The drug "Moxifloxacin", the pharmacological action of which will be discussed later, belongs to the group of fluoroquinolones. The tool has a bactericidal, antibacterial effect. Next, we will discuss what the drug "Moxifloxacin" is. Instructions for use, analogues will also be given in the article.
Effect
How is Moxifloxacin active? The description of the drug should begin with a description of the mechanism of its effect on bacteria. The bactericidal effect of the agent is associated with inhibition (inhibition) of bacterial topoisomerases IV and II. This, in turn, leads to disturbances in the processes of replication, transcription, and repair of DNA biosynthesis in microbial cells. The result is their death. Medication "Moxifloxacin" instructions for use characterizes as a broad-spectrum antibiotic.
Resistance
Onthe antibacterial activity of the drug "Moxifloxacin" is not affected by the mechanisms that provoke resistance to tetracyclines, macrolides, aminoglycosides, cephalosporins and penicillins. There is also no cross-resistance effect. To date, no cases of plasma resistance have been identified. Resistance to the drug "Moxifloxacin" develops rather slowly through multiple mutations.
Activity spectrum
Means Moxifloxacin (instructions for use - confirmation of this) affects many strains of gram-positive and gram-negative microbes, acid-fast bacteria, anaerobes, atypical microorganisms (mycoplasmas, chlamydia and others), as well as bacteria that are resistant to macrolide and beta-lactam antibiotic medicines.
Suction
When taken orally, the absorption of the drug "Moxifloxacin" is fast and almost complete. Absolute bioavailability for intravenous administration and oral administration is about 91%. When taken orally (50-1200 mg once, 600 mg / day for 10 days), the pharmacokinetics of the drug is linear. The maximum concentration when taking 400 mg is noted after 0.5-4 hours. When used simultaneously with meals, there is an increase in the duration of the period to reach Cmax (by two hours) and its decrease by about 16%. The duration of absorption remains the same. However, these data are not clinically relevantallows you to use the drug "Moxifloxacin" regardless of food. After a single intravenous infusion of 400 mg over an hour, the maximum concentration is noted at the end of the infusion.
Distribution
Within three days of application, an equilibrium state is reached. Plasma protein binding is about 45%. There is a fairly rapid distribution of the drug "Moxifloxacin" in organs and tissues. The highest concentrations are created in the lung tissue and bronchial mucosa, subcutaneous structures and skin, nasal sinuses, and inflammatory foci. In saliva and interstitial fluid, the drug is found in a free form that is not bound to proteins. Its concentration here is higher than in plasma. Along with this, the drug is found in large quantities in the organs of the peritoneum, the tissues of the genital organs of women and in the peritoneal fluid.
Metabolism
The drug "Moxifloxacin" (the description of the drug in the annotation contains this information) is undergoing a biotransformation of the second phase. Excretion is carried out by the kidneys and intestines unchanged and in the form of inactive sulfo compounds and glucuronides. Metabolites are found in plasma. Their concentrations are lower than those of the original compound. In the course of research, it was proved that these decay products do not have a negative effect on the body.
Means "Moxifloxacin": what is it prescribed for?
The drug is recommended for infectious inflammatory pathologies inadults, provoked by microorganisms that have sensitivity to it. In particular, indications include exacerbation of chronic bronchitis, acute sinusitis, community-acquired pneumonia (caused by bacterial strains that exhibit multiple resistance, including antibiotics). Means "Moxifloxacin" instructions for use recommends for infections of soft tissues and skin, complicated lesions of subcutaneous structures (including an infected diabetic foot) and intra-abdominal infections (polymorphic processes, intraperitoneal abscesses, and so on). A medication is prescribed for streptococcal pneumonia with multiple resistance to antibacterial agents, including in the presence of strains resistant to penicillins, two or more drugs from the groups of second-generation cephalosporins, macrolides, tetracyclines. The indications also include inflammatory lesions in the pelvic organs of an uncomplicated nature. With endometritis and salpingitis, the agent in question is also recommended (this is evidenced by the instructions for use attached to the drug "Moxifloxacin"). Eye drops are prescribed for bacterial conjunctivitis provoked by microorganisms that are sensitive to the drug. It is also necessary to take into account existing guidelines for the treatment of infectious pathologies.
Medication "Moxifloxacin": dosage and method of administration
The drug is administered orally (orally) and intravenously. Durationtreatment with the drug "Moxifloxacin", the dosage of which is 400 mg / day, depends on the type of pathology and its severity, as well as on the observed therapeutic effect:
- Exacerbation of chronic bronchitis - 5-10 days.
- Community-acquired pneumonia - 7-14 days of stepwise therapy (intravenous infusion followed by oral administration).
- Losses of soft tissues, skin (uncomplicated), as well as acute sinusitis - 7 days.
- For intra-abdominal infections (complicated) - 5-14 days of stepwise therapy.
- In complicated lesions of subcutaneous structures and skin - 7-21 days.
- In inflammatory pathologies of the pelvic organs - 14 days.
More detailed information is contained in the instructions for use attached to the drug "Moxifloxacin". Tablets are not allowed to be chewed. You need to drink water in a small amount.
Local use
The medicine "Moxifloxacin" (drops) can be prescribed to patients from a year old. As practice shows, improvement occurs on the fifth day. After this, treatment should be continued for another 2-3 days. Patients are instilled into the affected eye drop by drop three times a day. If there is no effect for five days, the question of the correctness of therapy or diagnosis should be raised. The duration of treatment depends on the bacteriological and clinical course, as well as on the severity of the pathology.
Additional information about infusion solution
Medication"Moxifloxacin" instructions for use recommends administering within an hour. In this case, the medicine can be both undiluted and diluted. The solution is compatible with sodium chloride 0.9%, water for injection, dextrose solutions at a concentration of 10% and 40%, xylitol 20%, Ringer. Only clear liquid is used. After dilution, the drug remains stable for a day at room temperature. Do not keep the product in the refrigerator. If the infusion is administered in conjunction with other agents, each of them is administered separately.
Side effects
As a result of treatment with the drug "Moxifloxacin", the development of fungal infections, leukopenia, anemia, thrombocytopenia is likely. In some cases, during therapy, there is an increase in the prothrombin period, a change in thromboplastin concentrations. In some patients, the drug can provoke allergic reactions, laryngeal edema, urticaria, anaphylactic shock, itching, eosinophilia, rash. In rare cases, there is hyperglycemia, hyperlipidemia, hyperuricemia. In the process of treatment, mental disorders are likely. In particular, patients may experience hyperactivity, anxiety, depression, depersonalization, hallucinations, psychotic reactions, accompanied by suicidal thoughts. Common side effects include headaches and dizziness, tremors, drowsiness, confusion, taste disturbances, sleep disturbances, and disorientation. In some cases, against the background of the use of the drug, there may be coordination disorders, convulsions,accompanied by various clinical manifestations, hypesthesia, olfactory disorder. A number of patients had deterioration in speech, attention, peripheral neuropathy, amnesia, polyneuropathy. When applied topically, vision may deteriorate up to its loss. However, the latter is considered a transitory state.
Effect on the cardiovascular system
Frequent negative consequences of the use of the drug "Moxifloxacin" are prolongation of the QT-interval in patients with hypokalemia, palpitations, vasodilation, tachycardia. Rare side effects include hypertension and hypotension, ventricular tachyarrhythmias, syncope. Cardiac arrest has been extremely rare. The latter is predominantly characteristic of persons predisposed to acute ischemia, bradycardia (clinically significant).
Influence on other systems and organs
In some cases, the drug can cause shortness of breath, including an asthmatic condition. A number of patients had disorders in the gastrointestinal tract. In particular, during treatment, nausea, vomiting, diarrhea, and stomach pain occurred. Relatively rare side effects are loss of appetite, dyspepsia, flatulence, gastroenteritis (except erosive), constipation. Some patients were diagnosed with stomatitis, dysphagia, pseudomembranous colitis. Against the background of therapy, an increase in transaminase activity, impaired liver function, and the development of fulminant hepatitis, leading to life-threatening liver failure, are likely. Rarely, cutaneous bullous lesions have been reported.reactions (epidermal toxic necrolysis, Stevens-Jones syndrome). Some patients experienced myalgia, arthralgia, convulsions, increased muscle tone, tendonitis, muscle weakness. In rare cases, tendon ruptures, arthritis, gait disturbances as a result of damage to the musculoskeletal system can be observed. In patients against the background of the use of the drug, there may also be disturbances in the activity of the urinary system. In particular, dehydration (provoked by diarrhea or a decrease in the amount of fluid consumed), kidney dysfunction, and insufficiency are noted. Common side effects include sweating, non-specific pain, and malaise. Thrombophlebitis or phlebitis is likely in the intravenous area.
Who is the remedy not prescribed for?
The medicine "Moxifloxacin" has the following contraindications:
- Pathology of the tendons in history, developed as a result of antibiotic therapy of the quinolone group.
- Having a long QT interval (acquired or congenital).
- Electrolyte disorders (particularly uncorrected hypokalemia).
- Bradycardia (clinically significant).
- Heart failure with decreased left ventricular ejection function.
- Irregular heart rhythm (history).
In case of lactose intolerance, glucose-galactose malabsorption, lactase deficiency, the drug "Moxifloxacin" is also not recommended (the composition of the drug includes lactose, and therefore the mentioned pathologies are included in the list). The remedy is not prescribed for pregnant and lactating women. Tablets and solution are allowed to be prescribed to patients from 18 years of age. The drug is not recommended for hypersensitivity to the components.
Special occasions
Caution is needed when prescribing the drug to patients with CNS pathologies that predispose to the development of seizures. The risk group includes patients with proarrhythmic conditions. These include, in particular, acute ischemia, especially in the elderly and women. Also, caution is observed in the treatment of patients with cirrhosis of the liver. Dose adjustments may be required in concomitant therapy with potassium-lowering agents.
More information
As practice shows, the drug is well tolerated by many patients. Specialists often prescribe this remedy for infectious lesions. This is due to the fact that the drug is highly effective against many bacteria. However, there is always the possibility of side effects, which are warned by the instructions for use attached to Moxifloxacin. Analogues of the drug, if necessary, should be selected by the doctor individually. You can replace the remedy with such medicines as: "Avelox", "Vigamox", "Rotomox", "Moxifur", "Moksin" and others. If negative consequences appear, a sharp deterioration in the condition, as well as the occurrence of symptoms that are not described in the annotation, you should immediately consult a doctor. When using drops, do not allow excessive amounts to get into the eyes.drug. If this happens, it is necessary to rinse them with water as soon as possible. With an overdose, there is an increase in side effects.
In closing
The drug "Moxifloxacin" is considered a fairly strong antibacterial agent. In this regard, it is highly recommended not to violate the prescriptions of the doctor. In particular, this applies to the amount and frequency of use of the agent. Do not exceed the dosage. Intravenous administration should be carried out in a special room by a qualified person who can provide assistance if necessary. You should not self-medicate. If there is no result of therapy, you should consult a doctor. Immediately before using the drug "Moxifloxacin", you should carefully read the instructions.
