"Moxifloxacin": instructions for use, description, composition

The drug "Moxifloxacin", the pharmacological action of which will be discussed below, belongs to the group of fluoroquinolones. The product has a bactericidal, antibacterial effect. Next, we discuss what the "Moxifloxacin" medicine is. Instructions for use, analogues will also be given in the article.

Effect

How is the "Moxifloxacin" active? Description of the drug should start with the characteristics of the mechanism of its effect on bacteria. The bactericidal effect of the agent is associated with the inhibition (inhibition) of bacterial topoisomerases IV and II. This, in turn, leads to disturbances in the processes of replication, transcription, repair of the biosynthesis of DNA from microbial cells. As a result, their death occurs. Medication "Moxifloxacin" instructions for use characterizes as a broad-spectrum antibiotic.

Resistance

The 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 slowly enough through multiple mutations.

Activity spectrum

"Moxifloxacin" (instructions for use as confirmation) affects many strains of gram-positive and gram-negative microbes, acid-fast bacteria, anaerobes, atypical microorganisms (mycoplasma, chlamydia, etc.), 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 with intravenous administration and oral administration is about 91%. At oral intake (50-1200 mg once, 600 mg / day for 10 days) pharmacokinetics of the drug is linear. The maximum concentration at reception of 400 mg is noted through 0,5-4 hours. When applied simultaneously with food, there is an increase in the duration of the Cmax achievement period (by two hours) and its decrease by approximately 16%. The duration of absorption remains the same. However, this information is not clinically relevant, 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

The equilibrium state is reached within three days of application. Binding to plasma proteins 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, inflammatory foci. In saliva and interstitial fluid, medication is found in a protein that is not bound to proteins, free form. 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 female genital organs and in the peritoneal fluid.

Metabolism

The drug "Moxifloxacin" (the description of the preparation in the annotation contains this information) is biotransformation of the second phase. Excretion is performed by the kidney and intestine system in an unchanged form and in the form of inactive sulfo compounds and glucoronides. Metabolites are found in plasma. Their concentrations are lower than those of the original compound. During the research it was proved that these decay products do not have a negative effect on the body.

The remedy "Moxifloxacin": from what it is appointed?

The medication is recommended for infectious inflammatory pathologies in adults provoked by microorganisms that have sensitivity to it. In particular, the evidence includes exacerbation of chronic bronchitis, acute sinusitis, community-acquired pneumonia (caused by strains of bacteria exhibiting multiple resistance, including antibiotics). Moxifloxacin is recommended for use in infections of soft tissues and skin, complicated subcutaneous tissue lesions (infected diabetic foot, including) and intra-abdominal infections (polymorphic processes, intraperitoneal abscesses, etc.). A medicament 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 second-generation cephalosporins, macrolides, tetracyclines. The indications also include inflammatory lesions in pelvic organs of uncomplicated nature. For endometritis and salpingitis, the agent 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 drug. It is also necessary to take into account existing guidelines for the treatment of infectious pathologies.

Medication "Moxifloxacin": dosage and route of administration

The drug is administered orally (orally) and intravenously. The duration of treatment 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 is 5-10 days.
• Community-acquired pneumonia - 7-14 days of stepwise therapy (intravenous infusion with a subsequent transition 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 stepwise therapy.
• With complicated lesions of subcutaneous structures and skin - 7-21 days.
• With inflammatory pathologies of the pelvic organs - 14 days.

For more details, see the instructions for use with the drug "Moxifloxacin". Tablets are not allowed to chew. You need to drink water in a small amount.

Local use

The drug "Moxifloxacin" (drops) can be prescribed to patients from year to year. As practice shows, the improvement comes on the fifth day. After this, continue the treatment for another 2-3 days. Patients are instilled in the affected eye drop by drop thrice a day. If there is no effect for five days, the question of the correctness of the 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.

In addition to the solution for infusions

The medication "Moxifloxacin" is recommended for use for an hour. The medicine can be either undiluted or 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 throughout the day at room temperature. Do not keep the product in the refrigerator. If the infusion is assigned together with other agents, each of them is administered separately.

Side effects

Due to the treatment with the drug "Moxifloxacin" is likely the development of fungal infections, leukopenia, anemia, thrombocytopenia. In a number of cases, on the background of therapy, there is an increase in the prothrombin period, a change in the concentrations of thromboplastin. 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. To frequent side effects include headaches and dizziness, tremors, drowsiness, confusion, disorders of taste sensitivity, sleep disorders, disorientation. In some cases, against the background of the use of the drug, coordination disorders, seizures accompanied by various clinical manifestations, hypoesthesia, and smell disorders may occur. A number of patients reported worsening of speech, attention, peripheral neuropathy, amnesia, and polyneuropathy. With local application, vision may deteriorate until it is lost. However, the latter is considered a transitory state.

Influence on the cardiovascular system

Frequent negative consequences with the use of the drug "Moxifloxacin" are the prolongation of the QT-interval in patients with hypokalemia, palpitation, vasodilation, tachycardia. Rare side effects include hypertension and hypotension, ventricular tachyarrhythmias, syncope. Very rarely there was a cardiac arrest. The latter is mainly characteristic of persons predisposed to acute ischemia, bradycardia (clinically significant).

Influence on other systems and organs

In some cases, the drug may provoke shortness of breath, including an asthmatic condition. A number of patients had abnormalities in the digestive tract. In particular, against the background of the treatment there was nausea, vomiting, diarrhea, stomach pain. Relatively rare side effects are deterioration of appetite, dyspeptic phenomena, flatulence, gastroenteritis (except erosive), constipation. Some patients were diagnosed with stomatitis, dysphagia, pseudomembranous colitis. On the background of therapy, probably an increase in the activity of transaminases, a violation of liver function, the development of fulminant hepatitis, leading to liver failure, life-threatening. Very rarely there were cutaneous bullous reactions (epidermal toxic necrolysis, Stevens-Jones syndrome). Some patients experienced myalgia, arthralgia, convulsions, muscle tone, tendonitis, muscle weakness. In rare cases, tendon ruptures, arthritis, gait disorders due to musculoskeletal injuries can be observed. Patients on the background of the use of medication may also experience disturbances in the activity of the urinary system. In particular, dehydration is noted (provoked by diarrhea or a decrease in the volume of fluid used), renal dysfunction, insufficiency. The general side effects include sweating, nonspecific pain, malaise. In the field of intravenous administration, thrombophlebitis or phlebitis is likely.

Who is not assigned a remedy?

Contraindications for the drug "Moxifloxacin" are as follows:

• Pathologies of tendons in the anamnesis, developed as a result of antibiotic therapy of a group of quinolones.
• The presence of an extended QT-interval (acquired or congenital).
• Electrolyte disorders (in particular, uncorrected hypokalemia).
• Bradycardia (clinically significant).
• Heart failure with a decreased ejection function in the left ventricle.
• Heart rhythm disturbances (in the anamnesis).

With lactose intolerance, glucose-galactose malabsorption, lactase deficiency, the drug "Moxifloxacin" is also not recommended (the composition of the medicine includes lactose, and the mentioned pathologies are included in the list). Not prescribed for pregnant and lactating. Tablets and solution are allowed to be administered to patients from 18 years of age. The drug is not recommended for hypersensitivity to components.

Special cases

Caution is necessary when prescribing a drug to patients with CNS pathologies that predispose to the development of convulsive seizures. The risk group includes patients with proarrhythmic conditions. They 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 adjustment may be required with simultaneous therapy with potassium lowering agents.

additional information

As practice shows, the medicine 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 with the "Moxifloxacin" agent. Analogues of the medicine, if necessary, should be selected by the physician individually. You can replace the remedy with such medicines as "Avelox", "Vigamox", "Rotomox", "Moxifur", "Moxin" and others. If there are negative consequences, a sharp deterioration in the condition, as well as the appearance of symptoms not described in the annotation, you should immediately consult a doctor. When using drops, do not allow excessive amounts of the drug to enter the eyes. If this happens, you should rinse them with water as soon as possible. In case of an overdose, there is an increase in side effects.

Finally

The drug "Moxifloxacin" is considered to be a strong enough antibacterial agent. In this regard, it is not recommended to violate the doctor's instructions. In particular, this relates to the number and frequency of application of the drug. Do not exceed the dosage. Intravenous administration should be carried out in a special office by a qualified employee who can provide assistance if necessary. Do not self-medicate. If there is no result of therapy, you should contact the doctor. Immediately before using the drug "Moxifloxacin", you should carefully read the instructions.