What is the difference between ciprofloxacin and levofloxacin. Ofloxacin in urological practice. Spectrum of action and therapeutic effects

In this article we will try to figure out which is better levofloxacin or ciprofloxacin. To give a solid answer, it is necessary to dwell in more detail on the features of the use of each of these drugs separately.

Ciprofloxacin

Ciprofloxacin belongs to the classical fluoroquinolones, which have wide indications for use in respiratory infections of the lower respiratory tract and ENT pathology. Clinical experience shows that this drug is active against gram-negative bacteria, staphylococci and atypical pathogens (chlamydia, mycoplasma, etc.). At the same time, ciprofloxacin is not effective enough in diseases caused by pneumococci.

The selection of the optimal drug for the treatment of any disease should be handled exclusively by a highly qualified doctor.

Indications

Being a broad-spectrum antibacterial drug, Ciprofloxacin is successfully used in the treatment of patients suffering from respiratory infections of the respiratory tract and ENT pathology. In what diseases of the respiratory system and diseases of the ear, throat, nose, this drug from the group of classic fluoroquinolones is used:

1. Acute and chronic bronchitis (at the stage of exacerbation).
2. Pneumonia caused by various pathogenic microorganisms.
3. Inflammation of the middle ear, paranasal sinuses, throat, etc.

Contraindications

Like most drugs, Ciprofloxacin has its contraindications. In what situations this representative of classical fluoroquinolones cannot be used in the treatment of respiratory diseases and ENT pathology:

• Allergic reaction to ciprofloxacin.
• Pseudomembranous colitis.
• Childhood and adolescence (until the end of the formation of the skeletal system). An exception is children with pulmonary cystic fibrosis who have developed infectious complications.
• Pulmonary form of anthrax.

In addition, patients with the following disorders and pathological conditions have restrictions on the use of Ciprofloxacin:

• Progressive atherosclerotic lesion of the blood vessels of the brain.
• Severe disorders of cerebral circulation.
• Various heart diseases (arrhythmia, heart attack, etc.).
• Decreased levels of potassium and/or magnesium in the blood (electrolyte imbalance).
• Depressive state.
• epileptic seizures.
• Severe disorders of the central nervous system (for example, stroke).
• Myasthenia.
• Serious malfunctions of the kidneys and / or liver.
• Advanced age.

Side effects

According to clinical practice, adverse reactions in the vast majority of patients taking fluoroquinolones are observed infrequently. We list the undesirable effects that occur in about 1 out of 1000 patients taking Ciprofloxacin:

• Dyspeptic disorders (vomiting, pain in the abdomen, diarrhea, etc.)
• Decreased appetite.
• Feeling of heartbeat.
• Headache.
• Dizziness.
• Periodic sleep problems.
• Changes in the main blood parameters.
• Weakness, fatigue.
• Allergic reaction.
• Various skin rashes.
• Pain in muscles and joints.
• Functional disorders of the kidneys and liver.

Do not buy Levofloxacin or Ciprofloxacin without first talking to your doctor.

special instructions

With extreme caution, ciprofloxacin is prescribed to patients who are already taking drugs that lead to a prolongation of the QT interval:

1. Antiarrhythmic drugs.
2. Macrolide antibiotics.
3. Tricyclic antidepressants.
4. Antipsychotics.

Clinical observations show that Ciprofloxacin enhances the effect of hypoglycemic drugs. With their simultaneous use, careful monitoring of blood glucose should be carried out. It has been recorded that drugs that reduce acidity in the gastrointestinal tract (antacids), and which contain aluminum and magnesium, reduce the absorption of fluoroquinolones from the digestive tract. The interval between the use of an antacid and an antibacterial drug should be at least 120 minutes. I would also like to note that milk and dairy products can affect the absorption of Ciprofloxacin.

In case of an overdose of the drug, headache, dizziness, weakness, convulsive attacks, dyspeptic disorders, functional disorders of the kidneys and liver may develop. There is no specific antidote. Wash the stomach, give activated charcoal. If necessary, symptomatic therapy is prescribed. Carefully monitor the patient's condition until complete recovery.

Levofloxacin

Levofloxacin is a third-generation fluoroquinolone. It has a high activity against gram-negative bacteria, pneumococci and atypical pathogens of respiratory infections. Most pathogens that show resistance (resistance) to the "classic" second-generation fluoroquinolones may be sensitive to more modern drugs such as Levofloxacin.

Eating does not affect the absorption of Ciprofloxacin or Levofloxacin. Modern fluoroquinolones can be taken both before and after meals.

Indications

Levofloxacin is an antibacterial drug with a wide spectrum of action. It is actively involved in the following diseases of the respiratory system and ENT organs:

• Acute or chronic inflammation of the bronchi (at the stage of exacerbation).
• Inflammation of the paranasal sinuses (sinusitis, sinusitis, etc.).
• Infectious and inflammatory processes in the ear, throat.
• Pneumonia.
• Infectious complications of cystic fibrosis.

Contraindications

Despite the fact that Levofloxacin belongs to the new generation of fluoroquinolones, this drug can not be prescribed in all cases. What are the contraindications to the use of Levofloxacin:

• An allergic reaction to a drug or its analogues from the fluoroquinolone group.
• Serious kidney problems.
• epileptic seizures.
• Tendon injury associated with prior fluoroquinolone therapy.
• Children and teenagers.
• Periods of childbearing and breastfeeding.

Levofloxacin should be used with extreme caution in elderly patients.

Side effects

As a rule, all adverse reactions are classified according to severity and frequency of occurrence. We list the main undesirable effects from taking Levofloxacin, which may occur:

• Problems with the functioning of the gastrointestinal tract (nausea, vomiting, diarrhea, etc.).
• Headache.
• Dizziness.
• Allergic reactions (skin rashes, itching, etc.).
• Elevated levels of essential liver enzymes.
• Drowsiness.
• Weakness.
• Pain in muscles and joints.
• Damage to the tendons (inflammation, tears, etc.).

Self-administration of Levofloxacin or Ciprofloxacin without the permission of the attending physician can have serious consequences.

special instructions

Since the likelihood of joint damage is high, Levofloxacin is not prescribed in childhood and adolescence (up to 18 years), except in extremely severe cases. When using antibacterial drugs for the treatment of age-related patients, it should be borne in mind that this category of patients may have impaired renal function, which is a contraindication for the appointment of fluoroquinolones.

During therapy with Levofloxacin, patients who have previously suffered a stroke or severe traumatic brain injury may develop epileptic seizures (convulsions). If there is a suspicion of the presence of pseudomembranous colitis, it is necessary to immediately stop taking Levofloxacin and prescribe the optimal course of therapy. In such situations, it is strongly not recommended to use drugs that inhibit intestinal motility.

Although rare, there may be cases of inflammation of the tendons (tendinitis) when using Levofloxacin. Older patients are more prone to these types of side effects. Concurrent use of glucocorticosteroids significantly increases the risk of developing tendon ruptures. If a tendon lesion is suspected (inflammation, ruptures, etc.), fluoroquinolone therapy is stopped.

In case of an overdose of this drug, symptomatic therapy should be carried out. The use of dialysis in such cases is ineffective. There is no specific antidote.

During therapy with Levofloxacin, it is not recommended to engage in activities that require increased concentration and quick reaction (for example, driving a car). Also, due to the risk of developing photosensitivity, refrain from excessive skin exposure to ultraviolet rays.

What drug to choose?

How to determine which is better Levofloxacin or Ciprofloxacin? Of course, only an experienced specialist can make the best choice. Nevertheless, when choosing a drug, it is necessary to rely on 3 main aspects:

A good drug will be considered one that is not only effective, but also less toxic and affordable. In terms of effectiveness, Levofloxacin has its advantages over Ciprofloxacin. Along with the preserved activity against gram-negative pathogenic microorganisms, Levofloxacin has a more pronounced antibacterial effect against pneumococci and atypical pathogens. However, it is inferior to Ciprofloxacin in activity against the pathogen Pseudomonas (P.) aeruginosa. It has been noted that pathogens that are resistant to ciprofloxacin may be susceptible to levofloxacin.

The type of pathogen and its sensitivity to antibacterial agents are decisive when choosing the optimal fluoroquinolone (in particular, Ciprofloxacin or Lefovloxacin).

Both drugs are well absorbed in the intestine when taken orally. Food practically does not affect the absorption process, with the exception of milk and dairy products. They are convenient to use because they can be administered 1-2 times a day. Regardless of whether you take Ciprofloxacin or Levofloxacin, in rare cases, unwanted side reactions may develop. As a rule, dyspeptic disorders (nausea, vomiting, etc.) are noted. Some patients taking fluoroquinolones of the second or third generation complain of headache, dizziness, weakness, fatigue, sleep disturbance.

In elderly patients, especially against the background of glucocorticosteroid therapy, tendon ruptures are possible. Due to the risk of developing joint damage, fluoroquinolones are limited in use during periods of childbearing and breastfeeding, as well as in childhood.

Currently, for most patients, the price aspect is of paramount importance. A pack of Ciprofloxacin tablets costs about 40 rubles. Depending on the dosage of the drug (250 or 500 mg), the price may fluctuate, but not significantly. A more modern Levofloxacin will cost you an average of 200-300 rubles. The price will depend on the manufacturer.

However, the final decision as to what is best for the patient Ciprofloxacin or Levofloxacin is made solely by the attending physician.

Levofloxacin: analogues, review of essential drugs similar to Levofloxacin

According to the latest medical statistics, the spread of prostatitis and its forms has recently begun to increase. The reasons for this situation can be called a lot of factors, among which, the main place is occupied by the unsatisfactory attitude of a man to his health, poor ecology, poor-quality food, etc.

Therefore, it is not surprising how seriously pharmacologists have to work to offer patients the latest and most effective drugs for the treatment of prostatitis. Among them, there is also Levofloxacin - an antibiotic of the latest generation, with a wide spectrum of action.

This type of drug, like Amoxiclav, belongs to antibiotics with a wide spectrum of action and is ideal for the systemic treatment of various diseases, including prostatitis (acute, chronic, bacterial).

The release form of the drug is tablets or solutions for injection. Any form of the drug is quickly absorbed into the blood, affects the body at the cellular level, and the directed action of the drug allows you to effectively kill entire colonies of harmful microorganisms. For people suffering from infectious and bacterial diseases, it will be much cheaper to purchase such a medication than buying other antibiotic synonyms and substitutes, which also have side effects and contraindications.

Levofloxacin analogues have the following properties:

• They have a wide and active spectrum of effects on the body.
• Able to quickly penetrate into the tissues of the prostate.
• Show a high degree of activity and directional action.

Before taking the medicine, you should read all the information that the instructions for taking the drug offer you. Like any other antibiotic, domestic or imported, Levofloxacin can cause side effects and individual intolerance.

Today you can choose not only Levofloxacin, analogues of this drug, similar in composition, action and form of release, are presented on the market in large quantities.

Tavanic is the same effective antibiotic that is prescribed for a variety of diseases. Characterized by a high degree of drug activity and impact on groups of harmful microorganisms, its use allows you to get positive results of treatment in the shortest possible time of therapy. The price of the product depends on the form of release: tablets can be bought from 600 rubles, an injection solution will cost you 1620 rubles.

Ciprofloxacin is an active antibiotic with a wide spectrum of action. It is used to treat infectious diseases of internal organs and tissues, in particular - the genitourinary system. The drug is produced in various forms, for example, these are eye drops, suspensions and solutions for injections, tablets and capsules. The cost of an antibiotic is low, from 18 rubles, and any pharmacy can offer you this drug.

Along with the Russian analogues discussed above, there are also foreign analogues of Levofloxacin on the market that can defeat any infectious disease.

Elefloks, produced by an Indian pharmaceutical company, is actively used to treat various forms of prostatitis, inhibits the activity of harmful microorganisms. It is used in systemic treatment, in which the disease is quickly treatable.

Glevo - a product of Indian pharmacology, with a wide spectrum of action, is excellent for the treatment of all forms of prostatitis.

Levofloxacin belongs to the group of fluoroquinols. To the same group with the active substance levofloxacin belong:

All antibiotics of this group are very effective in the treatment of prostatitis. Therefore, your choice of a drug can only be influenced by your individual intolerance to the components of one of them, the severity of the disease, in which it is necessary to use complex treatment, in which not all antibiotics may be compatible with other drugs. All drugs have detailed instructions, after reading which you will find out what side effect you can expect, what contraindication in your case may affect the choice of remedy.

Tavanic or Levofloxacin which is better?

As we have already noted, both of these drugs belong to the group of fluoroquinols, with an active active ingredient - levofloxacin, which quickly penetrates into the blood, then it is taken by the plasma and distributed to all tissues of the body.

The drug Levofloxacin has an active effect on various areas of tissues affected by harmful microorganisms, and it acts directly at the cellular level, which speeds up treatment and gives positive results. With prostatitis, different groups of bacteria can be present in the body that affect the organ and cause disease: anaerobic gram-positive and gram-negative, simple microorganisms and chlamydia. With all these "pests" the drug fights very effectively.

Tavanic is an antibiotic of the latest generation with high rates of effectiveness in the treatment of diseases of various internal organs, bone tissue.

The active substance in the drug is levofloxacin, auxiliary - crospovidone, cellulose, titanium dioxide, macrogol 8000, iron oxide red and yellow. When taking the drug, its concentration in the blood lasts for a rather long period.

The antibacterial drug gives the fastest and most positive results in the treatment of various forms of prostatitis, ranging from mild to chronic, as it affects tissue cells, their membranes and walls. It is especially effective in complex treatment, because. its active and active component, levofloxacin, interacts well with other drugs.

If we compare Tavanic or Levofloxacin, which is better, then the first drug has fewer side effects and has a faster action and the spectrum of its effects is much wider.

Comparing the cost of drugs, it can be noted that you can buy Levofloxacin at a price of 77 rubles, and Tavanic - from 590 rubles.

Most often, when the doctor has prescribed a course of treatment with this drug, the patient is prescribed 2 doses.

The average daily dose of the drug at each dose is from 500 ml to 1 g, depending on the form of the disease, the prostate gland is in. If injections are prescribed, then the daily dose of liquid is from 250 to 500 ml, depending on the severity of the disease. The medicine is taken regardless of the meal, because. mucosa quickly absorbs the substances of the drug.

With mild forms of prostatitis, as well as with diseases that affect the bronchi, the course of treatment can be from 14 to 28 days. In this case, the daily dose is from 500 ml to 1 g.

To decide whether Tavanic or Levofloxacin is better, the attending physician will help you, who will select the optimal antimicrobial drug for effective therapy.

Levofloxacin or Ciprofloxacin: a comparative evaluation of drugs

The drug has a wide spectrum of action, inhibits the vital activity of various microorganisms, quickly penetrates into the bloodstream, is distributed throughout the tissues of the body, and any infection is amenable to such therapy.

The doctor prescribes the drug, which calculates the daily dose of the drug.

The course of treatment can be from 1 to 4 weeks, depending on the degree of the disease.

If we consider Levofloxacin and Ciprofloxacin, the difference lies in the fact that the first is more effective, it can interact with other drugs, while Ciprofloxacin, under the influence of other drugs, can reduce its concentration and activity, which delays the course of treatment.

Both drugs, Levofloxacin and Ciprofloxacin, are antibiotics that should only be taken on the advice of a doctor who considers each clinical case on an individual basis.

The main difference between the two antibiotics is the active substance: in the first preparation it is levofloxacin, and in the second it is ofloxacin. Under the action of Ofloxacin, not all groups of bacteria can be destroyed, since microorganisms have a different degree of sensitivity to ofloxacin, so the treatment of prostatitis may be different due to the causes of the disease and the effectiveness of treatment may also differ.

Levofloxacin Astrapharm: description of the drug and its distinctive features

Distinctive features from Levofloxacin

Levofloxacin Astrapharm is able to inhibit the activity of gram-positive and gram-negative microbes, while Levofloxacin acts on all groups of bacteria.

Most often, Levofloxacin Astrapharm is used to effectively treat bacterial chronic prostatitis.

In therapy with Levofloxacin, a positive trend is observed already in the middle of treatment, and this occurs regardless of the form of the disease.

If we talk about Levofloxacin Astrapharm blister, then it is more effective in the treatment of mild and moderate forms of prostatitis.

Regardless of what choice you make in the treatment of prostatitis, you must remember that only a systemic, well-chosen treatment can give positive dynamics and results.

Specialty: Urologist Work experience: 21 years

Specialty: Urologist-andrologist Work experience: 26 years

Levofloxacin: analogues of the active substance, features of the therapeutic effect and indications for admission

According to the instructions for use, Levofloxacin is an original broad-profile antibiotic that is active against a number of pathogens of infectious processes in the human body.

The drug Levofloxacin, analogues of which can be presented in different forms of release, can be effectively used in diseases of the ENT system. Thus, quite often this drug is prescribed to patients with otitis media, sinusitis, sinusitis, pharyngitis, etc. The active substance of this medicine will be no less effective in relation to skin infectious lesions, as well as diseases of the urinary and reproductive systems (prostatitis, pyelonephritis, chlamydia, etc.).

According to statistics, today Levofloxacin has several medicinal analogues, which can be presented in the form of drops and tablets, and also have a cheaper price. Reviews of these drugs can be read on numerous patient forums. At the same time, more than 60% of adults are regularly exposed to infectious lesions of various body systems, so the need for the use of Levofloxacin is more than in demand today.

Levofloxacin is produced, analogues of which also have a wide therapeutic spectrum of action, in the form of tablets, injections, and eye drops. As for the pharmacological effect, this drug is a potent antibiotic that helps to destroy pathogenic infectious foci.

Levofloxacin is contraindicated, as well as its main substitutes, during pregnancy, childhood, severe kidney and liver diseases. Elderly people should take such a drug strictly under the supervision of a doctor.

Analogues

All analogues of Levofloxacin (synonyms for the therapeutic effect) are divided into two separate subgroups:

• Analogues for the active substance of the drug.
• Analogues for the pharmacological group.

By active substance

Analogues of Levofloxacin, which will be presented below, can be prescribed for the treatment of pneumonia, sinusitis, protracted bronchitis, various urological lesions, as well as pyelonephritis. It is forbidden to prescribe such drugs to children under eighteen years of age, pregnant women, as well as in case of individual intolerance to the active substance of the drug by a person.

The most effective analogues of Levofloxacin (according to the active substance) are:

Levofloxacin, as well as generics, should be taken in the morning before meals. In acute infectious lesions, the permissible dosage of the drug is 250 mg (1 tablet per day). The duration of therapy is determined by the attending physician. On average, it takes five to ten days to completely suppress the infection.

As for the side effects of Levofloxacin analogues, compared to the previous generation drugs, these drugs are much better tolerated and provoke adverse reactions in no more than 1.5% of all cases. At the same time, patients may experience nausea, abdominal pain, improvement in the functioning of the heart, kidneys and digestive system.

By generation of quinolones

A striking analogue of Levofloxacin in the generation of quinolones is the drug Sparfloxacin. Also, like Levofloxacin, it belongs to the last, third generation of antibiotics. This drug is most effective in relation to gram-negative foci of infection, in particular, to staphylococci.

Sparfloxacin is prescribed for the same indications of the patient as Levofloxacin (analogues can be prescribed by a doctor). Thus, such an antibiotic can be used to treat chlamydia, leprosy, inflammatory diseases of the urethra and respiratory system.

As for contraindications, in addition to the standard prohibitions that are attributed to Levofloxacin, Sparfloxacin also has a ban in the form of bradycardia and hepatitis.

The price for such an analogue of the drug is 340 rubles per package (6 tablets).

Tavanic or Levofloxacin: which is better, characteristics and features of the best antibiotic analogues

One of the most popular foreign analogues of Levofloxacin is Tavanic, which is produced by a French manufacturer. Many patients do not know whether Tavanic or Levofloxacin is better.

With a detailed study of both these drugs, it should be said that, unlike Levofloxacin, Tavanic has only one dosage form of release (solution for infusion). This is the downside of this drug.

Tavanic or Levofloxacin (which is better for adults, the attending physician should decide in each case) have very similar indications for use, since both drugs are approved for use in prostatitis, sinusitis, respiratory and genitourinary infections. Moreover, both drugs are available for sale in pharmacies.

When asked whether Tavanic or Levofloxacin is better, it is also important to note the cost of the first drug, which can reach up to 1200 rubles, which will be significantly higher than the average price for Levofloxacin.

Another analogue of Levofloxacin, which has a similar therapeutic effect, is the drug Moxifloxacin. It has a pronounced antibacterial effect against infectious pathogens of different classes.

Compared with Levofloxacin, Moxifloxacin has the following advantages:

• The drug has a wider spectrum of action.
• Does not provoke allergies when exposed to ultraviolet radiation.
• It can be used in conjunction with other antibiotics without causing negative reactions.

In turn, the following disadvantages of this analogue are distinguished in comparison with Levofloxacin:

• Less effective for infections of the urinary system.
• It does not have complete reception security.
• It has a large list of contraindications.
• It has a bad effect on the metabolism of vitamins when taken.

As for eye drops, Levofloxacin in this form of release has analogues in the form of Floxal, Signicef ​​and Ofloxacin. The use of these drugs is allowed only as prescribed by a doctor, with strict adherence to the dosage. If it is necessary to treat children, it is important that the therapy is supervised by a specialist.

Remember that self-medication is dangerous for your health! Be sure to consult with your doctor! The information on the site is presented for informational purposes only and does not claim to be a reference and medical accuracy, is not a guide to action.

Articles

The most common causative agents of CP are representatives of the gram-negative bacteria Enterobacteria ceae, which come from the gastrointestinal tract. The most common strains are Escherichia coli, which are found in 65-80% of infections. Pseudomonas aeruginosa, Serratia spp., Klebsiella spp. and Enterobacter aerogenes, and Acinetobacter spp. are detected in 10-15%. Enterococci account for 5 to 10% of confirmed prostate infections. When examining patients with chronic pancreatitis, ureaplasmas, mycoplasmas, chlamydia, trichomonas, gardnerella, anaerobes, fungi of the genus Candida are increasingly found, which are among the likely causative agents of this disease.

Fluoroquinolone of the 3rd generation, levofloxacin - REMEDIA (Simpex Pharma Pvt Ltd.) - has a wide spectrum of antimicrobial activity. It is included in a new group of fluoroquinolones, which, along with high activity against many gram-negative bacteria, is characterized by increased activity against gram-positive microbes, atypical microorganisms and anaerobes.

It is known that CP leads to significant impairments in the quality of life of men and, in addition to the syndrome of pelvic pain and urinary disorders, can become one of the causes of sexual dysfunction and have a depressing effect on male fertility.

Proven uropathogens in chronic bacterial prostatitis (CKD) are representatives of the family of gram-negative bacteria, to a lesser extent - gram-positive microorganisms.

The issue of the role of nonclostrid and facultative anaerobic bacteria in the development of prostatitis is discussed. There is still no complete clarity regarding atypical pathogens such as chlamydia, ureaplasma, mycoplasma, which are unproven, but likely causes in the initiation of CP.

It has been established that only fluoroquinolone antibiotics, alpha 1-blockers and non-steroidal anti-inflammatory drugs meet the requirements of evidence-based medicine in the treatment of patients with CP.

The purpose of the study: to evaluate the efficacy and safety of the fluoroquinolone levofloxacin (commercial name Remedia) in the treatment of CKD and CP

BRANDSof 19

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Oh, this is not an easy choice! What is better - Ciprofloxacin or Levofloxacin?

In the treatment of diseases of the respiratory system, fluoroquinolone antibiotics are widely used.

They are highly effective and have a wide spectrum of action. Among the most popular drugs are Ciprofloxacin and Levofloxacin.

These analogue medicines are successfully used in the field of pulmonology and otolaryngology. With their help, ailments associated with inflammation of the ENT organs, pulmonary diseases and respiratory tract diseases are treated. Respiratory infections are no exception.

Both drugs are successfully used in the treatment of progressive forms of tuberculosis. To understand which remedy is better, it is advisable to consider in more detail the features of each of them and compare the effectiveness of the drugs.

Ciprofloxacin

Ciprofloxacin is a classic fluoroquinolone showing increased activity against staphylococci and chlamydia. As for diseases that develop as a result of pneumococcal infection entering the body, the drug is ineffective in their regard.

Photo 1. Packing Ciprofloxacin in the form of tablets with a dosage of 250 mg. Producer "OZ GNTsLS".

Ciprofloxacin is prescribed for tuberculosis of the respiratory system. In some cases, complex treatment is carried out with Pyrazinamide, Streptomycin and Isoniazid. It has been clinically proven that monotherapy against tuberculosis is less effective.

Indications for use

Absolute indications for the use of Ciprofloxacin are:

• acute bronchitis, and exacerbations of the disease in a chronic form;
• severe form of tuberculosis;
• pulmonary inflammation;
• infections that develop as a result of cystic fibrosis;
• inflammation of the middle ear - otitis;
• sinusitis;
• frontitis;
• pharyngitis;
• tonsillitis;
• complicated infections and inflammation of the urinary system;
• chlamydia;
• gonorrhea;
• infectious diseases of the gastrointestinal tract;
• infectious skin lesions, burns, ulcers and a number of others.

The drug can be used in the treatment of postoperative infectious complications.

The main active ingredient of the drug is ciprofloxacin. The composition of the drug includes auxiliary components: starch, talc, titanium and silicon dioxide, magnesium stearate and lecithin. The drug has several forms of release: tablets, solutions for injection and infusion.

Ciprofloxacin has its contraindications and side effects. In most cases, the drug is easily tolerated, but while taking it, there may be:

• allergic reactions;
• swelling of the vocal cords;
• anorexia;
• leukopenia;
• agranulocytosis;
• thrombocytopenia;
• kidney failure;
• the occurrence of pain in the abdomen;
• stool disorder;
• insomnia;
• violation of taste perceptions;
• headache;
• exacerbation of epilepsy.
• individual intolerance to its individual components;
• hypersensitivity to ciprofloxacin.

The drug is not prescribed to women during pregnancy and lactation, as well as to children under 15 years of age. Antibiotics should be used with caution in renal failure.

Levofloxacin

Levofloxacin is a third generation fluoroquinolone. The drug shows high efficiency in relation to pneumococcal, atypical respiratory and gram-negative bacterial infections. Even those pathogens that are fairly resistant to second-generation antibacterial fluoroquinolones are susceptible to Levofloxacin.

Photo 2. Packing of Levofloxacin in the form of tablets with a dosage of 500 mg. Producer "Teva".

The drug is used in pulmonary tuberculosis. The spectrum of its action in this regard is completely identical to Ciprofloxacin. When conducting monotherapy, clinical improvement in patients is observed after about a month.

Indications for use

Indications for the use of Levofloxacin are:

• exacerbation of bronchitis;
• inflammatory processes in the paranasal sinuses, characterized by a complicated course, for example, sinusitis;
• pulmonary inflammation of any form;
• inflammatory processes of the infectious nature of the ENT organs;
• infections that develop against the background of cystic fibrosis;
• inflammation of the genitourinary system: pyelonephritis, inflammation of the prostate, chlamydia;
• soft tissue abscesses;
• furunculosis.

The active substance of the drug is the chemical component of the same name - levofloxacin. The composition of the drug contains additional components: cellulose, sodium chloride, dihydrate, disodium edetate, titanium dioxide, iron oxide, calcium stearate.

Levofloxacin has several forms of release. Today, in domestic pharmacies, you can buy drops, tablets and a solution for infusion.

Contraindications and side effects

Like any other drug, fluoroquinolone Levofloxacin has a number of side effects:

• allergy to individual components of the drug;
• violation of the functional features of the gastrointestinal tract;
• headache accompanied by dizziness;
• muscle and joint pain;
• feeling tired, drowsiness;
• inflammation of the tendons;
• acute liver failure;
• depression;
• rhabdomyolysis;
• neutropenia;
• hemolytic anemia;
• asthenia;
• exacerbation of porphyria;
• exacerbation of epilepsy;
• development of a secondary infection.

Contraindications to taking the drug are:

• a tendency to develop an allergic reaction to individual medicinal components, i.e. individual intolerance;
• unhealthy kidneys;
• epilepsy;
• drug-induced tendon injury associated with treatment with fluoroquinolone antibacterial drugs.

Levofloxacin is not prescribed to women during pregnancy and while breastfeeding, as well as to children and adolescents. Caution should be exercised by patients with renal pathologies and geriatric patients.

In case of drug overdose, symptomatic treatment is expected. Dialysis is not very efficient.

During the therapeutic course, it is not advisable to drive a car and engage in other activities that require a quick reaction and increased attention.

Given the likelihood of photosensitivity, it is recommended to stay as little as possible under the influence of direct sunlight.

Which is better: Ciprofloxacin or Levofloxacin? How are antibiotics different?

In order not to make a mistake in the choice and purchase one of the above drugs, it is necessary to determine which one is better. Far from superfluous in resolving this issue will be the advice of a specialist. When evaluating an antibacterial agent, it is necessary to build on the following criteria:

Comparison of drugs: which is more effective

Levofloxacin and Ciprofloxacin have a similar purpose, that is, their spectrum of action is identical, but the first drug has a number of advantages in terms of effectiveness.

The active substance of Ciprofloxacin is ciprofloxacin, Levofloxacin contains the main component levofloxacin.

Unlike Ciprofloxacin, the antibacterial effect of Levofloxacin against pneumococcal infections and atypical microorganisms is more pronounced. The drug remains active against gram-negative bacteria.

It is known that some pathogens that are not sensitive to Ciprofloxacin show instability before exposure to Levofloxacin. The latter drug is more active against Pseudomonas (P.) aeruginosa.

The type of bacterium and the degree of its sensitivity is a determining factor in the selection of a drug.

Photo 3. Packing of Levofloxacin in the form of a solution for intravenous infusion at a dosage of 5 mg / ml. Producer "Belmedpreparaty".

Both fluoroquinolones are well tolerated by the body, have excellent oral absorption and are successfully used as an effective anti-tuberculosis agent. Levofloxacin shows greater effectiveness in this regard, because it is used in the form of intravenous injections.

The concentration of the active substance in the tablets is less than in the second preparation. Levofloxacin is more often prescribed as the only drug for monotherapy. Eating does not matter during treatment. Both those and other tablets can be taken both before and after meals.

As for adverse reactions, they occur rarely and with the same frequency when taking both Levovloxacin and Ciprofloxacin. Undesirable effects are similar in their manifestations. Patients taking these fluoroquinolones may experience the following:

• bouts of nausea accompanied by vomiting;
• headache;
• dizziness;
• fast fatigue, fatigue;
• insomnia.

Contraindications for taking both drugs are identical.

Price difference

As for the price, Ciprofloxacin is more affordable. One pack of medicine (500 mg) can be bought at a pharmacy for 80 rubles. Levofloxacin will cost at least 250 rubles per pack. Both drugs are sold exclusively by prescription.

Useful video

Watch a video that tells about the features of the antibiotic Levofloxacin: indications for use, dosages, side effects, compatibility with other drugs.

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An online journal about tuberculosis, lung diseases, tests, diagnostics, medicines and other important information about it.

And Urinary tract infection (UTI) is one of the most urgent problems of modern urology. Inadequate therapy of this condition often leads to bacteremia and sepsis. In the US, UTIs cause 7 million visits to a doctor each year and 1 million hospitalizations.

Treatment of urinary tract infection involves effective and timely antibiotic therapy, subject to the restoration of normal urodynamics, and aims to prevent urosepsis and the occurrence of relapses. Antibacterial drugs of the fluoroquinolone group are the drugs of choice for the treatment of UTIs worldwide.

An additional problem that significantly complicates the treatment of UTIs is the high resistance of microorganisms to most antibacterial drugs that have been used for a long time in urological practice. Hospitalism, inadequate duration of treatment, and incorrect prescription of drugs often lead to the emergence of antibiotic-resistant strains. The emergence of a new effective drug for the treatment of UTI is a significant event and attracts close attention of doctors.

Levofloxacin (LF) - a new antimicrobial drug of the quinolone group - is the L-isomer of ofloxacin. Since levofloxacin accounts for almost all of the antimicrobial activity in the racemic mixture of isomers, its activity in vitro twice the activity of ofloxacin. Both drugs show a similar level of toxicity in animal experiments, which suggests that levofloxacin is more effective due to the lower level of side effects. LF is intended for the treatment of infectious and inflammatory processes caused by microorganisms sensitive to LF. Recent studies have demonstrated good efficacy of LF in the treatment of complicated and uncomplicated urogenital infections. The pharmacokinetics of LF is similar to that of ofloxacin: the half-life is approximately 6-7 hours, and the maximum concentration in blood serum is reached 1.5 hours after ingestion. The mechanism of action of LF is similar to that of all fluoroquinolones and consists in the inhibition of bacterial topoisomerase-4 and DNA gyrase, enzymes responsible for replication, transcription and recombination of microbial DNA.

LF has a wide spectrum of antimicrobial activity. LF affectsin vitro for the following infectious agents:

Aerobic gram-positive: Streptococcus agalactiae, Staphylococcus aureus and saprophyticus, Enterococcus faecalis, Streptococcus pneumoniae, Streptococcus pyogenes;

Aerobic gram-negative: Enterobacter cloacae, Escherichia coli, Haemophilus influenzae, Haemophilus parainfluenzae, Klebsiella pneumoniae, Legionella pneumophila, Moraxella catarrhalis, Proteus mirabilis, Pseudomonas aeruginosa;

Other microorganisms: Chlamydia pneumoniae, Mycoplasma pneumoniae.

resistance to LF associated with spontaneous mutations, in vitro is relatively rare. Despite the presence of cross-resistance between Lf and other fluoroquinolones, some microorganisms resistant to quinolones may be sensitive to Lf.

LF is contraindicated in persons with hypersensitivity to LF or other quinolone drugs (their components). At present, the effect of LF on children, adolescents, pregnant and lactating mothers has not been studied.

The most commonly reported side effects are nausea (1.3%), diarrhea (1.1%), dizziness (0.4%) and insomnia (0.3%). All of the above effects are dose-dependent and quickly disappear after dose reduction or drug withdrawal.

The ease of use of LF - once a day - is another advantage of this drug. An analysis of scientific publications devoted to studies of the efficacy and tolerability of LF makes it possible to more clearly present its differences from other quinolones.

G. Richard et al. studied the efficacy and safety of LF 250 mg once daily versus ciprofloxacin 500 mg twice daily for 10 days in the treatment of 385 patients suffering from UTIs in a randomized, double-blind, multicenter study. Before treatment, all patients underwent bacteriological examination of urine, according to which all patients showed an increase in pathogenic microflora and the microbial count was 105 microbial bodies in 1 ml of urine. Clinical recovery was observed in 92% of patients treated with LF, and 88% of patients treated with ciprofloxacin. Side effects were noted in 4 and 3% of patients, respectively. The authors conclude that the efficacy and safety of LF therapy is comparable to that of ciprofloxacin.

Y. Kawada et al. compared the efficacy of LF at a dose of 100 mg twice a day (135 patients) and ofloxacin at a dose of 200 mg twice a day (126 patients) in the treatment of patients with complicated urinary infection. A positive clinical result was obtained in 83.7% of patients in the LF group and in 79.4% of patients in the ofloxacin group. These differences were not statistically significant. Side effects were noted in 4.9% of patients in the ofloxacin group. In the LF group, no such effects were noted, which, according to the authors, indicates a better tolerability of the drug.

No significant difference was found in the efficacy and tolerability of LF and other quinolones in a randomized, double-blind study by G. Richard et al. They used LF 250 mg once daily and ofloxacin 200 mg twice daily in 581 patients with uncomplicated UTI. Clinical improvement or cure was observed in 98.1% of patients in the LF group and in 97% of patients in the ofloxacin group.

In another study by G. Richard, I. Klimberg et al. compared the efficacy and tolerability of LF, ciprofloxacin and lomefloxacin in the treatment of 259 patients with acute pyelonephritis for 10 days. With the same efficiency, the authors note a significantly lower level of side effects in the treatment of LF compared with other drugs (gastrointestinal disorders in 2 patients and vaginitis in 1).

An interesting, in our opinion, study was performed by I. Klimberg et.al. They studied the efficacy and tolerability of LF and lomefloxacin in the treatment of complicated urinary infections. After randomization, patients received therapy with these drugs at a standard dosage for 7-10 days. At the same time, safety was assessed in 461 patients and microbiological efficacy in 336 of them. The average level of elimination of pathogens in the LF group was 95.5%, and in the lomefloxacin group - 91.7%. Side effects were noted, respectively, in 2.6 and 5.2% of patients. At the same time, photosensitivity and dizziness were more common in the lomefloxacin group, and nausea was more common in the LF group. Six patients in each group experienced various gastrointestinal disorders. The authors claim that the effectiveness of LF is approximately the same as other quinolones, while the tolerability of LF is somewhat better.

Thus, levofloxacin is a new antimicrobial drug used to treat infectious and inflammatory processes in the upper and lower urinary tract. Despite the fact that the effectiveness of the drug is close to that of other quinolones, the obvious advantages of LF are the low level of side effects and the possibility of a single dose per day. The existence of an intravenous form of the drug allows it to be more effectively used in the treatment of complicated urinary infections.

Materials and methods

We have undertaken a study of the effectiveness of LF in patients with complicated urinary tract infection. LF was administered to 20 patients (19 women and 1 man) aged 24 to 56 years (mean age 41.3 years) with complicated UTI observed at the Department of Urology of the Moscow State Medical University and in the CDC City Clinical Hospital No. 50. In 19 patients, there was an exacerbation of chronic pyelonephritis and chronic cystitis. One patient was prescribed the drug after contact ureterolithotripsy due to the development of infectious and inflammatory complications. LF was prescribed at a dose of 250 mg per day for 10 days.

The study included patients with UTIs in the initial stages of the development of inflammation, who had not taken antibacterial drugs before the start of the study.

The inclusion criterion was the presence of at least one clinical symptom (chills, pain in the lumbar region, dysuria, pain in the suprapubic region, nausea, vomiting) in combination with microbiological criteria:

The number of leukocytes in the urine is more than 10 in the field of view;

The number of colony-forming units of the pathogen> 104;

Sensitivity to LF according to the sample with disks.

Prior to taking the drug, all patients underwent a routine urological examination, including urine culture for flora with determination of sensitivity to antibiotics, general urinalysis, clinical and biochemical blood tests, ultrasonographic monitoring (ultrasound), X-ray urological examination. None of the examined had signs of impaired passage of urine through the upper urinary tract.

The analysis of the results was carried out on the basis of a subjective assessment of the effectiveness of treatment by patients and a doctor, as well as the dynamics of objective studies: blood and urine tests, ultrasound images, urine cultures performed before the start of treatment, on the 3rd, 10th and 17th days of treatment.

No clinical benefit from treatment was defined as persistence or worsening of clinical symptoms at any time after 3 days of treatment.

The comparison group consisted of 23 patients (mean age 38.7 years) with acute pyelonephritis who were treated with ciprofloxacin 1.0 g per day.

results

In 90% of patients, the effectiveness of LF therapy was considered very good, and in 10% - good. Tolerability of the drug was very good in 55% of patients, good in 40% and moderate in 5% of patients.

In the ciprofloxacin group, 70% of patients showed very good treatment efficacy, 18% - good. In 3 patients (12%), ciprofloxacin therapy was ineffective, which was expressed in the preservation of severe hyperthermia and local pain in the lumbar region. Two of them were operated on due to the development of purulent inflammation: they underwent a kidney revision, decapsulation and nephrostomy.

The main complaints of the patients were pain in the lumbar region from the affected organ, chills, frequent painful urination, weakness - all these complaints were associated with an active inflammatory process in the upper and lower urinary tract. By the end of treatment, all patients treated with levofloxacin and 88% of patients treated with ciprofloxacin felt satisfactory and had no complaints.

Ultrasound monitoring of the size of the kidneys and the thickness of the renal parenchyma, carried out throughout the study in the main group, recorded a positive trend: an increase in the size of the kidney affected by the inflammatory process and local thickening of the parenchyma regressed by 10-17 days of treatment in all patients.

Pain on palpation of the lumbar region on the side of the lesion also regressed in all patients by the end of the study.

Monitoring of the culture study of urine against the background of LF therapy revealed a positive trend, expressed in a progressive decrease in the degree of bacteriuria, and by the 10-17th day of therapy, the urine culture was sterile. In the treatment of LF, inflammatory changes in the peripheral blood regressed. This was reflected in the normalization of the number of leukocytes (Fig. 1) and the disappearance of the stab shift in the blood formula.

Rice. 1. Dynamics of the number of blood leukocytes in the treatment of LF

All patients of the main group with an acute inflammatory process in the upper urinary tract before treatment had severe leukocyturia, which regressed by 10-17 days, which was confirmed by control urine tests (Fig. 2).

Rice. 2. Dynamics of the number of leukocytes in the analysis of urine in the treatment of LF

The patients of the comparison group who completed the study also showed normalization of the blood count, however, the decrease in blood leukocytosis was less significant (up to 7.8x109 on average), and leukocyturia remained at the level of 6-10 leukocytes per field of view.

Against the background of LF treatment, on the 3-10th day from the start of treatment, 6 patients (30%) experienced adverse reactions in the form of nausea, and 3 of them (15%) had episodes of diarrhea. It should be noted that these phenomena were insignificant. By the end of the study, complaints of nausea were made by 3 patients suffering from chronic gastritis for a long time. None of the patients required special treatment due to the above adverse reactions, and none of them refused therapy.

In the ciprofloxacin group, adverse reactions in the form of nausea and diarrhea that did not require discontinuation of the drug were noted in 18% of patients.

Discussion

According to our data, the efficacy and safety of LF treatment were found to be good to very good in 95% of patients. Similar results are given in their works by G. Richard, C. DeAbate et.al., who used the drug according to a similar scheme and received a clinical effect in 98.1% of patients. Kondo K. et al. report a 100% success rate for treatment with levofloxacin. Such high results are explained by the short duration of the use of levofloxacin in urological practice, which determines the absence of strains of microorganisms resistant to its action. It should be noted that resistance to drugs of this pharmacological group associated with spontaneous mutations in vitro, is extremely rare.

The effectiveness of levofloxacin therapy in patients with acute pyelonephritis in the study by G. Richard et al. was 92%, while in the comparison group, where treatment with ciprofloxacin was carried out, it was slightly lower and equaled 88%. At the same time, the number of side effects recorded during treatment and expressed in various intensities of dyspeptic symptoms was 2% in the levofloxacin group, and 8% in the ciprofloxacin group.

According to our data, bacteriological examination of urine on the 10th day of admission and 7 days after discontinuation of treatment showed the absence of bacteriuria in all patients included in the study. I. Klimberg et al. studied the microbiological efficacy of levofloxacin in 171 patients. The course of treatment was 10 days. The drug was taken in the standard dosage - 250 mg once a day. The average level of elimination of pathogenic agents in the group was 95.5%.

Fu K.P. et.al., examining the safety of levofloxacin therapy, concluded that the most common side effects were nausea (1.3%) and diarrhea (1.1%). Dizziness (0.4%) and insomnia (0.3%) are somewhat less common. In our patients, sleep disturbances and dizziness were not observed, which is probably due to the small number of patients in the group compared to Fu K.P., however, diarrhea and nausea were also quite common in our patients.

Based on our clinical study of the effectiveness of 10-day LF therapy, we can conclude that levofloxacin is an effective and safe agent for the treatment of patients with complicated urinary tract infection.

Levofloxacin -

Tavanik (trade name)

(Aventis Pharma)

In this article we will try to figure out which is better levofloxacin or ciprofloxacin. To give a solid answer, it is necessary to dwell in more detail on the features of the use of each of these drugs separately.

Ciprofloxacin

Ciprofloxacin belongs to the classical fluoroquinolones, which have wide indications for use in respiratory infections of the lower respiratory tract and ENT pathology. Clinical experience shows that this drug is active against gram-negative bacteria, staphylococci and atypical pathogens (chlamydia, mycoplasma, etc.). At the same time, ciprofloxacin is not effective enough in diseases caused by pneumococci.

The selection of the optimal drug for the treatment of any disease should be handled exclusively by a highly qualified doctor.

Indications

Being a broad-spectrum antibacterial drug, Ciprofloxacin is successfully used in the treatment of patients suffering from respiratory infections of the respiratory tract and ENT pathology. In what diseases of the respiratory system and diseases of the ear, throat, nose, this drug from the group of classic fluoroquinolones is used:

1. Acute and chronic bronchitis (at the stage of exacerbation).
2. Pneumonia caused by various pathogenic microorganisms.
3. Inflammation of the middle ear, paranasal sinuses, throat, etc.

Contraindications

Like most drugs, Ciprofloxacin has its contraindications. In what situations this representative of classical fluoroquinolones cannot be used in the treatment of respiratory diseases and ENT pathology:

• Allergic reaction to ciprofloxacin.
• Pseudomembranous colitis.
• Childhood and adolescence (until the end of the formation of the skeletal system). An exception is children with pulmonary cystic fibrosis who have developed infectious complications.
• Pulmonary form of anthrax.

In addition, patients with the following disorders and pathological conditions have restrictions on the use of Ciprofloxacin:

• Progressive atherosclerotic lesion of the blood vessels of the brain.
• Severe disorders of cerebral circulation.
• Various heart diseases (arrhythmia, heart attack, etc.).
• Decreased levels of potassium and/or magnesium in the blood (electrolyte imbalance).
• Depressive state.
• epileptic seizures.
• Severe disorders of the central nervous system (for example, stroke).
• Myasthenia.
• Serious malfunctions of the kidneys and / or liver.
• Advanced age.

Side effects

According to clinical practice, adverse reactions in the vast majority of patients taking fluoroquinolones are observed infrequently. We list the undesirable effects that occur in about 1 out of 1000 patients taking Ciprofloxacin:

• Dyspeptic disorders (vomiting, pain in the abdomen, diarrhea, etc.)
• Decreased appetite.
• Feeling of heartbeat.
• Headache.
• Dizziness.
• Periodic sleep problems.
• Changes in the main blood parameters.
• Weakness, fatigue.
• Allergic reaction.
• Various skin rashes.
• Pain in muscles and joints.
• Functional disorders of the kidneys and liver.

Do not buy Levofloxacin or Ciprofloxacin without first talking to your doctor.

special instructions

With extreme caution, ciprofloxacin is prescribed to patients who are already taking drugs that lead to a prolongation of the QT interval:

1. Antiarrhythmic drugs.
2. Macrolide antibiotics.
3. Tricyclic antidepressants.
4. Antipsychotics.

Clinical observations show that Ciprofloxacin enhances the effect of hypoglycemic drugs. With their simultaneous use, careful monitoring of blood glucose should be carried out. It has been recorded that drugs that reduce acidity in the gastrointestinal tract (antacids), and which contain aluminum and magnesium, reduce the absorption of fluoroquinolones from the digestive tract. The interval between the use of an antacid and an antibacterial drug should be at least 120 minutes. I would also like to note that milk and dairy products can affect the absorption of Ciprofloxacin.

In case of an overdose of the drug, headache, dizziness, weakness, convulsive attacks, dyspeptic disorders, functional disorders of the kidneys and liver may develop. There is no specific antidote. Wash the stomach, give activated charcoal. If necessary, symptomatic therapy is prescribed. Carefully monitor the patient's condition until complete recovery.

Levofloxacin

Levofloxacin is a third-generation fluoroquinolone. It has a high activity against gram-negative bacteria, pneumococci and atypical pathogens of respiratory infections. Most pathogens that show resistance (resistance) to the "classic" second-generation fluoroquinolones may be sensitive to more modern drugs such as Levofloxacin.

Eating does not affect the absorption of Ciprofloxacin or Levofloxacin. Modern fluoroquinolones can be taken both before and after meals.

Indications

Levofloxacin is an antibacterial drug with a wide spectrum of action. It is actively involved in the following diseases of the respiratory system and ENT organs:

• Acute or chronic inflammation of the bronchi (at the stage of exacerbation).
• Inflammation of the paranasal sinuses (sinusitis, sinusitis, etc.).
• Infectious and inflammatory processes in the ear, throat.
• Pneumonia.
• Infectious complications of cystic fibrosis.

Contraindications

Despite the fact that Levofloxacin belongs to the new generation of fluoroquinolones, this drug can not be prescribed in all cases. What are the contraindications to the use of Levofloxacin:

• An allergic reaction to a drug or its analogues from the fluoroquinolone group.
• Serious kidney problems.
• epileptic seizures.
• Tendon injury associated with prior fluoroquinolone therapy.
• Children and teenagers.
• Periods of childbearing and breastfeeding.

Levofloxacin should be used with extreme caution in elderly patients.

Side effects

As a rule, all adverse reactions are classified according to severity and frequency of occurrence. We list the main undesirable effects from taking Levofloxacin, which may occur:

• Problems with the functioning of the gastrointestinal tract (nausea, vomiting, diarrhea, etc.).
• Headache.
• Dizziness.
• Allergic reactions (skin rashes, itching, etc.).
• Elevated levels of essential liver enzymes.
• Drowsiness.
• Weakness.
• Pain in muscles and joints.
• Damage to the tendons (inflammation, tears, etc.).

Self-administration of Levofloxacin or Ciprofloxacin without the permission of the attending physician can have serious consequences.

special instructions

Since the likelihood of joint damage is high, Levofloxacin is not prescribed in childhood and adolescence (up to 18 years), except in extremely severe cases. When using antibacterial drugs for the treatment of age-related patients, it should be borne in mind that this category of patients may have impaired renal function, which is a contraindication for the appointment of fluoroquinolones.

During therapy with Levofloxacin, patients who have previously suffered a stroke or severe traumatic brain injury may develop epileptic seizures (convulsions). If there is a suspicion of the presence of pseudomembranous colitis, it is necessary to immediately stop taking Levofloxacin and prescribe the optimal course of therapy. In such situations, it is strongly not recommended to use drugs that inhibit intestinal motility.

Although rare, there may be cases of inflammation of the tendons (tendinitis) when using Levofloxacin. Older patients are more prone to these types of side effects. Concurrent use of glucocorticosteroids significantly increases the risk of developing tendon ruptures. If a tendon lesion is suspected (inflammation, ruptures, etc.), fluoroquinolone therapy is stopped.

In case of an overdose of this drug, symptomatic therapy should be carried out. The use of dialysis in such cases is ineffective. There is no specific antidote.

During therapy with Levofloxacin, it is not recommended to engage in activities that require increased concentration and quick reaction (for example, driving a car). Also, due to the risk of developing photosensitivity, refrain from excessive skin exposure to ultraviolet rays.

What drug to choose?

How to determine which is better Levofloxacin or Ciprofloxacin? Of course, only an experienced specialist can make the best choice. Nevertheless, when choosing a drug, it is necessary to rely on 3 main aspects:

A good drug will be considered one that is not only effective, but also less toxic and affordable. In terms of effectiveness, Levofloxacin has its advantages over Ciprofloxacin. Along with the preserved activity against gram-negative pathogenic microorganisms, Levofloxacin has a more pronounced antibacterial effect against pneumococci and atypical pathogens. However, it is inferior to Ciprofloxacin in activity against the pathogen Pseudomonas (P.) aeruginosa. It has been noted that pathogens that are resistant to ciprofloxacin may be susceptible to levofloxacin.

The type of pathogen and its sensitivity to antibacterial agents are decisive when choosing the optimal fluoroquinolone (in particular, Ciprofloxacin or Lefovloxacin).

Both drugs are well absorbed in the intestine when taken orally. Food practically does not affect the absorption process, with the exception of milk and dairy products. They are convenient to use because they can be administered 1-2 times a day. Regardless of whether you take Ciprofloxacin or Levofloxacin, in rare cases, unwanted side reactions may develop. As a rule, dyspeptic disorders (nausea, vomiting, etc.) are noted. Some patients taking fluoroquinolones of the second or third generation complain of headache, dizziness, weakness, fatigue, sleep disturbance.

In elderly patients, especially against the background of glucocorticosteroid therapy, tendon ruptures are possible. Due to the risk of developing joint damage, fluoroquinolones are limited in use during periods of childbearing and breastfeeding, as well as in childhood.

Currently, for most patients, the price aspect is of paramount importance. A pack of Ciprofloxacin tablets costs about 40 rubles. Depending on the dosage of the drug (250 or 500 mg), the price may fluctuate, but not significantly. A more modern Levofloxacin will cost you an average of 200-300 rubles. The price will depend on the manufacturer.

However, the final decision as to what is best for the patient Ciprofloxacin or Levofloxacin is made solely by the attending physician.

Antibiotic Ciprofloxacin: description, indications for use and medicinal properties of the drug

The group of fluoroquinolones, to which the antibiotic Ciprofloxacin belongs, appeared relatively recently. The first drug of this type began to be used only in the 1980s. Previously, antibacterial agents of this class were prescribed only for urinary tract infections. But now, due to their broad antimicrobial activity, fluoroquinolones, including the antibiotic Ciprofloxacin, are prescribed for bacterial pathologies that are difficult to treat, or for an unidentified pathogen.

The mechanism of the bactericidal action of this drug is based on the penetration of a pathogenic microorganism through the cell membrane and the effect on reproduction processes.

Fluoroquinolones inhibit the synthesis of bacterial enzymes that determine the twisting of the DNA strand around nuclear RNA, this is type I topoisomerase in gram-negative bacteria and class IV topoisomerase in gram-positive ones.

The antibiotic Ciprofloxacin is active against a wide range of bacteria that are resistant to most antimicrobial drugs (Amoxicillin and its more effective analogue Amoxiclav, Doxycycline, Tetracycline, Cefpodoxime and others).

As indicated in the instructions for use, the following strains of bacteria are sensitive to the action of Ciprofloxacin:

• golden and saprophytic staphylococcus aureus;
• the causative agent of anthrax;
• streptococcus;
• legionella;
• meningococcus;
• yersinia;
• gonococcus;
• hemophilic bacillus;
• moraxella.

E. coli, enterococci, pneumococci and some strains of Proteus have moderate sensitivity. Resistant to the action of the antibiotic Ciprofloxacin are mycoplasmas and ureaplasmas, listeria and other, infrequent bacteria.

The drug belongs to the second generation fluoroquinolones, while its analogue of the same group, no less common Levofloxacin, belongs to the third generation and is more used for the treatment of diseases of the respiratory tract.

The advantage of the antibiotic Ciprofloxacin is a wide choice of forms of release. So, for the treatment of bacterial eye infections to reduce the risk of systemic side effects, the drug is prescribed in the form of eye drops. In severe diseases, injections of Ciprofloxacin are necessary, or rather, infusions, the standard dosage is 100 mg - 200 mg / 100 ml. After normalization of the patient's condition, the patient is transferred to tablets (they are available with a concentration of the active ingredient of 250 and 500 mg). Accordingly, the price of the drug also differs.

The main ingredient of the drug is ciprofloxacin, the presence of excipients depends on the specific form of release of the antibiotic. In a solution for infusions, it is purified water and sodium chloride, in eye drops - various solvents and stabilizers, in tablets - talc, silicon dioxide, cellulose.

The antibiotic Ciprofloxacin is prescribed for children from 5 years of age and adults to treat such diseases:

• lesions of the lower respiratory tract, including pneumonia, caused by flora sensitive to fluoroquinolones;
• infections of ENT - organs, including tonsillitis, otitis media, sinusitis;
• diseases of the genitourinary system, for example, cystitis, pyelonephritis, urethritis, gonorrhea, bacterial prostatitis, adnexitis;
• various intestinal infections (shigellosis, salmonellosis, typhoid fever, cholera, enteritis, colitis);
• sepsis, peritonitis;
• infections affecting the skin, soft tissues, bones and cartilage, bacterial complications after burns;
• anthrax;
• brucellosis;
• yersiniosis;
• borreliosis;
• tuberculosis (as part of complex therapy);
• specific prophylaxis of bacterial infections in patients with immunodeficiency on the background of HIV or AIDS or the use of cytostatics.

In the form of eye drops, the antibiotic Ciprofloxacin is prescribed for infections of the mucous membrane of the organs of vision. According to experts, cases of development of resistance of the bacterial flora to the action of the drug have not been identified to date. But fluoroquinolones are classified as unsafe drugs, so they are not considered as first-line drugs for the treatment of uncomplicated bacterial infections.

Ciprofloxacin intramuscularly and in the form of eye drops and tablets

When taken orally, the antibiotic is absorbed fairly quickly, mainly these processes occur in the lower parts of the digestive tract. The maximum concentration is reached in an hour - one and a half after application of a tablet of Ciprofloxacin. The overall bioavailability of the drug is high and is about 80% (the exact concentration of the active ingredient in the body depends on the dose taken).

Only dairy products affect the absorption of the antibiotic, so they are advised to be excluded from the diet for the duration of treatment. Otherwise, food intake somewhat slows down the absorption of Ciprofloxacin, but the bioavailability indicators do not change.

With plasma proteins, the active component of the drug binds only 15-20%. Basically, the antibiotic is concentrated in the organs of the small pelvis and abdominal cavity, saliva, lymphoid tissue of the nasopharynx, and lungs. Ciprofloxacin is also found in synovial fluid, bone and cartilage tissue.

The drug enters the spinal canal in a small amount, so it is practically not prescribed for damage to the central nervous system. Approximately one third of the total dosage of Ciprofloxacin is metabolized in the liver, the rest is excreted by the kidneys in unchanged form. The half-life is 3-4 hours.

The exact amount of medication prescribed, as well as the duration of treatment, depends on many factors. First of all, it is the condition of the patient. The standard recommendation regarding the use of any antibacterial agent is to continue taking it for at least three days after the temperature has returned to normal. This applies to both oral forms and the use of Ciprofloxacin intramuscularly.

For adults, the dosage of the drug is 500 mg twice a day, regardless of the meal.

The annotation to the drug indicates the average duration of therapy:

• with diseases of the respiratory tract - up to two weeks;
• with lesions of the digestive system from 2 to 7 days, depending on the severity of the clinical picture and the causative agent of infection;
• in diseases of the genitourinary system, prostatitis therapy lasts the longest - up to 28 days, to eliminate gonorrhea, a single dose is sufficient, with cystitis and pyelonephritis, treatment is continued up to 14 days;
• with infections of the skin and soft tissues - an average of two weeks;
• with bacterial lesions of bones and joints, the duration of therapy is determined by the doctor and can last up to 3 months.

Important

The severe course of the infection is an indication for increasing the daily dosage for an adult to 1.5 g.

Important

The maximum daily dosage of the drug in childhood should not exceed 1.5 g per day.

Ciprofloxacin is not used intramuscularly. The antibiotic solution is administered only intravenously. At the same time, its action develops much faster than that of tablets. The maximum plasma concentration is reached after 30 minutes. The bioavailability of the Ciprofloxacin solution is also higher. With intravenous injections, it is almost completely excreted unchanged by the kidneys within 3-5 hours.

Unlike tablets, for many uncomplicated bacterial diseases, one infusion of Ciprofloxacin is sufficient. In this case, the daily dosage for adults is 200 mg or two injections during the day. For a child, the required amount of the drug is determined in the proportion of 7.5-10 mg / kg per day (but not more than 800 mg per day).

The ready solution for infusion is produced not in small ampoules, but in 100 ml vials, the concentration of the active substance is 100 or 200 mg. The drug can be used immediately, it does not require further dilution.

Ciprofloxacin eye drops are intended for the treatment of various eye infections (conjunctivitis, blepharitis, keratoses and ulcers) caused by sensitive flora. Also, the drug is prescribed to prevent postoperative and post-traumatic complications.

The total volume of the bottle with drops is 5 ml, while 1 ml of the solution contains 3 mg of active ciprofloxacin. With moderately severe symptoms of the disease and for prophylactic purposes, the drug is prescribed 1-2 drops in each eye every four hours. In complicated infections, the frequency of use is increased - the procedure is repeated every two hours.

Ofloxacin or Ciprofloxacin: which is better, other analogues of the drug, restrictions on use

The use of the drug is strictly contraindicated during pregnancy and lactation. In addition, Ciprofloxacin affects the formation of the structure of bone and cartilage tissue, so children under 18 years of age are prescribed it only for strict medical reasons.

Also, contraindications to taking the medicine are hypersensitivity not only to Ciprofloxacin, but also to other medicines from the fluoroquinolone group.

The use of an antibiotic should be carried out under strict medical supervision in violation of the excretory function of the kidneys, severe diseases of the central nervous system. If the use of Ciprofloxacin is started after the operation under general anesthesia, monitor the pulse and blood pressure.

Unlike other, safer antibacterial drugs from the class, for example, penicillins, the risk of adverse reactions during therapy with Ciprofloxacin is high.

The patient is warned about such possible side effects:

• impaired visual clarity and color perception;
• the occurrence of a secondary fungal infection;
• digestive disorders, accompanied by vomiting, nausea, heartburn, diarrhea, inflammatory lesions of the intestinal mucosa rarely develop;
• dizziness, headache, sleep disorders, anxiety and other disorders of the psycho-emotional state, sometimes convulsions;
• hearing loss;
• acceleration of heart rate, arrhythmias against the background of low blood pressure;
• shortness of breath, impaired lung function;
• disorders of the hematopoietic system;
• deterioration of kidney and liver function;
• rashes, itching, swelling.

Ciprofloxacin is part of many drugs.

So, instead of this medication, the doctor may prescribe the following medications to the patient:

• Tsiprolet (solution for infusion, eye drops, tablets of 250 and 500 mg);
• Betaciprol (eye drops);
• Quintor (tablets and infusion solution);
• Tsiprinol (in addition to injection and conventional tablets, there are also capsules with prolonged action);
• Ciprodox (tablets with a dosage of 250, 500 and 750 mg).

If we talk about analogues of this antibiotic, we should also mention other antibacterial agents from the group of fluoroquinolones. So, patients are often interested in the doctor, Ofloxacin or Ciprofloxacin, which is better? Or can it be replaced with more modern Norfloxacin or Moxifloxacin?

The fact is that the indications for use for all of these funds are the same. Like Ciprofloxacin, they work well against the main pathogens of cystitis, pneumonia, prostatitis and other infections. But doctors emphasize that the "older" generation of fluoroquinolone, the greater its activity against pathogenic flora. But at the same time, the risk of severe adverse reactions also increases.

Therefore, the question Ofloxacin or Ciprofloxacin, which is better is not entirely correct. An antibiotic should be prescribed solely on the basis of the identified pathogen and the general condition of the patient. In other words, if the doctor sees that Ciprofloxacin will cope with, for example, pyelonephritis, then there is no need to prescribe a stronger, but less safe Norfloxacin or Lomefloxacin.

As for the cost of an antibiotic, it largely depends on the manufacturer and the purity of the substance used to manufacture the drug. So, domestic eye drops with Ciprofloxacin cost from 20 to 30 rubles. A package of 10 tablets with a dosage of 500 mg will cost roubles. The cost of one vial of solution for infusion varies within the limits of rubles.

“Ciprofloxacin was prescribed to treat inflammation of the kidneys. Before that, other, weaker antibiotics were also prescribed, but only this drug helped. The first few days I had to endure droppers, then they switched to pills. I was also pleased with the low price of the medicine. ”

Given the high risk of dangerous adverse reactions, only a doctor should decide whether Levofloxacin or Ciprofloxacin is better. The drugs are quite toxic, therefore, it is additionally recommended to take biochemical and clinical blood and urine tests to prevent possible complications of therapy.

Specialty: Otorhinolaryngologist Work experience: 29 years

Specialty: Audiologist Experience: 7 years

Levofloxacin: analogues, review of essential drugs similar to Levofloxacin

According to the latest medical statistics, the spread of prostatitis and its forms has recently begun to increase. The reasons for this situation can be called a lot of factors, among which, the main place is occupied by the unsatisfactory attitude of a man to his health, poor ecology, poor-quality food, etc.

Therefore, it is not surprising how seriously pharmacologists have to work to offer patients the latest and most effective drugs for the treatment of prostatitis. Among them, there is also Levofloxacin - an antibiotic of the latest generation, with a wide spectrum of action.

This type of drug, like Amoxiclav, belongs to antibiotics with a wide spectrum of action and is ideal for the systemic treatment of various diseases, including prostatitis (acute, chronic, bacterial).

The release form of the drug is tablets or solutions for injection. Any form of the drug is quickly absorbed into the blood, affects the body at the cellular level, and the directed action of the drug allows you to effectively kill entire colonies of harmful microorganisms. For people suffering from infectious and bacterial diseases, it will be much cheaper to purchase such a medication than buying other antibiotic synonyms and substitutes, which also have side effects and contraindications.

Levofloxacin analogues have the following properties:

• They have a wide and active spectrum of effects on the body.
• Able to quickly penetrate into the tissues of the prostate.
• Show a high degree of activity and directional action.

Before taking the medicine, you should read all the information that the instructions for taking the drug offer you. Like any other antibiotic, domestic or imported, Levofloxacin can cause side effects and individual intolerance.

Today you can choose not only Levofloxacin, analogues of this drug, similar in composition, action and form of release, are presented on the market in large quantities.

Tavanic is the same effective antibiotic that is prescribed for a variety of diseases. Characterized by a high degree of drug activity and impact on groups of harmful microorganisms, its use allows you to get positive results of treatment in the shortest possible time of therapy. The price of the product depends on the form of release: tablets can be bought from 600 rubles, an injection solution will cost you 1620 rubles.

Ciprofloxacin is an active antibiotic with a wide spectrum of action. It is used to treat infectious diseases of internal organs and tissues, in particular - the genitourinary system. The drug is produced in various forms, for example, these are eye drops, suspensions and solutions for injections, tablets and capsules. The cost of an antibiotic is low, from 18 rubles, and any pharmacy can offer you this drug.

Along with the Russian analogues discussed above, there are also foreign analogues of Levofloxacin on the market that can defeat any infectious disease.

Elefloks, produced by an Indian pharmaceutical company, is actively used to treat various forms of prostatitis, inhibits the activity of harmful microorganisms. It is used in systemic treatment, in which the disease is quickly treatable.

Glevo - a product of Indian pharmacology, with a wide spectrum of action, is excellent for the treatment of all forms of prostatitis.

Levofloxacin belongs to the group of fluoroquinols. To the same group with the active substance levofloxacin belong:

All antibiotics of this group are very effective in the treatment of prostatitis. Therefore, your choice of a drug can only be influenced by your individual intolerance to the components of one of them, the severity of the disease, in which it is necessary to use complex treatment, in which not all antibiotics may be compatible with other drugs. All drugs have detailed instructions, after reading which you will find out what side effect you can expect, what contraindication in your case may affect the choice of remedy.

Tavanic or Levofloxacin which is better?

As we have already noted, both of these drugs belong to the group of fluoroquinols, with an active active ingredient - levofloxacin, which quickly penetrates into the blood, then it is taken by the plasma and distributed to all tissues of the body.

The drug Levofloxacin has an active effect on various areas of tissues affected by harmful microorganisms, and it acts directly at the cellular level, which speeds up treatment and gives positive results. With prostatitis, different groups of bacteria can be present in the body that affect the organ and cause disease: anaerobic gram-positive and gram-negative, simple microorganisms and chlamydia. With all these "pests" the drug fights very effectively.

Tavanic is an antibiotic of the latest generation with high rates of effectiveness in the treatment of diseases of various internal organs, bone tissue.

The active substance in the drug is levofloxacin, auxiliary - crospovidone, cellulose, titanium dioxide, macrogol 8000, iron oxide red and yellow. When taking the drug, its concentration in the blood lasts for a rather long period.

The antibacterial drug gives the fastest and most positive results in the treatment of various forms of prostatitis, ranging from mild to chronic, as it affects tissue cells, their membranes and walls. It is especially effective in complex treatment, because. its active and active component, levofloxacin, interacts well with other drugs.

If we compare Tavanic or Levofloxacin, which is better, then the first drug has fewer side effects and has a faster action and the spectrum of its effects is much wider.

Comparing the cost of drugs, it can be noted that you can buy Levofloxacin at a price of 77 rubles, and Tavanic - from 590 rubles.

Most often, when the doctor has prescribed a course of treatment with this drug, the patient is prescribed 2 doses.

The average daily dose of the drug at each dose is from 500 ml to 1 g, depending on the form of the disease, the prostate gland is in. If injections are prescribed, then the daily dose of liquid is from 250 to 500 ml, depending on the severity of the disease. The medicine is taken regardless of the meal, because. mucosa quickly absorbs the substances of the drug.

With mild forms of prostatitis, as well as with diseases that affect the bronchi, the course of treatment can be from 14 to 28 days. In this case, the daily dose is from 500 ml to 1 g.

To decide whether Tavanic or Levofloxacin is better, the attending physician will help you, who will select the optimal antimicrobial drug for effective therapy.

Levofloxacin or Ciprofloxacin: a comparative evaluation of drugs

The drug has a wide spectrum of action, inhibits the vital activity of various microorganisms, quickly penetrates into the bloodstream, is distributed throughout the tissues of the body, and any infection is amenable to such therapy.

The doctor prescribes the drug, which calculates the daily dose of the drug.

The course of treatment can be from 1 to 4 weeks, depending on the degree of the disease.

If we consider Levofloxacin and Ciprofloxacin, the difference lies in the fact that the first is more effective, it can interact with other drugs, while Ciprofloxacin, under the influence of other drugs, can reduce its concentration and activity, which delays the course of treatment.

Both drugs, Levofloxacin and Ciprofloxacin, are antibiotics that should only be taken on the advice of a doctor who considers each clinical case on an individual basis.

The main difference between the two antibiotics is the active substance: in the first preparation it is levofloxacin, and in the second it is ofloxacin. Under the action of Ofloxacin, not all groups of bacteria can be destroyed, since microorganisms have a different degree of sensitivity to ofloxacin, so the treatment of prostatitis may be different due to the causes of the disease and the effectiveness of treatment may also differ.

Levofloxacin Astrapharm: description of the drug and its distinctive features

Distinctive features from Levofloxacin

Levofloxacin Astrapharm is able to inhibit the activity of gram-positive and gram-negative microbes, while Levofloxacin acts on all groups of bacteria.

Most often, Levofloxacin Astrapharm is used to effectively treat bacterial chronic prostatitis.

In therapy with Levofloxacin, a positive trend is observed already in the middle of treatment, and this occurs regardless of the form of the disease.

If we talk about Levofloxacin Astrapharm blister, then it is more effective in the treatment of mild and moderate forms of prostatitis.

Regardless of what choice you make in the treatment of prostatitis, you must remember that only a systemic, well-chosen treatment can give positive dynamics and results.

Specialty: Urologist Work experience: 21 years

Specialty: Urologist-andrologist Work experience: 26 years

To date, in otolaryngology and pulmonology, various antibacterial agents are considered one of the main drugs. Due to the high effectiveness of drugs from the group of fluoroquinolones, they are quite often prescribed for the treatment of ENT diseases and respiratory infections. In this article we will try to figure out which is better levofloxacin or ciprofloxacin. To give a solid answer, it is necessary to dwell in more detail on the features of the use of each of these drugs separately.

Ciprofloxacin belongs to the classical fluoroquinolones, which have wide indications for use in respiratory infections of the lower respiratory tract and ENT pathology. Clinical experience shows that this drug is active against gram-negative bacteria, staphylococci and atypical pathogens (chlamydia, mycoplasma, etc.). At the same time, ciprofloxacin is not effective enough in diseases caused by pneumococci.

The selection of the optimal drug for the treatment of any disease should be handled exclusively by a highly qualified doctor.

Indications

Being a broad-spectrum antibacterial drug, Ciprofloxacin is successfully used in the treatment of patients suffering from respiratory infections of the respiratory tract and ENT pathology. In what diseases of the respiratory system and diseases of the ear, throat, nose, this drug from the group of classic fluoroquinolones is used:

1. Acute and chronic bronchitis (at the stage of exacerbation).
2. Pneumonia caused by various pathogenic microorganisms.
3. Inflammation of the middle ear, paranasal sinuses, throat, etc.

Contraindications

Like most drugs, Ciprofloxacin has its contraindications. In what situations this representative of classical fluoroquinolones cannot be used in the treatment of respiratory diseases and ENT pathology:

• Allergic reaction to ciprofloxacin.
• Pseudomembranous colitis.
• Childhood and adolescence (until the end of the formation of the skeletal system). An exception is children with pulmonary cystic fibrosis who have developed infectious complications.
• Pulmonary form of anthrax.

In addition, patients with the following disorders and pathological conditions have restrictions on the use of Ciprofloxacin:

• Progressive atherosclerotic lesion of the blood vessels of the brain.
• Severe disorders of cerebral circulation.
• Various heart diseases (arrhythmia, heart attack, etc.).
• Decreased levels of potassium and/or magnesium in the blood (electrolyte imbalance).
• Depressive state.
• epileptic seizures.
• Severe disorders of the central nervous system (for example, stroke).
• Myasthenia.
• Serious malfunctions of the kidneys and / or liver.
• Advanced age.

Side effects

According to clinical practice, adverse reactions in the vast majority of patients taking fluoroquinolones are observed infrequently. We list the undesirable effects that occur in about 1 out of 1000 patients taking Ciprofloxacin:

• Dyspeptic disorders (vomiting, pain in the abdomen, diarrhea, etc.)
• Decreased appetite.
• Feeling of heartbeat.
• Headache.
• Dizziness.
• Periodic sleep problems.
• Changes in the main blood parameters.
• Weakness, fatigue.
• Allergic reaction.
• Various skin rashes.
• Pain in muscles and joints.
• Functional disorders of the kidneys and liver.

Do not buy Levofloxacin or Ciprofloxacin without first talking to your doctor.

special instructions

With extreme caution, ciprofloxacin is prescribed to patients who are already taking drugs that lead to a prolongation of the QT interval:

1. Antiarrhythmic drugs.
2. Macrolide antibiotics.
3. Tricyclic antidepressants.
4. Antipsychotics.

Clinical observations show that Ciprofloxacin enhances the effect of hypoglycemic drugs. With their simultaneous use, careful monitoring of blood glucose should be carried out. It has been recorded that drugs that reduce acidity in the gastrointestinal tract (antacids), and which contain aluminum and magnesium, reduce the absorption of fluoroquinolones from the digestive tract. The interval between the use of an antacid and an antibacterial drug should be at least 120 minutes. I would also like to note that milk and dairy products can affect the absorption of Ciprofloxacin.

In case of an overdose of the drug, headache, dizziness, weakness, convulsive attacks, dyspeptic disorders, functional disorders of the kidneys and liver may develop. There is no specific antidote. Wash the stomach, give activated charcoal. If necessary, symptomatic therapy is prescribed. Carefully monitor the patient's condition until complete recovery.

Levofloxacin

Levofloxacin is a third-generation fluoroquinolone. It has a high activity against gram-negative bacteria, pneumococci and atypical pathogens of respiratory infections. Most pathogens that show resistance (resistance) to the "classic" second-generation fluoroquinolones may be sensitive to more modern drugs such as Levofloxacin.

Eating does not affect the absorption of Ciprofloxacin or Levofloxacin. Modern fluoroquinolones can be taken both before and after meals.

Indications

Levofloxacin is an antibacterial drug with a wide spectrum of action. It is actively involved in the following diseases of the respiratory system and ENT organs:

• Acute or chronic inflammation of the bronchi (at the stage of exacerbation).
• Inflammation of the paranasal sinuses (sinusitis, sinusitis, etc.).
• Infectious and inflammatory processes in the ear, throat.
• Pneumonia.
• Infectious complications of cystic fibrosis.

Contraindications

Despite the fact that Levofloxacin belongs to the new generation of fluoroquinolones, this drug can not be prescribed in all cases. What are the contraindications to the use of Levofloxacin:

• An allergic reaction to a drug or its analogues from the fluoroquinolone group.
• Serious kidney problems.
• epileptic seizures.
• Tendon injury associated with prior fluoroquinolone therapy.
• Children and teenagers.
• Periods of childbearing and breastfeeding.

Levofloxacin should be used with extreme caution in elderly patients.

Side effects

As a rule, all adverse reactions are classified according to severity and frequency of occurrence. We list the main undesirable effects from taking Levofloxacin, which may occur:

• Problems with the functioning of the gastrointestinal tract (nausea, vomiting, diarrhea, etc.).
• Headache.
• Dizziness.
• Allergic reactions (skin rashes, itching, etc.).
• Elevated levels of essential liver enzymes.
• Drowsiness.
• Weakness.
• Pain in muscles and joints.
• Damage to the tendons (inflammation, tears, etc.).

Self-administration of Levofloxacin or Ciprofloxacin without the permission of the attending physician can have serious consequences.

special instructions

Since the likelihood of joint damage is high, Levofloxacin is not prescribed in childhood and adolescence (up to 18 years), except in extremely severe cases. When using antibacterial drugs for the treatment of age-related patients, it should be borne in mind that this category of patients may have impaired renal function, which is a contraindication for the appointment of fluoroquinolones.

During therapy with Levofloxacin, patients who have previously suffered a stroke or severe traumatic brain injury may develop epileptic seizures (convulsions). If there is a suspicion of the presence of pseudomembranous colitis, it is necessary to immediately stop taking Levofloxacin and prescribe the optimal course of therapy. In such situations, it is strongly not recommended to use drugs that inhibit intestinal motility.

Although rare, there may be cases of inflammation of the tendons (tendinitis) when using Levofloxacin. Older patients are more prone to these types of side effects. Concurrent use of glucocorticosteroids significantly increases the risk of developing tendon ruptures. If a tendon lesion is suspected (inflammation, ruptures, etc.), fluoroquinolone therapy is stopped.

In case of an overdose of this drug, symptomatic therapy should be carried out. The use of dialysis in such cases is ineffective. There is no specific antidote.

During therapy with Levofloxacin, it is not recommended to engage in activities that require increased concentration and quick reaction (for example, driving a car). Also, due to the risk of developing photosensitivity, refrain from excessive skin exposure to ultraviolet rays.

What drug to choose?

How to determine which is better Levofloxacin or Ciprofloxacin? Of course, only an experienced specialist can make the best choice. Nevertheless, when choosing a drug, it is necessary to rely on 3 main aspects:

• Efficiency.
• Safety.
• Availability.

A good drug will be considered one that is not only effective, but also less toxic and affordable. In terms of effectiveness, Levofloxacin has its advantages over Ciprofloxacin. Along with the preserved activity against gram-negative pathogenic microorganisms, Levofloxacin has a more pronounced antibacterial effect against pneumococci and atypical pathogens. However, it is inferior to Ciprofloxacin in activity against the pathogen Pseudomonas (P.) aeruginosa. It has been noted that pathogens that are resistant to ciprofloxacin may be susceptible to levofloxacin.

The type of pathogen and its sensitivity to antibacterial agents are decisive when choosing the optimal fluoroquinolone (in particular, Ciprofloxacin or Lefovloxacin).

Both drugs are well absorbed in the intestine when taken orally. Food practically does not affect the absorption process, with the exception of milk and dairy products. They are convenient to use because they can be administered 1-2 times a day. Regardless of whether you take Ciprofloxacin or Levofloxacin, in rare cases, unwanted side reactions may develop. As a rule, dyspeptic disorders (nausea, vomiting, etc.) are noted. Some patients taking fluoroquinolones of the second or third generation complain of headache, dizziness, weakness, fatigue, sleep disturbance.

In elderly patients, especially against the background of glucocorticosteroid therapy, tendon ruptures are possible. Due to the risk of developing joint damage, fluoroquinolones are limited in use during periods of childbearing and breastfeeding, as well as in childhood.

Currently, for most patients, the price aspect is of paramount importance. A pack of Ciprofloxacin tablets costs about 40 rubles. Depending on the dosage of the drug (250 or 500 mg), the price may fluctuate, but not significantly. A more modern Levofloxacin will cost you an average of 200-300 rubles. The price will depend on the manufacturer.

However, the final decision as to what is best for the patient Ciprofloxacin or Levofloxacin is made solely by the attending physician.

Ofloxacin - an antibacterial drug second generation from the group of fluoroquinolones. Pharmacological agents of this group are an alternative to broad-spectrum antibiotics.

Due to the structure and mechanism of action, the drug has a high bactericidal activity against gram-negative and gram-positive microorganisms.

The main advantage of Ofloxacin is that it is effective in deactivating microflora, resistant to other antibiotics.

The use of Ofloxacin

The antibiotic has been successfully used to treat various diseases. The drug is used to treat infectious diseases of the respiratory tract(including pneumonia, bronchitis). The drug is widely used in otorhinolaryngology for the treatment of sinusitis, pharyngitis, otitis, laryngitis, tracheitis.

Photo 1. Packing of the drug Ofloxacin in the form of tablets with a dosage of 200 mg. Producer "Darnitsa".

At infectious diseases of the skin(for example, with furunculosis, carbunculosis, phlegmon), the drug shows high efficiency. Ofloxacin copes with the treatment of infections of the osteoarticular apparatus, gastrointestinal tract, small pelvis (for example, salpingitis, oophoritis).

Antibiotic used in nephrology and urology for the treatment of pyelonephritis, cystitis, urethritis. Among the pathologies of the venereological profile, the drug is used to treat gonorrhea, chlamydia. An antibacterial drug is prescribed to prevent the development of infectious pathologies. with immunodeficiencies(including HIV).

In ophthalmic practice the drug shows high efficiency in the fight against conjunctivitis, keratitis, blepharitis, iritis, complications after traumatization of the organ of vision.

Reference. An antibacterial drug is used to treat tuberculosis in combination with other drugs.

Contraindications

Ofloxacin has some contraindications for use:

• epileptic status;
• pathologies of the functions of the nervous system (meningitis, encephalitis in history);
• state of pregnancy;
• fermentopathy of glucose-6-phosphate dehydrogenase.

The drug is contraindicated in children under 18 years old, since the growth of the skeleton has not yet been completed by this point. Patients with diagnoses of atherosclerosis of the cerebral arteries, circulatory disorders of the brain, chronic kidney disease should limit the prescription of the antibiotic to the minimum dosage.

Side effects

From the gastrointestinal tract, the following adverse reactions may occur:

• condition anorexia;
• sensation nausea;
• defecation disorders(usually in the form of diarrhea);
• bloating;
• pain in the abdominal region;
• hyperactivity of liver enzymes;
• excess bilirubin;
• development jaundice due to cholestasis.

From the side of the central nervous system, the following adverse reactions may occur:

• cephalgia;
• convulsive jitter;
• dizziness;
• difficulty in movement;
• sensation numbness in the limbs;
• increased anxiety;
• depressive disorders;
• sensation double vision;
• changes taste perception.

On the part of the musculoskeletal system, the following adverse reactions may occur:

• muscle pain;
• joint pain;
• inflammation synovial sheaths and tendons.

From the side of the cardiovascular system, the following adverse reactions may occur:

• inflammation vessels;
• increase the frequency of myocardial contractions;
• significant depressurization up to collapse.

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From the side of the skin, the following adverse reactions may occur:

• petechial hemorrhages;
• dermatitis;
• rash in the form of papules;
• inflammation vessels.

From the side of the hematopoietic system, the following adverse reactions may occur:

• decrease in leukocytes;
• development agranulocytosis;
• development anemia;
• decrease in platelets;
• decrease in the work of all hematopoietic sprouts.

From the urinary system, the following adverse reactions may occur:

• sharp jade;
• violation kidney activity;
• increased creatinine in blood;
• excess content urea.

Possible manifestation of allergic diseases in the form of:

• urticaria;
• angioedema;
• skin rash;
• allergic pneumonitis;
• allergic jade;
• anaphylaxis(rarely).

Compound

One tablet of an antibacterial agent consists of 400 mg ofloxacin as an active ingredient, corn starch, cellulose, talc, povidone, calcium stearate, aerosil.

Levofloxacin

Levofloxacin - synthetic antibiotic fluoroquinolone. The active substance of the drug is isomeric analogue ofloxacin.

Compound

One Levofloxacin tablet contains 250 mg levofloxacin hemihydrate.

Photo 2. Packages of Levofloxacin in the form of tablets with a dosage of 250 and 500 mg. Producer "Dalhimfarm".

Indications

Indications for the use of Levofloxacin are infectious diseases caused by sensitive microflora:

• acute sinusitis;
• chronic bronchitis in the acute stage;
• pneumonia;
• urinary tract infections;
• prostatitis;
• skin infections;
• infections of the gastrointestinal tract.

Contraindications

Among the contraindications are: hypersensitivity to fluoroquinolones, status epilepticus, renal insufficiency, pregnancy and lactation.

A drug contraindicated children and adolescents.

Side effects

From the gastrointestinal tract there may be such adverse reactions as changes in the act of defecation (in the form of diarrhea), flatulence, pain of an abdominal nature. These effects are rare and appear in 1% cases.

From the side of the central nervous system there may be side effects such as cephalgic pain, patients sometimes feel dizzy, and the cycle of sleep and wakefulness is disturbed.

Fatigue appears, work capacity and stress resistance decrease.

From the musculoskeletal system pain of muscular and articular origin may be noted. A pain syndrome of this nature is subjectively felt by a person as an ache in the body.

Negative Effects from the cardiovascular system manifest themselves infrequently and are expressed in inflammation of the vessels, an increase in the frequency of myocardial contractions, a significant decrease in pressure up to collapse.

From the side of the skin the appearance of petechial hemorrhages, dermatitis, rash in the form of papules, inflammation of the vessels is possible.

Rarely occur allergic diseases in the form of urticaria and skin rash. Very rarely seen anaphylaxis and angioedema.

Important! Levofloxacin is widely used in phthisiology for the treatment of tuberculosis. It is a reserve medicine, it is used only if the strain of Koch's bacillus is highly resistant to other drugs.

Levofloxacin or Ofloxacin: which is better

The activity of Levofloxacin against microorganisms twice as much than ofloxacin. The half-life of a substance from the body lasts about 6 hours, and Ofloxacin - around 5.

The drugs differ in dosages. In order to treat infectious pathologies of the respiratory tract, it is prescribed. For the treatment of a similar pathology, 500 mg Levofloxacin once a day. This creates a concentration of Levofloxacin 2.5 times more than ofloxacin.

Ciprofloxacin

Ciprofloxacin is an antimicrobial drug with a wide spectrum of effects, also belongs to fluoroquinols. Medication has a bactericidal effect.

Compound

One antibiotic tablet contains 250 mg ciprofloxacin as active ingredient. The list of excipients consists of cellulose, hypromellose, croscarmellose, polysorbate, stearate.

Photo 3. Packing Ciprofloxacin in the form of tablets with a dosage of 500 mg. Produced by Actavis.

Indications

The indications for prescribing the drug are infectious pathologies of various systems:

• respiratory tract;
• ENT organs;
• urinary system;
• reproductive system;
• gastrointestinal tract;
• skin;
• musculoskeletal system.

The drug is used to prevent infections with immunodeficiencies.

Contraindications

Contraindications include high sensitization to drugs of the fluoroquinolone group. The drug should not be used to treat patients in status epilepticus. Insufficiency of kidney and liver function makes taking Ciprofloxacin unacceptable.

Attention! During gestation and lactation It is strictly forbidden to take any drugs from the group of fluoroquinolones.

The drug is contraindicated in children and adolescents. For older people, there is a high risk of kidney disease while taking an antibiotic.

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Side effects

Patients Ciprofloxacin is most often tolerated without adverse effects. Allergic manifestations (sensation of itching, rashes) are rarely noted, it rarely develops angioedema.

Photo 4. Quincke's edema in a woman. In some cases, it can cause suffocation.

Appetite may disappear, pain in the epigastrium, diarrhea, and malaise may be felt. Sometimes sleep is disturbed, cephalgic syndrome develops. The perception of taste and smell properties may be disturbed.

Important! Ciprofloxacin is successfully used by phthisiatricians for the treatment of tuberculosis. Being a remedy from the reserve group, the antibiotic shows a high effect against resistant colonies of tuberculosis bacteria.

Differences between Ciprofloxacin and Ofloxacin

Ciprofloxacin is a first-generation fluoroquinolone drug. Unlike Ofloxacin, its spectrum of action more narrow, because more bacteria are resistant to it. Ciprofloxacin and Ofloxacin are similar in mechanism of action and structure, but have a number of differences. The activity of Ciprofloxacin against microorganisms exceeds that of Ofloxacin.

The drugs differ from each other in effective doses. For the treatment of infectious diseases of the respiratory system, 200 mg ofloxacin twice a day. For the treatment of a similar pathology, 400 mg ciprofloxacin once a day. Ciprofloxacin has fewer side effects than ofloxacin.

Ofloxin and Ofloxacin: is it the same or is there any difference?

In order to find out if there is a difference in the drugs Ofloxin and Ofloxacin, it is necessary to analyze their composition, compare contraindications and side effects of antibiotics.

Compound

Ofloxin is an analogue of Ofloxacin. The composition as an active substance includes 200 mg ofloxacin. Excipients: corn starch, cellulose, talc, povidone, calcium stearate, aerosil.

Photo 5. Packing of Ofloxin in the form of tablets with a dosage of 400 mg. Produced by Zentiva.

Application

Medicine used in the treatment of:

• respiratory tract infections (including pneumonia, bronchitis);
• otorhinolaryngological diseases (sinusitis, pharyngitis, otitis media, laryngitis, tracheitis);
• infections of the skin (for example, with furunculosis, carbunculosis, phlegmon);
• diseases of the osteoarticular apparatus;
• ailments of the gastrointestinal tract;
• pelvic infections (eg, salpingitis, oophoritis);
• urological pathologies (pyelonephritis, cystitis, urethritis);
• venereal infections (gonorrhea, chlamydia).

Contraindications

Epilepsy and high sensitization to quinolones - contraindications for use Ofloksina.

It is forbidden to prescribe an antibiotic to pregnant women, as well as women in the lactation period.

In case of impaired renal function, the usual dosages are prescribed at the beginning of therapy, and later they are reduced, taking into account creatinine clearance values.

Side effects

Adverse reactions appear as dyspeptic disorders, appetite disappears, epigastric pains, diarrhea are noted. The concentration of bilirubin in the blood plasma increases. Anemia may develop with increased fatigue, the appearance of apathy.

The reaction rate slows down during complex work. Sleep is disturbed, dizzy, extremely rarely there can be hallucinations.
Ofloxin and Ofloxacin - complete structural analogues, and there are no differences between them.

Drug Comparison: Rational Choice of Fluoroquinolone Antibiotics

Ofloxacin and Ofloxin are the same medicine. Levofloxacin is an isomer of Ofloxacin and differs from the latter in a number of properties. To achieve the effect, a lower dose of the drug is needed, so the choice of Levofloxacin preferred.

Ciprofloxacin is a first generation fluoroquinolone less efficient to use than Ofloxacin and Levofloxacin, since a greater number of microorganisms managed to form resistance to it. For tuberculosis and severe infectious pathologies Odnoklassniki shows the highest effect