps, destroys the cytoplasm, cell wall and bacterial membranes.

Has a wide range of antibacterial activity against Gram-positive and Gram-negative bacteria, as well as anaerobic microflora and certain microorganisms: mycoplasma, rickettsia, ureaplasma.

Pharmacokinetics:

Bioavailability after oral administration is 99-100%. The maximum concentration of the drug in the blood plasma is reached after 1.3 hours. The connection with plasma proteins is 30-40%, penetrates into all tissues and organs, including leukocytes and alveolar macrophages.

The half-life is 6-8 hours.

It is metabolized and deactivated in the liver, eliminated by the kidneys - about 87% for 48 hours, less than 4% with feces for 72 hours. Up to 12% is removed during hemodialysis.

Indications:

It is used for the treatment of infectious and inflammatory diseases caused by sensitive microorganisms, both in acute and chronic stages of diseases.

ICD-10

I.A30-A49.A41.9 Septicemia, unspecified

X.J30-J39.J32.8 Other chronic sinusitis

X.J30-J39.J32 Chronic Sinusitis

X.J00-J06.J01 Acute Sinusitis

X.J40-J47.J40 Bronchitis, not specified as acute or chronic

X.J20-J22.J20 Acute bronchitis

XII.L00-L08.L03 Phlegmon

XI.K65-K67.K65.0 Acute peritonitis

XI.K80-K87.K81.1 Chronic cholecystitis

XI.K80-K87.K81.0 Acute cholecystitis

XIV.N10-N16.N11.1 Chronic obstructive pyelonephritis

X.J10-J18.J15 Bacterial pneumonia, not elsewhere classified

Contraindications:

Epilepsy, severe renal failure (creatinine clearance less than 20 ml / min), deficiency of glucose-6-phosphate dehydrogenase.

Individual intolerance.

Carefully:Older patients with kidney hypofunction probability.

Pregnancy and lactation:

Recommendations for FDA - Category C. It is used in pregnant women only for life indications. During treatment with the drug it is recommended to stop breastfeeding.

Dosing and Administration:

Inside or intravenously drip (within 1 hour) for 250-500 mg every 24 hours. The course of treatment is 7-10 days.

The highest daily dose: 500 mg.

The highest single dose: 500 mg.

Side effects:

Central and peripheral nervous system: dizziness, headache, drowsiness, paresthesia in the hands, hallucinatory disorders, seizures,decreased tactile sensitivity.

The cardiovascular system: rarely - tachycardia.

The system of hematopoiesis: neutropenia, thrombocytopenia, eosinophilia.

Metabolism: rarely - hypoglycemia.

Digestive system: dyspeptic disorders, diarrhea, increased activity of liver enzymes AST, ALT.

Musculoskeletal: tendon lesions (children's age), muscle weakness, rarely - rhabdomyolysis.

Dysbacteriosis.

Allergic reactions.

Overdose:

Symptoms: disorders of consciousness, convulsive attacks by the type of epipriplets.

Treatment: symptomatic.

Interaction:

With simultaneous use with theophylline, there is a decrease in convulsive activity.

Glucocorticoids increase the risk of rupture of tendons.

With the simultaneous use of vitamin K antagonists, hemorrhagic diathesis may develop.

Special instructions:

In the treatment of patients who have suffered a stroke or severe craniocerebral injury, convulsive activity increases.

Treatment with levofloxacin can begin, without waiting for the result of bacteriological studies of the sensitivity of the pathogenic flora to antibiotics.

Given the possible complications of the central nervous system, patients are undesirable to drive cars and perform work in an unstable position of the body.

Instructions

Levofloxacin (Levofloxacinum)