Can ciprofloxacin and levofloxacin be taken at the same time?

The effect of antibiotics in pyelonephritis

Pyelonephritis is an inflammatory disease of one or two kidneys at once, which affects the renal pelvis. This leads to the development of acute symptoms and disruption of the paired organ. The cause of the disease is almost always an infection that penetrates the body. There is an ascending and descending route of infection.

The first involves the penetration of microbes into the kidneys through the urethra and bladder, the second most often develops when there is a source of infection in the body.

Antibiotics for kidney pyelonephritis play the most important role, especially with the development of acute inflammation. This is due to the fact that they act directly on pathogens that cause the disease. When they enter the body, the components of the products suppress the vital activity of bacteria, which disrupts their metabolic processes.

As a result, the pathogens die, and the patient’s condition noticeably improves. The disease can be caused by staphylococci, streptococci, Pseudomonas aeruginosa or enterobacteria. Antibiotics of different groups act on all these microbes, which makes it possible to effectively treat pyelonephritis.

It is worth noting that there are medications with bacteriostatic and bactericidal effects. The former are considered less effective because they stop the reproduction and development of microbes, but do not destroy them.

The latter quickly kill bacteria, so they are a more preferable option. Today, pharmaceutical companies produce antibiotics that have bacteriostatic and bactericidal effects at the same time.

Composition and action

The drug is produced in several forms, depending on which the amount of the active substance ofloxacin varies: tablets with a dosage of 200-400 mg, eye ointment - 3 mg in 1 gram, solution for infusion - 200 mg in 100 ml.

In addition to the main component, the drug contains excipients:

1. Corn starch, calcium stearate, talc, titanium dioxide, hypromellose, macrogol 4000, microcrystalline cellulose, colloidal silica, propylene glycol and povidone.
2. Vaseline, methyl parahydroxybenzoate and propyl parahydroxybenzoate.
3. Sodium chloride with distilled water.

The active substance of Ofloxacin inhibits DNA gyrase of pathogenic microorganisms, which accelerates the supercoiling reaction of deoxyribonucleic acid. As a result, bacterial DNA becomes unstable and the cell dies. Among the groups of bacteria most sensitive to the drug are staphylococci, Escherichia coli, chlamydia, Klebsiella, Legionella, Neisseria, some pathogens of intestinal infections and acne, whooping cough, parapertussis. Anaerobic bacteria, the causative agents of syphilis and Nocardia asteroides are resistant to the action of the product.

Indications and contraindications

The drug helps in the treatment of many infectious diseases, the causative agents of which are pathogenic bacteria sensitive to the active substance of the drug. The main groups of diseases for which the antibiotic Ofloxacin is prescribed:

1. Infectious and inflammatory diseases of the gastrointestinal tract and hepatobiliary system.
2. Bacterial lesions of bones and joints, including polio.
3. Inflammatory diseases of the membranes of the spinal cord and brain of an infectious nature (meningitis).
4. Infections of the skin and soft tissues, accompanied by the development of purulent processes.
5. Lower respiratory tract diseases (bronchitis and pneumonia).
6. Pathological lesions of the ENT organs (laryngitis, sinusitis, tonsillitis, pharyngitis, otitis media).
7. Sexually transmitted diseases (chlamydia and gonorrhea).
8. Infectious and inflammatory pathologies of the urinary system (urethritis, cystitis, pyelonephritis).
9. Bacterial diseases of the female pelvic organs (salpingitis, cervicitis, endometritis, parametritis, oophoritis).
10. Infectious eye lesions (blepharitis, meibomitis, conjunctivitis, dacryocystitis, keratitis).
11. Bacterial inflammation of the male genital organs (orchitis, prostatitis, epididymitis).

In addition, according to the instructions for use of the tablets, Ofloxacin is considered a good prophylactic against bacterial infections in patients with immunodeficiency. In this case, the drug should be taken under the strict supervision of the attending physician.

Depending on the form of release of the drug, there are contraindications for its use. The solution and tablets should not be taken by patients with a deficiency of glucose-6-phosphate dehydrogenase, epilepsy, increased convulsive readiness (after stroke, head injury, inflammatory diseases of the central nervous system), hypersensitivity to the active substance or quinolone derivatives.

Pregnant and nursing mothers will have to stop taking the drug in these forms. It is also contraindicated in patients under 18 years of age: this is due to the unfinished process of skeletal development. Ofloxacin can be taken with extreme caution in case of organic lesions of the central nervous system, chronic renal failure and atherosclerotic changes in the vessels of the brain.

The main limitation when using Ofloxacin is considered to be age under 15 years.

Side effects

Taking Ofloxacin solution and tablets may be accompanied by a number of side effects. They can manifest themselves with varying degrees of severity. Among the most common reactions, the following are worth highlighting:

1. Skin - dermatitis, petechiae, papular rash.
2. Central nervous system - hand tremors, headaches, nightmares, deterioration of fine motor skills, impaired skin sensitivity, manifestation of phobias, depressive states, muscle cramps, dizziness. There may also be hallucinations, double vision and distortion of color vision, increased intracranial pressure, hearing, smell and taste disorders.
3. Cardiovascular system - decreased vascular tone, vasculitis, tachycardia.
4. Musculoskeletal system - tendonitis, arthralgia, synovitis, myalgia.
5. Urinary organs - development of renal failure, decreased functional activity of the kidneys, interstitial nephritis.
6. Circulatory system - agranulocytosis, leukopenia, hemolytic or aplastic anemia, thrombocytosis.
7. Gastrointestinal tract - loss of appetite, abdominal pain, diarrhea, nausea, vomiting, cholestatic jaundice, flatulence, increased bilirubin levels in the blood, pseudomembranous enterocolitis.
8. Allergic manifestations - bronchospasm, urticaria, fever, angioedema, itching, anaphylactic shock, Lyell's syndrome, allergic pneumonitis.

In case of an overdose of the drug, dizziness, confusion, convulsions, vomiting, lethargy, drowsiness, and disorientation may occur. Treatment of such conditions should be accompanied by mandatory gastric lavage, forced diuresis and symptomatic treatment. Convulsive syndrome is eliminated by Diazepam.

Before using the drug, you should carefully study the instructions for Ofloxacin. There are a few special instructions that need to be taken into account:

1. You should not drink alcohol while taking medication.
2. The drug is not suitable for the treatment of acute tonsillitis and pneumonia caused by pneumococcus.
3. The use of the drug may give a false negative result when conducting tests to detect tuberculosis.
4. While taking an antibiotic, exacerbations of myasthenia gravis are possible in patients with a predisposition.
5. Exposure to UV rays and sunlight is not recommended.
6. It is not advisable to be treated with the drug for more than two months.
7. It should be used with caution in people with kidney or liver disease and constantly monitor the concentration of the drug in plasma.
8. Women should stop using tampons during treatment to avoid the development of candidiasis.
9. The medicine can provoke tendonitis, which may be accompanied by tendon rupture. If symptoms of the disease appear, it is necessary to stop taking the drug, immobilize the affected limb and consult an orthopedist.
10. The presence of allergic manifestations and adverse reactions from the central nervous system is considered a direct indication for discontinuation of the drug.
11. For confirmed pseudomembranous colitis, oral administration of Metronidazole and Vancomycin is additionally prescribed.
12. During the entire period of treatment, you should refrain from driving vehicles and engaging in potentially dangerous activities due to decreased concentration and deterioration in the speed of psychomotor reactions.

What other effective drugs exist for the treatment of pyelonephritis?

Uroseptics

As we said above, a multicomponent regimen is used to treat pyelonephritis.
After antibiotic therapy, the use of uroseptics is justified. The most frequently prescribed include: Palin, Pimidel, Furomag, Furadonin, Nitroxoline, 5-NOK. As first-line drugs for acute pyelonephritis, they are ineffective, but as an additional step, after adequate treatment with antibacterial agents, they work well. It is justified to take uroseptics in the autumn-spring period to prevent relapse, since antibiotics are not used for chronic pyelonephritis. Typically, drugs from this group are prescribed in courses of 10 days. Immunomodulators
The work of the immune system plays a significant role in resisting microorganisms that cause inflammation of the genitourinary organs.
If the immune system had worked at the proper level, primary pyelonephritis may not have had time to develop. This means that the goal of immunotherapy is to improve the body’s immune response to pathogens. For this purpose, the following drugs are prescribed: Genferon, Panavir, Viferon, Kipferon, Cycloferon, etc. Additionally, taking multivitamins with microelements is justified.
Treatment of acute pyelonephritis with antibiotics can be complicated by candidiasis (thrush), so we must not forget about antifungal drugs: Diflucan, Flucostat, Pimafucin, Nystatin, etc.

How to take Ciprofloxacin correctly for cystitis

How effective is Ciprofloxacin for cystitis? What is better – Ciprofloxacin or Furadonin? We invite you to find answers to these and many other questions in our article.

As you know, cystitis most often occurs in women: a typical female disease. Why women's? According to statistics, in 90% of cases this disease affects females and only 10% - males. This is due to the structural features of the female body. Microbes quickly penetrate the genitourinary system, after which they rapidly multiply in an environment favorable to them. It is because of this that when treating cystitis you usually cannot do without a course of antibiotics. In this case, one of the drugs that has proven itself well is the antibiotic Ciprofloxacin.

Latest generation antibiotics

Antibiotics for kidney pyelonephritis are necessary not only for quickly eliminating symptoms. They also help prevent serious complications that the disease can cause. The latest generation products are considered the most effective and have minimal negative effects on the body.

They are:

• Piprax is the newest antibiotic from the penicillin group, belongs to the 5th generation. Effective against gram-negative and gram-positive microorganisms, quickly copes with the symptoms of pyelonephritis and improves the general condition of the patient. In most cases, the patient is prescribed intramuscular or intravenous injections.
• Isipen is a semisynthetic antibiotic from the penicillin group that has a pronounced therapeutic effect for pyelonephritis. Prescribed for moderate and advanced stages of the disease. The best option is to use a lyophilisate to prepare a solution that is administered intramuscularly.
• Invanz is the newest antibiotic that allows you to fight various forms of pyelonephritis at any stage. Helps quickly improve the patient's condition and prevent complications even after the first signs appear.
• Avikaz is a combination drug of the latest generation, which contains avibactam and ceftazidime as the main active component. Helps cope with the symptoms of pyelonephritis in cases where other medications have not brought the expected result.

Such means are used quite rarely today. Some of them have only received an approved certificate. But in special cases, when other drugs do not help cope with the disease, new antibacterial drugs can help the patient.

• Treatment of chronic, acute pyelonephritis with antibiotics: list of tablets, injections

Possibilities of clinical use of levofloxacin

Antibacterial drugs from the fluoroquinolone group occupy one of the leading positions in the treatment of various bacterial infections, including in outpatient settings. However, ciprofloxacin, ofloxacin, and lomefloxacin are currently so popular

Antibacterial drugs from the fluoroquinolone group occupy one of the leading positions in the treatment of various bacterial infections, including in outpatient settings. However, the currently popular ciprofloxacin, ofloxacin, lomefloxacin, pefloxacin have high activity against gram-negative pathogens, moderate activity against atypical pathogens and little activity against pneumococci and streptococci, which significantly limits their use, especially for respiratory infections.

In the last decade, new drugs from this group - the so-called - have begun to enter clinical practice. new fluoroquinolones, which retain the high activity against gram-negative pathogens characteristic of their predecessors, and at the same time are significantly more active against gram-positive and atypical microorganisms. One such drug is levofloxacin (Tavanic). According to its chemical structure, it is a levorotatory isomer of ofloxacin. A wide spectrum of antibacterial activity, high safety, and convenient pharmacokinetic properties make it possible for its wide use in various infections.

Mechanism of action

Levofloxacin has a rapid bactericidal effect because it penetrates into the microbial cell and inhibits, like first-generation fluoroquinolones, bacterial DNA gyrase (topoisomerase II), which disrupts the process of bacterial DNA formation. Human cell enzymes are not sensitive to fluoroquinolones, and the latter do not have a toxic effect on the cells of the macroorganism. Unlike drugs of the previous generation, new fluoroquinolones inhibit not only DNA gyrase, but also the second enzyme responsible for DNA synthesis, topoisomerase IV, isolated from some microorganisms, primarily gram-positive ones. It is believed that the high antipneumococcal and antistaphylococcal activity of the new fluoroquinolones is explained by the effect on this enzyme.

Levofloxacin has a clinically significant dose-dependent post-antibiotic effect, significantly longer than ciprofloxacin, as well as a long-term (2-3 hours) subinhibitory effect.

Under the influence of levofloxacin, an increase in the function of polymorphonuclear lymphocytes was noted in healthy volunteers and HIV-infected patients. Its immunomodulatory effect on tonsillar lymphocytes in patients with chronic tonsillitis has been shown. The data obtained allow us to speak not only about antibacterial activity, but also about the synergistic anti-inflammatory and antiallergic effect of levofloxacin.

Spectrum of antimicrobial activity

Levofloxacin is characterized by a broad antimicrobial spectrum, including gram-positive and gram-negative microorganisms, including intracellular pathogens (Table 1).

When comparing the effectiveness of various antibacterial drugs against pathogens of respiratory infections, it was found that levofloxacin is superior to other drugs in terms of antimicrobial activity. All strains of pneumococcus were sensitive to it, including penicillin-resistant ones, with a relatively lower sensitivity of pneumococci to comparison drugs: ofloxacin - 92%, ciprofloxacin - 82%, clarithromycin - 96%, azithromycin - 94%, amoxicillin/clavulanate - 96%, cefuroxime - 80%. All strains of Moraxella catarrhalis, Haemophilus influenzae and methicillin-sensitive Staphylococcus aureus, and 95% of Klebsiella pneumoniae strains were also sensitive to levofloxacin.

Resistance

The possibility of widespread clinical use of levofloxacin and other new fluoroquinolones raises concerns about the danger of developing resistance to them. Chromosomal mutations are the main mechanism providing microbial resistance to fluoroquinolones. In this case, there is a gradual accumulation of mutations in one or two genes and a stepwise decrease in sensitivity. The development of clinically significant pneumococcal resistance to levofloxacin is observed after three mutations and, therefore, seems unlikely. This is confirmed by experimental data: levofloxacin caused spontaneous mutations 100 times less frequently than ciprofloxacin, regardless of the sensitivity of the tested pneumococcal strains to penicillin and macrolides. Widespread use of the drug in recent years in the USA and Japan has not led to an increase in resistance to it. According to K. Yamaguchi et al., 1999, the sensitivity of bacteria to levofloxacin over five years, i.e., since the beginning of its widespread use, has not changed and exceeds 90% for both gram-negative and gram-positive pathogens.

The greater risk of developing antibiotic resistance is associated not with pneumococci, but with gram-negative bacteria. At the same time, according to some data, the use of levofloxacin in intensive care units is not accompanied by a significant increase in the resistance of gram-negative intestinal flora.

Pharmacokinetics

Levofloxacin is well absorbed from the gastrointestinal tract. Its bioavailability is 99% or more. Since levofloxacin is almost not metabolized in the liver, this helps to quickly achieve its maximum concentration in the blood (much higher than that of ciprofloxacin). Thus, when volunteers were prescribed a standard dose of fluoroquinolone, the values ​​of its maximum concentration in the blood when taking levofloxacin were 2.48 μg/ml/70 kg, ciprofloxacin - 1.2 μg/ml/70 kg.

After taking a single dose of levofloxacin (500 mg), its maximum concentration in the blood, equal to 5.1 ± 0.8 mcg/ml, is achieved after 1.3-1.6 hours, while the bactericidal activity of the blood against pneumococci remains up to 6.3 hours, regardless of their sensitivity to penicillins and cephalosporins. For a longer period of time, up to 24 hours, the bactericidal effect of blood on gram-negative bacteria of the Enterobacteriacae family is maintained.

The half-life of levofloxacin is 6-7.3 hours. About 87% of the administered dose of the drug is excreted unchanged in the urine over the next 48 hours.

Levofloxacin penetrates quickly into tissues, with tissue concentrations of the drug being higher than those in the blood. Particularly high concentrations are established in the tissues and fluids of the respiratory tract: alveolar macrophages, bronchial mucosa, bronchial secretions. Levofloxacin also reaches high concentrations inside cells.

Pyelonephritis

Description:

Pyelonephritis is an acute or chronic kidney disease with an infectious-inflammatory nature of damage, with disruption of the renal structure and function of the urinary system.

Immunological aspects of the course of pyelonephritis

Causes of Pyelonephritis:

Escherichia coli is the etiological agent of pyelonephritis

Symptoms of Pyelonephritis:

Right-sided pyelonephritis on ultrasound

Diagnostics:

Treatment of Pyelonephritis:

Sources used: www.24farm.ru

For what diseases is medicine prescribed?

Indications for use of Ofloxacin:

• infectious diseases of the genitourinary system: urethritis, prostatitis, gonorrhea, mycoplasmosis, pyelonephritis;
• diseases of the respiratory system: bronchitis, pneumonia, otitis media, tracheitis, sinusitis, tonsillitis;
• damage to soft tissues and skin: osteomyelitis, erysipelas, furunculosis, infected wounds, bedsores;
• sepsis;
• peritonitis.

Treatment of chronic pyelonephritis

With kidney pyelonephritis, the chronic form develops quite quickly. Especially in the absence of timely and comprehensive treatment. In this case, antibiotics are used in combination with other agents to achieve a complex effect.

• Pain with pyelonephritis

The treatment regimen involves not only taking medications, but also adhering to the regimen, as well as normalizing nutrition. The patient is advised to avoid salty, spicy, sour foods, alcohol, and carbonated drinks for some time. This will ease the load on the kidneys. Diuretic herbs are often prescribed, but only the doctor makes the decision.

Among the antibiotics, choose those that are highly effective and have a lower degree of toxicity:

• Augmentin is prescribed 2 injections per day, administered intravenously after preliminary dilution with saline solution. The duration of treatment is 10-14 days, depending on the severity of the patient’s condition.
• Ceftazidime is an effective broad-spectrum antibiotic from the group of cephalosporins. Prescribed as intramuscular or intravenous injections. The patient is administered from 2 to 4 g per day. The duration of treatment is 7-10 days.
• Doxycycline is an antibiotic from the tetracycline group, which is highly effective in the fight against pyelonephritis. The patient is prescribed from 0.5 to 2 g of the drug in the form of tablets or injections per day. The maximum duration of the course is 10 days. It is worth noting that tetracyclines are dangerous antibiotics, especially during pregnancy and childhood.
• Levomycetin is a drug from the group of fluoroquinolones that has a pronounced bactericidal effect. Used for 10-14 days. During this period, the patient is administered 1 g of the drug intramuscularly or intravenously 2 times a day.

In addition to antibiotic therapy, non-steroidal anti-inflammatory drugs are added, which also block substances that provoke the inflammatory process, relieve pain and reduce body temperature. The chronic form of the disease is quite difficult to treat; two antibiotics from different groups are often used.

Contraindications

Contraindications for Ciprofloxacin include:

• Individual intolerance to any fluoroquinolones;
• Epilepsy (involuntary body spasms with or without loss of consciousness);
• Tendon injuries;
• Severe renal or liver failure;
• Heart diseases;
• Age up to 18 years;
• During pregnancy and breastfeeding.

Levofloxacin should not be taken if:

• Individual intolerance to any fluoroquinolones;
• Epilepsy;
• Tendon injuries;
• Severe renal or liver failure;
• Heart diseases;
• Under 18 years of age;
• During pregnancy and lactation.

2. Medical nutrition

The diet of patients with chronic pyelonephritis without arterial hypertension, edema and chronic renal failure differs little from the usual diet, i.e. A diet with a complete content of proteins, fats, carbohydrates, and vitamins is recommended. A dairy-vegetable diet meets these requirements; meat and boiled fish are also allowed. The daily diet should include dishes from vegetables (potatoes, carrots, cabbage, beets) and fruits rich in potassium and vitamins C, P, group B (apples, plums, apricots, raisins, figs, etc.), milk, dairy products ( cottage cheese, cheese, kefir, sour cream, yogurt, cream), eggs (soft-boiled, omelet). The daily energy value of the diet is 2000-2500 kcal.

Throughout the entire period of the disease, the intake of spicy foods and seasonings is limited.

In the absence of contraindications, the patient is recommended to consume up to 2-3 liters of liquid per day in the form of mineral waters, fortified drinks, juices, fruit drinks, compotes, and jelly. Cranberry juice or fruit drink is especially useful, as it has an antiseptic effect on the kidneys and urinary tract. Forced diuresis helps relieve the inflammatory process. Fluid restriction is necessary only when an exacerbation of the disease is accompanied by a violation of the outflow of urine or arterial hypertension.

During the period of exacerbation of chronic pyelonephritis, the consumption of table salt is limited to 5-8 g per day, and in case of impaired urine outflow and arterial hypertension - to 4 g per day.

Outside of exacerbation, with normal blood pressure, the almost optimal amount of table salt is allowed - 12-15 g per day.

• Diet for pyelonephritis: the importance of proper nutrition in eliminating renal pathology

For all forms and at any stage of chronic pyelonephritis, it is recommended to include watermelons, melons, and pumpkin in the diet, which have a diuretic effect and help cleanse the urinary tract of microbes, mucus, and small stones.

With the development of chronic renal failure, the amount of protein in the diet is reduced; in case of hyperazotemia, a low-protein diet is prescribed; in case of hyperkalemia, potassium-containing products are limited (for details, see the chapter “Treatment of chronic renal failure”).

In case of chronic pyelonephritis, it is advisable to prescribe predominantly acidifying foods (bread, flour products, meat, eggs) for 2-3 days, then an alkalizing diet (vegetables, fruits, milk) for 2-3 days. This changes the pH of the urine, the interstitium of the kidneys and creates unfavorable conditions for microorganisms.

Quintor

The drug is noted for its high effectiveness in pathologies that are caused by bacterial infection. This explains the use of Quintor in such situations as:

1. General infection of the systemic bloodstream as a result of sepsis. Especially if the process develops against the background of a reduced immune status of the body.
2. If wounds, ulcers on the body, foci of abscess or phlegmon are sluggish and protracted.
3. When diffuse inflammation of the retroperitoneal space occurs as a consequence of peritonitis.
4. The occurrence of arthritis with septic manifestations, and damage to joints and bone tissue by osteomyelitis.
5. For prevention during the rehabilitation period after surgery.

The frequency, dosage and duration of the course are selected by the doctor individually. Usually it is 0.25 grams per day three times (morning, lunch and evening).

For elderly people, and patients diagnosed with epilepsy or atherosclerosis, as well as for impaired glomerular filtration of the kidneys, the medicine is prescribed with caution, under medical supervision. Quintor is not used in pediatric practice.

Treatment for acute pyelonephritis

The acute form of the disease is usually accompanied by severe symptoms, a significant increase in body temperature, the appearance of pus in the urine, and increased frequency of urination. In addition, patients may report pain in the kidney area, which intensifies with sudden movements.

To relieve symptoms, specialists use antibiotics, non-steroidal anti-inflammatory drugs, as well as blood purification drugs in the form of a solution for intravenous administration using a dropper.

The standard therapeutic regimen involves the use of the following medications:

• Azitral is an antibiotic from the macrolide group, which is actively used for various inflammatory pathologies of the kidneys. It is highly effective, well tolerated and rarely causes complications. The patient is administered 1 to 2 g of the drug per day using a dropper. The powder is first dissolved in 100-200 ml of 0.9% saline solution. The duration of treatment is from 3 to 7 days.
• Cefepime is a 4th generation cephalosporin that helps to cope even with advanced acute pyelonephritis. It is administered intramuscularly or intravenously in an amount of 1-2 g per day. The dosage depends on the severity of the condition. Usually the course lasts no more than 10 days.
• Nimesil is a non-steroidal anti-inflammatory drug based on nimesulide. Helps relieve fever and pain, alleviates general condition. The drug is available in powder form for solution. It must be taken orally. For 1 sachet you will need 100-120 ml of warm water. You should not take more than 3 packets per day, and you should not use the drug for more than 5 days in a row.
• Reosorbilact is a solution used to cleanse the blood of toxins that actively accumulate during the development of microorganisms in any organ. The drug is administered intravenously using a dropper in the amount of 200 ml per day. The course consists of 5-7 daily infusions.

If any complications occur, the doctor prescribes symptomatic treatment and adds other drugs to the standard regimen.

Side effects

Side effects of Ciprofloxacin include:

• Development of fungal infections;
• Intestinal inflammation;
• Increased agitation;
• Headache, dizziness;
• Deterioration of vision;
• Noise in ears;
• Heartbeat;
• Changes in blood pressure;
• Nausea;
• Jaundice;
• Pain in bones and joints;
• Tendon inflammation or rupture;
• Impaired kidney function.

Levofloxacin can lead to the development of the following conditions:

• Development of fungal infections;
• Intestinal inflammation;
• Increased agitation;
• Headache, dizziness;
• Deterioration of vision;
• Noise in ears;
• Heartbeat;
• Changes in blood pressure;
• Nausea;
• Jaundice;
• Pain in bones and joints;
• Tendon inflammation or rupture;
• Impaired kidney function.

Any of these drug reactions occur in less than 1% of patients. However, the degree of their severity when they appear can be quite serious. Ciprofloxacin and Levofloxacin affect the metabolism of connective tissue, which can lead to tendon ruptures in adults or deformation of joints and bones in young patients. For this reason, the drugs are strictly contraindicated for use before the age of 18 years.

Derivatives of 8-hydroxyquinoline

This group includes drugs that contain nitroxoline. Positive properties:

1. It is a uroseptic with a bactericidal effect on microbes.
2. Manifests itself in relation to fungal flora.
3. The concentration of the drug is achieved after 1.5 hours.

This group of drugs is effective in the treatment of pyelonephritis. This is due to the accumulation in large quantities in the urine and the effect on various types of bacteria.

Available only in tablets, which are taken for 7–14 days. The drug is often used to treat any diseases of the urinary system.

Usually combined with other antibacterial drugs. Nitroxoline is active in the treatment of chronic pyelonephritis. Therefore, it is recommended to use it to prevent relapses of the disease.

Interaction with other drugs

Ofloxacin goes well with:

• sodium salt of hydrochloric acid;
• Ringer's mixture;
• five percent fructose mixture;
• five percent dextrose solution.

You should also not take medicine with heparin in one form or another.

The following drugs can increase the amount of the active substance Ofloxacin in plasma:

• Cimetidine;
• all drugs that block tubular secretion;
• loop diuretics (Furosemide).

When used with nitroimidazoles and methylxanthines derivatives, the possibility of increased neurotoxic “explosions” increases.

When used simultaneously with glucocorticoids, the risk of tendon rupture increases.

When used with carbonic anhydrase inhibitors and sodium bicarbonate, the possibility of crystalluria and nephrotic "bursts" increases.

Features of treatment during pregnancy

Antibiotics for kidney pyelonephritis can be prescribed even during pregnancy. It is at this time that a woman’s paired organ is most susceptible to disease. For treatment, antibiotics from the penicillin group are used, for example Augmentin, Amoxicillin. The dosage is determined individually, but usually 1.2 g of the product in the morning and evening is sufficient.

If it is impossible to use tablets, the specialist will prescribe injections in a similar dosage.

In addition to penicillins, cephalosporins, such as Ceftriaxone, are allowed to be used. Dosage – 2 g per day, course duration – from 7 to 14 days. These medications do not have a toxic effect on the body of the mother and child. However, it is worth remembering that any antibacterial agent is used only after consulting a doctor.

Experts always prescribe antibiotics to pregnant women with caution, as the risk of developing fetal defects or other complications increases. If the potential benefits of therapy outweigh the possible harm, such drugs become the only method of treatment. It is also recommended that a woman drink at least 2 liters of fluid per day and follow a diet that excludes salty and spicy foods.

It is better not to lie on your back while sleeping; doctors believe that the outflow of urine is more efficient if a woman lies on her side. This helps prevent stagnation of urine and the development of microorganisms in it. If all recommendations are followed, the patient is successfully cured.

Reception features

The tablets should be taken without chewing, with plenty of clean water. Although the absorption of the drug does not depend on food intake, it is still recommended to take the tablets on an empty stomach, so it is better absorbed. Remember that foods containing calcium (all milk) may reduce absorption. As well as iron, zinc, magnesium, aluminum. You should not only avoid them in food, but also monitor the composition of the medications that you take together with Tsiprolet (see interaction). Their use should be limited in time, leaving a gap of 2-3 hours.

Foods rich in calcium interfere with the absorption of Tsiprolet and reduce its concentration in tissues

Tsiprolet is excreted by the kidneys. Do not allow urine to become alkaline, otherwise the drug will promote the formation of salt crystals. With concomitant diseases of these organs, for example, renal failure, the medicine can be compensatory removed from the body with feces. In this case, the doctor will definitely adjust the dose of the drug to avoid side effects.

Antibiotics for acute complicated pyelonephritis or hospital-acquired kidney infection

Fluoroquinolones are prescribed for the treatment of acute complicated pyelonephritis.

(Ciprofloxacin, Levofloxacin, Pefloxacin, Ofloxacin), but use the intravenous route of administration, i.e.
These antibiotics for pyelonephritis also exist in injections. Aminopenicillins
: amoxicillin/clavulanic acid.
Cephalosporins
, for example, Ceftriaxone 1.0 g 2 times a day, course 10 days, Ceftazidime 1-2 g 3 times a day intravenously, etc.
Aminoglycosides
: Amikacin 10-15 mcg per 1 kg per day - 2-3 times.
In severe cases, a combination of Aminoglycoside + Fluoroquinolone, or Cephalosporin + Aminoglycoside
.

Cifran or Ciprofloxacin – which is better?

A combined medication that provides a wide spectrum of action due to the 2 main components of Ciprofloxacin and Tinidazole. The first ingredient is in a volume of 250 to 300 milligrams, the concentration of the second is from 500 to 600 mg. A successful ratio of the two constituent chemical compounds causes activity against infection, provoking the development of pneumonia and bronchitis, cholecystitis, cholangitis and osteomyelitis. In addition, it is effective in the treatment of diseases transmitted through sexual contact (gonorrhea, chlamydia).

The therapeutic dose providing a therapeutic effect is two tablets per day. Side effects and contraindications are similar to the drug Ciprofloxacin.

Table – existing forms of the drug Cifran with prices *

Antibiotics for children

In childhood, pyelonephritis occurs almost as often as acute respiratory diseases. This is due to hypothermia, decreased immunity and other factors. At the same time, girls suffer from the disease 3 times more often, which is associated with the anatomical features of the urethra.

Symptoms of the disease in preschool and school age are easily confused with signs of diseases of the digestive tract. The main method of treatment is the use of antibiotics. Additionally, other medications are used.

The standard regimen involves taking the following medications:

• Cefuroxime is an antibiotic from the cephalosporin group, prescribed to children when signs of pyelonephritis appear. Usually you need to take 1 tablet (dosage 125 mg) in the morning and evening. Duration of treatment – ​​10 days.
• Sumamed is an antibiotic from the macrolide group. It is highly effective and is approved for use in children from 6 months of age. Children under 3 years of age are prescribed a suspension at a dosage of 10 mg per 1 kg of body weight. You need to take the medicine 2 times a day. Duration of treatment is 3-5 days. Children from 3 years of age are prescribed 2 tablets per day. The dose in each tablet is 125 mg.
• Suprax is an antibiotic from the group of 3rd generation cephalosporins. Available in the form of water-soluble tablets. You should take 1 tablet per day (dose 200 mg), dissolving it in water or sweet syrup. Duration of treatment is 3-7 days.

Additionally, children are prescribed medicinal herbs. Chamomile has an anti-inflammatory and antiseptic effect, horsetail stimulates the formation and excretion of urine. Decoctions or infusions are prepared based on herbs. The dosage for children of different ages is different, so you should consult your doctor before taking it.

Ciprolet and ciprofloxacin - what is the difference?

These drugs are structural analogues, since there are no differences in the main component that fights bacteria that are sensitive to it. Ciprofloxacin and Ciprolet contain the same active substance - ciprofloxacin

. It has its advantages and disadvantages compared to other antibiotics (see below), but in the same forms and dosages the effect should be identical for both drugs.

In practice, this is not always the case, since a small percentage of the difference in efficiency depends on the quality of the raw materials, the purity of the chemical composition and additional components. These indicators are entirely up to the individual manufacturer, so when choosing, it is important not to go for cheapness, especially since the difference between Tsiprolet and domestic ciprofloxacin in price is very small.

Tsiprolet is a product of the Indian pharmaceutical company Dr. Reddis, which specializes in the production of inexpensive generics (analogues of original drugs from large pharmaceutical corporations). Available in 3 forms:

1. tablets 250 or 500 mg,
2. bottles with solution for infusion (droppers) 2 mg/ml,
3. and eye drops 3 mg/ml.

Ciprolet 500 mg

There is also a fourth separate type of Tsiprolet A, where each tablet additionally contains 600 mg of tinidazole (an antiprotozoal agent), similar in action to metronidazole. Prescribed for mixed infections, often sexually transmitted.

Domestic Ciprofloxacin is produced by several companies.
It differs in the set of auxiliary components of the tablets and in price. The main brands available in almost all our pharmacies are listed in the table. What is the difference between Ciprolet and Ciprofloxacin tablets?

"Ekotsifol" 10 tab.

Differences in the composition of auxiliary components are also present. For example, Ecotsifol additionally contains lactulose. And the closest in composition of formative substances to the Indian representative is Ciprofloxacin-Teva, which can be chosen if there is a need to switch from Ciprolet to ciprofloxacin.

For the elderly

Antibiotics for kidney pyelonephritis in older people are used with caution, since many of the drugs have a negative effect on a weakened body and also provoke various complications.

It is worth noting that in elderly patients, the disease most often becomes chronic, since the body is weakened, and in most cases there are concomitant disorders. This complicates the course of the disease.

Nephrologists or therapists most often prescribe antibiotics from the fluoroquinolone group to elderly patients. They are effective, act on most microorganisms and help get rid of symptoms in a short time. Non-fluorinated quinolones are not used in the case of pyelonephritis because they have a narrow spectrum of action.

However, 2nd, 3rd and 4th generation medications are often prescribed. The course of treatment lasts at least 10 days. At this time, the patient receives from 1 to 3 g of antibacterial drug. The most commonly prescribed drugs are Ofloxacin, Ciprofloxacin, and Levofloxacin. A good therapeutic effect can be obtained by consuming Zanotsin or Floxal.

4th generation drugs are also often prescribed to elderly patients. They usually contain the substance moxifloxacin. The most popular drug in this group is Moxin; Avelox and Plevilox are often used.

It is important to remember that for elderly patients, simply taking antibiotics is not enough. It is necessary to adhere to a diet and take an infusion based on medicinal herbs. Additionally, after the disappearance of acute symptoms, physiotherapy is prescribed.

If kidney pyelonephritis is diagnosed, it is important to start treatment in a timely manner. Antibiotics in this case become the main method of treatment, helping to prevent complications and improve the general condition of the patient.

Article design: Oleg Lozinsky

Ciprofloxacin analogues in tablets - list with prices

• Norfloxacin – from 180 rubles;
• Tsiprolet – from 60 rubles;
• Ecotsifol – from 90 rubles;
• Tsiprinol – from 73 rubles;
• Levofloxacin – from 61 rubles;
• Tsifran – from 50 rubles;
• Tsiprobay – from 380 rubles;
• Quintor - from 190 rubles.

Table – existing forms of the drug Ciprofloxacin with prices *

Criteria for the effectiveness of antibiotics for pyelonephritis

[44], [45], [46], [47]

Early criteria (48-72 hours)

Positive clinical dynamics:

• reduction of fever;
• reduction of manifestations of intoxication;
• improvement of general well-being;
• normalization of the functional state of the kidneys;
• urine sterility after 3-4 days of treatment.

[48], [49], [50], [51], [52], [53]

Late criteria (14-30 days)

Persistent positive clinical dynamics:

• no recurrence of fever;
• absence of chills for 2 weeks after the end of antibacterial therapy;
• negative results of bacteriological examination of urine on the 3-7th day after the end of antibacterial therapy.

Final criteria (1-3 months)

No recurrent urinary tract infections within 12 weeks after the end of antibacterial treatment for pyelonephritis.

[54], [55], [56], [57], [58], [59], [60]

Requirements for prescribing the drug

Before prescribing ciprofloxacin, you must inform your doctor in advance about all other substances that enter your body daily to prevent the development of unwanted reactions.

All these rules must be followed not only while taking the drug, but also several days later, until it is completely removed from the bloodstream.

When using ciprofloxacin, it should be remembered that ureaplasma, clostridia and some other microorganisms are resistant to it. Therefore, before prescribing it, it is necessary to conduct a microbiological examination of urine to determine sensitivity to antibiotics.

Sulfonamides

Treatment with antibiotics from the sulfonamide group is carried out for mild cases of the disease. Drugs only have a bacteriostatic effect, that is, they reduce the growth and activity of microbes, but do not kill.

The mechanism is based on the inhibition of growth enzymes that are necessary for microbes. Inhibits folic and dihydrofolic acids.

As a result, nucleic acid synthesis is disrupted, so a new bacterial cell will not form.

For pyelonephritis, the drug is used in the form of tablets or injections. Treatment is carried out in combination with other antibiotics.

At present they are not used as they do not have a bactericidal effect. Not suitable for monotherapy of severe cases of pyelonephritis.

Doctors prescribe sulfonamides for chronic pyelonephritis. Thanks to the action, further development of pathogenic flora does not occur, which leads to the necessary therapeutic effect.

Alternate Substitution Formats

Most anti-tuberculosis drugs are available in tablet format. Ecotsifol is considered one of the main analogues of this form of the drug. It is produced by ABVA RUS. In the treatment of infectious ophthalmological diseases, Cipraz drops are prescribed instead of Ciprofloxacin.

It is also suitable for inpatient treatment. The drug is also available in the form of a solution for infusion. It is produced by Razak Laboratories (Iran).

Peculiarities! During treatment with antibiotics, it is necessary to regularly monitor the condition of the liver, kidneys, circulatory system and heart.

Reviews about the drug

The overwhelming majority of reviews are positive, but there are also negative ones, the reason for which is either the patient’s self-medication or an inadequate assessment of his condition. The most important condition for obtaining a guaranteed positive result is seeking medical help from a specialist who can correctly diagnose the pathology, its severity and course, take into account concomitant diseases and, if necessary, prescribe complex therapy.

Here are some of the many cases where Monural actually helped patients.

The patient is 32 years old. complaints of pain in the lower abdomen, frequent and painful urination. After taking a single 3 gram packet of granules, the symptoms completely disappeared after about 20 hours.

Mother is sick. “My teenage daughter caught a cold and got cystitis while on a camping trip. After consultation with a urologist, she took Monural once at a dose of 2 grams and recovered within a day.”

Patient, 63 years old: “I am 63 years old and recently underwent bladder catheterization. I think that it was thanks to Monural that I did not have complications in the urinary tract. I took one dose of 3 grams before the manipulation and the second one a day later.”

Due to the combination of the most important features of the antibiotic and its high therapeutic activity with rarely recorded adverse reactions, Monural is widely used in nephrology and urology. It helps patients of all ages with infectious diseases of the urinary system and is a reliable and very promising drug.

Source: https://2pochki.com/medicamenty/monural-lecheniya-pielonefrita

Effect on the kidneys

The kidneys are the filter of the human body, so everything that enters it intravenously, intramuscularly, orally as tablets ends up in the kidneys. A large number of drugs can lead to pathological changes in kidney tissue - nephrotoxicity.

The following groups of citizens are especially at risk when taking antibiotics:

1. Aged people.
2. Children.
3. People with kidney disease (renal failure).
4. People suffering from diabetes.

Antibiotic therapy should be selected by a specialist, his consultation is strictly mandatory, since in a huge range of drugs there are many pitfalls, and not always what suits one person and does not cause adverse reactions will suit another. Do not self-medicate, take care of your health.