Antibiotics fluoroquinolones

Ciprofloxacin (Cipro, Cipro XR, Proquin XR) [Antibiotic/ Fluoroquinolone] Uses Rx lower resp tract, sinuses, skin skin structure, bone/joints, urinary tract Infxns including prostatitis Action Quinolone antibiotic DNA gyrase Dose Adults. 250-750 mg PO ql2h XR 500-1000 mg PO q24h or 200-400 mg IV ql2h in renal impair Caution [C, /-] Children <18 y Contra Component sensitivity Disp Tabs, susp, inj SE Restlessness, N/V/D, rash, ruptured tendons, T LFTs Interactions T Effects Wf probenecid T effects OF diazepam, theophylline, caffeine, metoprolol, propranolol, phenytoin, warfarin effects W/ antacids, didanosine, Fe salts. Mg, sucralfate, Na bicarbonate,... 

BUPROPION 1. ANTIBIOTICS - fluoroquinolones 2. ANTICANCER AND IMMUNO-MODULATING DRUGS-corticosteroids, interferons 3. ANTIDEPRESSANTS-TCAs 4. ANTIMALARIALS - chloroquine, mefloquine 5. ANTIPSYCHOTICS 6. BRONCHODILATORS -theophylline 7. CNS STIMULANTS 8. PARASYMPATHOMIMETICS T risk of seizures. This risk is marked in elderly people, in patients with a history of seizures, with addiction to opiates/cocaine/ stimulants, and in diabetics treated with oral hypoglycaemics or insulin Bupropion is associated with a dose-related risk of seizures. These drugs, which lower seizure threshold, are individually epileptogenic. Additive effects occur when combined Extreme caution. The dose of bupropion should not exceed 4S0 mg/day (or 150 mg/day in patients with severe hepatic cirrhosis)... 

The role of enterococci in nosocomial infections is probably due to a variety of factors of which antimicrobial resistance appears to be a primary cause. Enterococci possess a broad spectrum of both natural (intrinsic) resistance and acquired (transferable) resistance (Franz et al. 2003). Examples of antibiotics to which the enterococci present an intrinsic resistance include the P-lactam antibiotics (third generation cephalosporins), sulphonamides and clindamycin and aminoglycosides in low levels (Eranz et al. 2003). Acquired resistance based on plasmids or transpo-sons acquisition has relevance for chloramphenicol, erythromycin, high levels of clindamycin, aminoglycosides, tetracycline, high levels of P-lactam antibiotics, fluoroquinolones and glycopeptides like vancomycin (Murray 1990 Leclercq 1997). In particular, vancomycin-resistant enterococci (VRE) pose a major problem... 

The results showed that the compounds studied with more frequency in the aquatic environment, and of which, logically, there is more information, are the antibiotics, analgesics and anti-inflammatories (like diclofenac, ibuprofen, naproxen, acetylsalicylic acid, and paracetamol), as well as the p-blocker atenolol. In the category of antibiotics, several families are included, like the macrolides (erythromycin), the fluoroquinolones (ofloxacin and ciprofloxacin), sulfonamides (sulfamethoxazole), penicillins (amoxicillin), the metronidazol, and trimethoprim. Other therapeutic groups also widely studied and frequently found in the environmental waters are the lipid regulators (gemfibrozil and bezafibrat), antiepileptic carbamaze-pine, and antidepressants (diazepam, fluoxetine, paroxetine) (see Table 3). 

Kim EJ, Kim KS, Shin WH. Electrophysiological safety of DW-286a, a novel fluoroquinolone antibiotic agent. Hum Exp Toxicol 2005 24 19-25. 

Complicated exacerbation FEV, less than 50% predicted Comorbid cardiac disease Greater than or equal to 3 exacerbations per year Antibiotic therapy in the previous 3 months Above organisms plus drug-resistant pneumococci, P-lactamase-producing H. influenzae and M. catarrhalis, Escherichia coli, Proteus spp., Enterobacter spp., Klebsiella pneumoniae Oral P-Lactam/P-Iactamase inhibitor (amoxicil 1 i n-clavulanate) Fluoroquinolone with enhanced pneumococcal activity (levofloxacin, gemifloxacin, moxifloxacin) Intravenous P-Iactam/P-Iactamase inhibitor (ampicillin-sulbactam) Second- or third-generation cephalosporin (cefuroxime, ceftriaxone) Fluoroquinolone with enhanced pneumococcal activity (levofloxacin, moxifloxacin)... 

Empiric antibiotic therapy is an appropriate approach to traveler s diarrhea. Eradication of the causal microbe depends on the etiologic agent and its antibiotic sensitivity. Most cases of traveler s diarrhea and other community-acquired infections result from enterotoxigenic (ETEC) or enteropathogenic (EPEC) Escherichia coli. Routine stool cultures do not identify these strains primary empiric antibiotic choices include fluoroquinolones such as ciprofloxacin or levofloxacin. Azithromycin may be a feasible option when fluoroquinolone resistance is encountered. 

Initiation of prophylactic antibiotics is recommended during acute variceal bleeding this is typically done with an oral fluoroquinolone (e.g., ciprofloxacin 500 mg twice daily x 7 days) or an IV third-generation cephalosporin. Prophylactic antibiotic therapy reduces in-hospital infections and mortality in patients hospitalized for variceal bleeding.44... 

Common adverse effects of calcium salts include constipation, bloating, cramps, and flatulence. Changing to a different salt form may alleviate symptoms for some patients. Calcium salts may reduce the absorption of levothyroxine, iron and some antibiotics, such as tetracycline and fluoroquinolones. 

Because an infection slows the healing of a corneal abrasion, prophylactic antibiotics are often used. Studies on the efficacy of this are mixed. Discontinue the use of contact lenses until the abrasion is healed and the antibiotic course complete. In contact lens wearers, choose an antibiotic that covers Pseudomonas aeruginosa, like gentamicin ointment or solution or a fluoroquinolone.3 Antibiotic resistance is an increasing problem. Resistance occurs primarily with older antibiotics, but has been reported for fluoroquinolones as well. Two newer fluoroquinolones, gatifloxacin and moxifloxacin, do not yet have reports of resistance. These agents are more expensive.6... 

Gram-negative rods Tobramycin 3-14 mg/mL or Gentamicin 3-14 mg/mL or Ceftazidime SO mg/mL or Fluoroquinolones 3 mg/mL Less severe keratitis may use less frequent dosing Antibiotics may be alternated each hour for ulcers and contact lens... 

The comorbid conditions that can affect therapy and outcomes in patients with CAP include diabetes mellitus, COPD, congestive heart failure, and renal failure.27,28 If the patient has not received antibiotics in the past 3 months, then clarithromycin or azithromycin is the recommended first-line therapy by the IDSA. If the patient has received antibiotics in the last 3 months, then the IDSA recommends using either a respiratory fluoroquinolone alone or a combination of an oral P-lactam and an advanced macrolide/azalide (e.g., clarithromycin/azithromydn). The ATS recommends combination therapy or monotherapy with a respiratory fluoroquinolone for all patients with comorbidities. The p-lactam agents recommended include high-dose amoxicillin, high-dose amoxicillin-clavulanate, cefpodoxime, cefprozil, and cefuroxime. 

Failure to respond to initial therapy after 3 days requires patient reevaluation to consider changing therapy to cover pathogens not treated with the initial choice. Antibiotics traditionally have been given for at least 10 to 14 days, with up to 21 days needed for resolution in some patients.31 Recent data suggest that 5-day treatment courses of some fluoroquinolones and telithromycin are as effective as longer courses in adults with... 

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