Abaktal instructions for use
Abaktal is an antibiotic belonging to the class of fluoroquinolones of the first generation.
International name: Pefloxacinum
Form of issue
- Tablets containing 20 or 40 mg of active ingredient (in the package can be 4, 10, 20 or 50 pieces);
- Vials (volume 100 ml) or ampoules (volume 5 ml), containing 8% solution for injection.
- 1 tablet contains 558.5 mg of perfloxacin mesylate dihydrate (this corresponds to 400 mg of "pure" perfloxacin);
- In 1ml of the solution the content of perfloxacin is 80 mg.
Mechanism of action
The drug acts on the gene apparatus of microbes due to suppression of replication of DNA molecules (blocking of DNA-gyrase). This leads to the fact that the causative agent of an infectious disease is dying. The pronounced bactericidal action of the drug is associated with the presence in its chemical formula of a fluorine atom. An important aspect of the action of an antibiotic is that it is capable of causing the death not only of those bacteria that are at rest but also those that are actively multiplying.
Peculiarities of pharmacokinetics
After reception in a tablet form, Abaktal quickly undergoes absorption and enters the systemic circulation (bioavailability level - 100%). The maximum concentration of the drug in the blood is recorded after 1.5 - 2 hours after ingestion. The degree of binding of antibiotic molecules to proteins is about 30%. Abaktal well penetrates into such internal environments of the body as saliva, sputum, bronchial secretion and amniotic fluid. High concentration of the drug is also noted in the prostate gland and bones of the skeleton.
The main chemical reactions associated with the metabolism of Abaktal occur in the liver. The drug is excreted, mainly by the kidneys.
After a single admission into the body, the half-life of the antibiotic is 8 hours, after a second time, 12 hours.
In urine, the trace concentrations of Abaktal are recorded 3-4 days after the last administration of the drug.
In cases of renal failure, the half-life and plasma concentration of the drug do not change significantly.
In the case of hepatic failure, the half-life of Abaktal from the systemic blood flow may increase two or more times, which requires appropriate correction of the frequency of administration of the antibiotic.
Spectrum of antimicrobial activity: the drug is sensitive to both Gram-positive and Gram-negative microorganisms (possess greater sensitivity) among them:
- Staphylococcus aureus
- Klebsiella spp.
- Escherechia coli
- Proteus mirabilis
- Serratia spp.
- Haemophilus influenza
- Salmonella spp.
- Enterobacter spp.
- Citrobacter spp.
- Neisseria gonorrhoeae
- Shigella spp.
- Proteus spp. (Only indole-positive strains).
The following varieties of microorganisms possess an average level of sensitivity to Abaktal:
- Streptococcus spp. (Including the causative agent of lobar pneumonia - Streptococcus pneumoniae)
- Chlamidia spp.
- Clostridium perfringens
- Pseudomonas spp.
- Mycoplasma spp.
- Acinetobacter spp.
Mycobacterium tuberculosis, Gram-negative anaerobic microorganisms, and spirochaetes have a high level of resistance to Abaktal.
Indications for use
Treatment of infectious diseases caused by microorganisms with high or medium sensitivity to Abaktal:
- Diseases of the respiratory apparatus ( bronchitis , pharyngitis , sinusitis, pneumonia, tonsillitis , cystic fibrosis).
- Infections of the urinary system (pyelonephritis, cystitis , urethritis, endometritis, vaginitis, prostatitis, tubular abscess).
- Some venereal diseases ( chlamydia and gonorrhea ).
- Infectious diseases of the digestive system (typhoid fever, salmonellosis, shigellosis, cholera, empyema of the gallbladder).
- Skin lesions (infected ulcers, burns, wound surfaces, can be used to treat abscesses).
- Septic conditions (peritonitis, endocarditis, meningococcal meningitis, intra-abdominal abscesses).
- Infectious diseases in people with congenital or acquired immunodeficiency.
- Treatment and prevention of nosocomial infections.
Mode of application
The drug can be used as a monotherapy or in combination with other antibacterial agents. The average daily dose of Abaktal is 800 mg. To maintain a constant concentration of antibiotic in the blood serum, it is recommended to administer 400 mg of the drug 2 times a day.
During the treatment of urinary tract infections, it is permissible to use Pefloxacin 1 tablet (400 mg) once a day.
In the treatment of gonorrhea (uncomplicated flow), a dose of 800 mg of Abaktal is used once.
The maximum dose received by a patient within 24 hours should not exceed 1.2 grams.
At the phenomena of hepatic insufficiency Abaktal is prescribed in a dosage of 400 mg once every 24-48 hours (depending on the severity of the disease).
In tableted form Abaktal is best taken with food to prevent the occurrence of undesirable reactions. In this case, tablets can not be divided or crushed.
Infusion therapy with the drug is carried out only in a hospital after a sample for the tolerability of pefloxacin. In / in the drip, usually prescribed 400 mg of antibiotic 2 times a day (with a strict interval of 12 hours). The drug is injected slowly to avoid the creation of toxic concentrations in vital organs (the duration of the infusion should be at least an hour).
In diseases that threaten the life of the patient, it is permissible at the starting stage of pharmacotherapy to administer once-only IV 800 mg of Pefloxacin.
In surgical units to prevent infection of the patient in the postoperative period, Abaktal therapy begins before surgery (400-800 mg of the drug is administered intravenously).
In the presence of patients with liver failure, a single dose of the drug is calculated by the formula: 8 mg x body weight (kg).
In patients of the older age group, dose adjustment is performed depending on the presence of concomitant pathology.
Time of onset of the effect: evaluation of the level of effectiveness of Abaktal therapy is carried out 72 hours after the first use of the antibacterial drug.
- Age to 18 years.
- The period of pregnancy and breastfeeding.
- Allergic reactions to preparations of a group of fluoroquinolones in the anamnesis.
- With caution should be used in patients with exacerbation of mental or neurological diseases, as well as in liver failure.
Use during pregnancy
Pefloxacin is prohibited for use in obstetric practice. When using an antibacterial drug, breastfeeding should be discontinued for the entire treatment period.
Interaction with other pharmacological agents
- It should avoid sharing Abaktal with drugs belonging to the class of antacids (Maalox, Almagel, etc.). If necessary, the interval between ingestion of said medicinal products should be at least 2 hours.
- In case of combining Pefloxacin with antihistamines (ranitidine, cimetidine), the frequency of antibiotic intake is increased due to an increase in the time of its circulation in the blood plasma.
- If Abaktal is used with indirect anticoagulants, then there may be hemorrhagic conditions.
- It is inadmissible to combine pefloxacin with chloramphenicol and tetracyclines (antagonist preparations).
- Central nervous system: dizziness, convulsions , headache, anxiety, hallucinations, sleep disorders, tremor, depression, sleep disturbance.
- Digestive system: decreased appetite, nausea, diarrhea, perversion of taste sensations, dyspepsia vomiting. Perhaps a transient increase in the level of bilirubin and phosphatase alkaline.
- Urinary system: crystalluria. Very rarely - interstitial nephritis, hematuria.
- Musculoskeletal: tendonitis, myalgia, arthritis. The cases of the appearance of ruptures of the Achilles tendon are described.
- At the injection site, phlebitis is possible.
- Allergy reactions are immediate.
- Others: a transient change in the erythrocyte or leukocyte formula.
Confusion, vomiting, nausea, hallucinations may occur. With repeated excess of the dose, it is possible to develop a convulsive syndrome, loss of consciousness up to the level of coma.
Treatment of overdose phenomena is carried out in the toxicological center. First aid to the victim consists in washing the stomach, setting the siphon enema and taking the activated charcoal inside.
Treatment of intoxication with Pefloxacin by hemodialysis method is ineffective.
Analogs for ATC code 4-th level:
Levot P, Norbaktin, Cyprinol, Ofloxin, Lomefloxacin, Zanocin, Eleflox, Ciprobai, Lomflox, Sparflot, Tariwid, Zoflox, Levofloxacin, Floracid, Glevo, Avelox, Flexide
Analogue according to the active substance: