The drug "Moxifloxacin", the pharmacological effect of which will be discussed later, belongs to the group of fluoroquinolones. The tool has a bactericidal, antibacterial effect. Next, we will discuss what is the medicine "Moxifloxacin". Instructions for use, analogues will also be given in the article.
the 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 drug is associated with the inhibition (inhibition) of bacterial topoisomerases IV and II. This, in turn, leads to disturbances in the processes of replication, transcription, and repair of the biosynthesis of DNA of microbial cells. As a result, their death occurs. The medication "Moxifloxacin" describes the instructions for use as a broad-spectrum antibiotic.
Resistance
The antibacterial activity of the drug "Moxifloxacin" is not affected by mechanisms that provoke resistance to tetracyclines, macrolides, aminoglycosides, cephalosporins and penicillins. The effect of cross-resistance is also not observed. To date, no cases of plasma resistance have been identified. Resistance to the drug "Moxifloxacin" develops rather slowly through multiple mutations.
Activity spectrum
Moxifloxacin (instructions for use - confirmation of this) affects many strains of gram-positive and gram-negative microbes, acid-resistant bacteria, anaerobes, atypical microorganisms (mycoplasmas, chlamydia and others), as well as bacteria that are resistant to macrolide and beta-lactam antibiotic drugs .
Suction
When taken orally, the absorption of the drug "Moxifloxacin" is fast and almost complete. Absolute bioavailability with 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 are linear. The maximum concentration when taking 400 mg is observed after 0.5-4 hours. When used simultaneously with food, there is an increase in the duration of the period of reaching Cmax (by two hours) and its decrease by about 16%. The duration of the absorption remains the same. However, this information does not have clinical significance, which allows the use of the drug "Moxifloxacin" regardless of food. After a single intravenous infusion of 400 mg for an hour, the maximum concentration is noted at the end of the infusion.
Distribution
Within three days of application, an equilibrium state is achieved. Binding to plasma proteins is about 45%. A fairly rapid distribution of the drug "Moxifloxacin" in organs and tissues is noted. The highest concentrations are created in the lung tissue and bronchial mucosa, subcutaneous structures and skin, sinuses, and inflammatory foci. In saliva and interstitial fluid, the drug is found in unbound protein, free form. Its concentration here is higher than in plasma. At the same time, 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) undergoes biotransformation of the second phase. Excretion is carried out by the kidney system and intestines in an unchanged form and in the form of inactive sulfo compounds and glucuronides. Metabolites are found in plasma. Their concentration is lower than that of the original compound. In the course of studies, it was proved that these decay products do not have a negative effect on the body.
Means "Moxifloxacin": why is it prescribed?
The medication is recommended for infectious inflammatory pathologies in adults, provoked by microorganisms that have sensitivity to it. In particular, exacerbation of chronic bronchitis, acute sinusitis, community-acquired pneumonia (caused by strains of bacteria exhibiting multiple resistance, including antibiotics) are referred to as indications. Moxifloxacin is recommended for use in soft tissue and skin infections complicated by lesions of the subcutaneous structures (including an infected diabetic foot) and intra-abdominal infections (polymorphic processes, intraperitoneal abscesses, etc.). 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. For endometritis and salpingitis, the drug in question is also recommended (this is indicated 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 medication. Existing guidelines for the treatment of infectious diseases should also be taken into account.
Medication "Moxifloxacin": dosage and method of administration
The drug is prescribed orally (orally) and intravenously. The duration of treatment with the Moxifloxacin medication, 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 step therapy (intravenous infusion, followed by switching to oral administration).
- Lesions of soft tissues, skin (uncomplicated), as well as acute sinusitis - 7 days.
- With intra-abdominal infections (complicated) - 5-14 days of step therapy.
- With complicated lesions of the subcutaneous structures and skin - 7-21 days.
- With inflammatory pathologies of the pelvic organs - 14 days.
More detailed information contains the instructions for use attached to the drug "Moxifloxacin". Tablets are not allowed to chew. It is necessary to wash down with water in a small volume.
Local use
The drug "Moxifloxacin" (drops) can be prescribed to patients from a year. As practice shows, improvement occurs on the fifth day. After this, treatment should be continued for another 2-3 days. Patients are instilled dropwise into the affected eye 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.
More about infusion solution
The drug "Moxifloxacin" instructions for use recommends to be administered within an hour. In this case, the medicine can be either undiluted or diluted. The solution is compatible with 0.9% sodium chloride , water for injection, dextrose solutions at a concentration of 10% and 40%, xylitol 20%, Ringer. Only clear liquid is used. After dilution, the medication remains stable throughout the day at room temperature. Do not keep the product in the refrigerator. If the infusion is prescribed in conjunction with other agents, each of them is administered separately.
Side effects
Due to the treatment with Moxifloxacin, the development of fungal infections, leukopenia, anemia, and thrombocytopenia is likely. In some cases, during therapy, an increase in the prothrombin period, a change in thromboplastin concentrations are noted. In some patients, the drug can provoke allergic reactions, laryngeal edema, urticaria, anaphylactic shock, itching, eosinophilia, rash. In rare cases, hyperglycemia, hyperlipidemia, hyperuricemia are noted. During 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 disorders, sleep disturbances, disorientation. In some cases, against the background of the use of the drug, coordination disorders, convulsions accompanied by various clinical manifestations, hypesthesia, and olfaction disorders may occur. A number of patients showed impaired speech, attention, peripheral neuropathy, amnesia, polyneuropathy. When applied topically, vision may worsen, even to the point of losing it. However, the latter is considered a transient state.
Effects on the cardiovascular system
Frequent negative consequences when using the Moxifloxacin medication are lengthening of the QT interval in patients with hypokalemia, palpitations, vasodilation, and tachycardia. Hypertension and hypotension, ventricular tachyarrhythmias, and fainting are rare side effects. Cardiac arrest was extremely rare. The latter is mainly characteristic of individuals predisposed to acute ischemia, bradycardia (clinically significant).
Impact on other systems and organs
In some cases, the drug can provoke shortness of breath, including an asthmatic condition. A number of patients had abnormalities in the digestive tract. In particular, during treatment, nausea, vomiting, diarrhea, and stomach pain arose. Relatively rare side effects are impaired appetite, dyspeptic symptoms, flatulence, gastroenteritis (except for erosive), constipation. Some patients were diagnosed with stomatitis, dysphagia, pseudomembranous colitis. Against the background of therapy, an increase in the activity of transaminases, impaired liver function, the development of fulminant hepatitis, leading to life-threatening liver failure, are likely. Cutaneous bullous reactions (epidermal toxic necrolysis, Stevens-Jones syndrome) were extremely rare. In some patients, myalgia, arthralgia, cramps, increased muscle tone, tendonitis, muscle weakness were observed. In rare cases, tendon ruptures, arthritis, gait disorders as a result of damage to the musculoskeletal system can be observed. In patients with the use of the medication, disturbances in the activity of the urinary system can also be observed. In particular, dehydration (provoked by diarrhea or a decrease in the amount of fluid consumed), renal dysfunction, and insufficiency are noted. Common side effects include sweating, nonspecific pain, and malaise. In the area of intravenous administration, thrombophlebitis or phlebitis is likely.
Who is not assigned a remedy?
Moxifloxacin has the following contraindications:
- A history of tendon pathologies that developed as a result of antibiotic therapy with the quinolone group.
- The presence of an elongated QT interval (acquired or congenital).
- Electrolyte disturbances (in particular, uncorrected hypokalemia).
- Bradycardia (clinically significant).
- Heart failure with reduced ejection function in the left ventricle.
- Heart rhythm disturbances (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). Not prescribed for pregnant and lactating. Tablets and solution are allowed for administration to patients from 18 years of age. Medication is not recommended for hypersensitivity to the components.
Special cases
Caution is necessary when prescribing medication to patients with CNS pathologies that predispose to the development of convulsive seizures. The risk group includes patients with proarrhythmic conditions. These include, in particular, acute ischemia, especially in older people and women. Caution is also observed in the treatment of patients with cirrhosis. Dose adjustment may be required with simultaneous therapy with agents that lower the concentration of potassium.
additional information
As practice shows, the medication is well tolerated by many patients. Specialists often prescribe this remedy for infectious lesions. This is due to the fact that the medication 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 the Moxifloxacin. Analogues of the drug, if necessary, should be selected individually by the doctor. You can replace the remedy with such drugs as: Avelox, Vigamox, Rotomox, Moxifur, Moxin and others. If negative consequences occur, a sharp deterioration in the condition, as well as the occurrence of symptoms not described in the annotation, you must immediately consult a doctor. When using drops, do not allow excessive eyes to get into the eyes. If this happens, rinse them with water as soon as possible. With an overdose, an increase in side effects is noted.
Finally
The drug "Moxifloxacin" is considered a fairly strong antibacterial agent. In this regard, it is highly recommended not to violate the doctor’s prescriptions. In particular, this applies to the amount and frequency of use of the product. Do not exceed dosage. Intravenous administration should be carried out in a special room by a qualified employee who can provide assistance if necessary. Do not self-medicate. If there is no result of therapy, you should consult a doctor. Immediately before using the medication "Moxifloxacin", you should carefully read the instructions.