Ciprofloxacin or ofloxacin which is better. Which is better - Ofloxacin or Ciprofloxacin? How not to make a mistake with the choice? Opinion about the drug

14.07.2020 Information

Catad_tema Genitourinary infections - articles

Ofloxacin in urological practice

V.E. Okhrits, E.I. Veliyev
Department of Urology and Surgical Andrology, RMAPO

Antibacterial drugs(ABP) class fluoroquinolones(PC), united by a common mechanism of action (inhibition of the synthesis of a key bacterial cell enzyme, DNA gyrase), currently occupy one of the leading positions in the chemotherapy of bacterial infectious diseases... The first quinolone was obtained by accident during the purification of the antimalarial drug chloroquine. It was nalidixic acid, which has been used for over 40 years to treat infections urinary tract (IMP). Subsequently, the introduction of a fluorine atom into the structure of nalidixic acid laid the foundation for a new class of ABP - PC. Further improvement of PC led to the appearance in the mid-1980s of monofluoro-quinolones (containing one fluorine atom in a molecule): norfloxacin, pefloxacin, ofloxacin, and ciprofloxacin.

Spectrum of action of PC

All PCs are drugs with a broad spectrum of action, which includes bacteria (aerobic and anaerobic, gram-positive and gram-negative), mycobacteria, chlamydia, mycoplasma, rickettsia, borrelia, and some protozoa.

PCs are characterized by activity against predominantly gram-negative bacteria: Families of Enterobacteriaceae (Citrobacter, Enterobacter, Escherichia coli, Klebsiella, Proteus, Providencia, Salmonella, Shigella, Yersinia), Neisseriae, Haemophilus, Moraxella, for which the minimum inhibitory concentration (MIC90)

PC in most cases is. Among PC there are differences in activity against different groups of microorganisms and certain types of bacteria. The most active PCs in vitro are ciprofloxacin (against Enterobacteriaceae and Pseudomonas aeruginosa) and ofloxacin (against gram-positive cocci and chlamydia).

Resistance bacteria to PC develops relatively slowly; it is mainly associated with mutations of genes encoding DNA gyrase or topoisomerase IV. Other mechanisms of bacterial resistance to PC are associated with impaired drug transport through porin channels in the outer cell membrane of a microbial cell or with the activation of release proteins that lead to the elimination of PC from the cell.

Pharmacokinetics of PC

All PCs are well absorbed in the gastrointestinal tract, reaching maximum blood concentrations in 1-3 hours; food intake slows down the absorption, but does not affect its completeness. PCs are characterized by high oral bioavailability, which in most drugs reaches 80-100% (with the exception of norfloxacin - 35-45%).

All PCs circulate in the body for a long time at therapeutic concentrations (half-life of 5-10 hours), due to which they are used 1-2 times a day.

PC concentrations in most body tissues are comparable to or higher than serum concentrations; in high concentration PCs accumulate in the parenchyma of the kidneys and in the prostate tissue. There is a good penetration of PC into cells - polymorphonuclear leukocytes, macrophages, which is important in the treatment of intracellular infections.

There are differences in the severity of metabolism to which PCs are exposed in the body. Pefloxacin is most susceptible to biotransformation (50–85%), the least is ofloxacin (less than 10%, while 75–90% of ofloxacin is excreted unchanged by the kidneys).

An important advantage of PC is that a number of drugs (ofloxacin, pefloxacin, ciprofloxacin) have two dosage forms- for oral administration and for parenteral administration. This makes it possible to use them sequentially (stepwise therapy), starting with intravenous administration and then moving on to taking drugs by mouth, which, of course, increases the compliance and economic feasibility of treatment.

FH portability

In general, PCs are well tolerated, although in 4–8% of patients they can cause undesirable effects (most often from gastrointestinal tract, central nervous system and skin).

About 20 years ago, in animal studies, the ability of PC to cause arthropathy was revealed, which was the reason for the de facto ban on the use of PC in pregnant women and children under 12 years of age. Appointment of PC to patients of these categories is possible only for health reasons. In publications concerning the use of PC in seriously ill children, the data on the frequent development of arthrotoxic effect have not been confirmed. It was noted in less than 1% of children and depended on age and gender: it was more common in adolescents than in young children, and in girls more often than in boys.

One of the safest PCs is considered ofloxacin... According to some researchers, during long-term follow-up of children and adolescents who received ofloxacin for health reasons, there were no cases of arthrotoxicity (both acute and cumulative). In addition, in patients with concomitant joint diseases, there was no exacerbation while taking ofloxacin.

Features of ofloxacin

Ofloxacin can be considered as one of the most highly active drugs from early PCs for the treatment of UTIs. Due to its structure and mechanism of action, ofloxacin has a high bactericidal activity. The drug is active against gram-negative and gram-positive microorganisms (including strains resistant to other ABPs), as well as intracellular pathogens.

Ofloxacin can be administered concurrently with many ABPs (macrolides, b-lactams). Due to this property, the drug is widely used in combination therapy for infectious diseases. Ofloxacin, in contrast to ciprofloxacin, retains activity with the simultaneous use of inhibitors of RNA polymerase synthesis (chloramphenicol and rifampicin), since it is practically not metabolized in the liver.

The bioavailability of ofloxacin after oral administration and parenteral administration is identical. Due to this, when replacing the injection route of administration of the drug with oral, dose adjustment is not required (one of the significant differences between ofloxacin and ciprofloxacin). Ofloxacin is prescribed 1-2 times a day. Food intake does not affect its absorption, however, when fatty foods are consumed, the absorption of ofloxacin slows down.

Ofloxacin penetrates well into target organs (for example, in chronic prostatitis - into tissue prostate). There is a linear relationship between the dose of ofloxacin used and its tissue concentration. The drug is excreted mainly by the kidneys (more than 80%) unchanged.

Ofloxacin, to a lesser extent than ciprofloxacin, interacts with other drugs, practically does not affect the pharmacokinetics of theophylline and caffeine.

The activity of ofloxacin is most pronounced in relation to gram-negative bacteria and intracellular pathogens (chlamydia, mycoplasma, ureaplasma), in relation to gram-positive flora and Pseudomonas aeruginosa, ofloxacin is less active. The bactericidal effect of ofloxacin manifests itself rather quickly, and the resistance of microorganisms to it develops slowly. This is due to its influence on one gene of DNA gyrase and on topoisomerase IV. The main differences between ofloxacin and other PCs(Yakovlev V.P., 1996):

1. Microbiological:

the most active drug among PCs of the second generation against chlamydia, mycoplasma and pneumococci;
equal activity with ciprofloxacin against gram-positive bacteria;
no effect on lacto- and bifidobacteria.

2. Pharmacokinetic:

high oral bioavailability (95-100%);
high concentrations in tissues and cells equal to or exceeding serum concentrations;
low metabolic rate in the liver (5–6%);
activity does not depend on the pH of the medium;
excretion unchanged in the urine;
half-life of 5-7 hours.

3. Clinical:

most favorable safety profile: no serious adverse effects in controlled trials;
no clinically significant phototoxic effect;
does not interact with theophylline.

FH in urological practice

Perhaps, PCs are most actively used in urological practice for antibacterial prophylaxis and therapy of UTI. An antibiotic therapy (ABT) drug for UTI should have the following properties:

proven clinical and microbiological efficacy;
high activity against the main uropathogens, low level microbial resistance in the region;
the ability to create high concentrations in urine;
high security;
convenience of reception, good patient compliance.

It is important to distinguish ambulatory and nosocomial UTIs. In case of UTIs occurring outside the hospital, the main causative agent is E. coli (up to 86%), and other microorganisms are much less common: Klebsiella pneumoniae - 6%, Proteus spp. - 1.8%, Staphylococcus spp. - 1.6%, P. aeruginosa - 1.2%, Enterococcus spp. - one%. In nosocomial UTIs, E. coli also leads, but the role of other microorganisms and microbial associations increases significantly, multidrug-resistant pathogens are much more common, and the sensitivity to ABP differs between hospitals.

According to the data of multicenter studies carried out in Russia, the resistance of uropathogens to widely used ABPs, such as ampicillin and co-trimoxazole, reaches 30%. If the level of antibiotic resistance of uropathogenic E. coli strains in the region is more than 10–20%, this drug should not be used for empiric ABT. Ofloxacin, ciprofloxacin, norfloxacin have the highest activity against E. coli among PCs. On average, 4.3% of E. coli strains resistant to PC are isolated in Russia. Comparable data were obtained in the United States and most European countries. At the same time, for example, in Spain the level of E. coli resistance to PC is much higher - 14–22%. Regions with a higher level of E. coli resistance to PC also exist in Russia - these are St. Petersburg (13% of strains are resistant) and Rostov-on-Don (9.4%).

Analyzing the resistance of E. coli, the main causative agent of outpatient and inpatient UTIs in Russia, it can be argued that PCs (ofloxacin, ciprofloxacin, etc.) can serve as drugs of choice for empirical treatment uncomplicated, and in some cases, complicated UTI.

The use of ofloxacin for the prevention and treatment of UTIs

Acute cystitis

Acute cystitis is the most common manifestation of UTI. The incidence of acute cystitis in women is 0.5–0.7 episodes of the disease per woman per year, and in men aged 21–50 years, the incidence is extremely low (6–8 cases per 10 thousand per year). The prevalence of acute cystitis in Russia, according to estimates, is 26–36 million cases per year.

In acute uncomplicated cystitis, it is advisable to prescribe short (3-5 days) courses of ABT.

However, in chronic recurrent cystitis, short courses of therapy are unacceptable - the duration of ABT for complete eradication of the pathogen should be at least 7-10 days.

For cystitis, ofloxacin is prescribed 100 mg 2 times a day or 200 mg 1 time a day. In chronic cystitis in young people, especially in the presence of concomitant sexually transmitted infections (in 20–40% of cases caused by chlamydia, mycoplasma or ureaplasma), ofloxacin is a priority among other PCs.

Acute pyelonephritis

Acute pyelonephritis is the most frequent illness kidneys in all age groups; women predominate among patients. Morbidity acute pyelonephritis is in Russia, according to estimates, 0.9-1.3 million cases per year.

Treatment of pyelonephritis is based on the use of effective ABT, subject to the restoration of urodynamics and, if possible, correction of other complicating factors (endocrine disorders, immunodeficiency, etc.). Initially, empirical ABT is performed, which, if necessary, is changed after receiving an antibioticogram; ABT should be long-term.

Ofloxacin can be used to treat pyelonephritis, taking into account its accumulation in the renal parenchyma and high concentrations in the urine, the drug is prescribed 200 mg 2 times a day for 10-14 days.

Prostatitis

Despite the advances in modern urology, the treatment of chronic prostatitis is still an unresolved problem. Etiopathogenetic concepts of chronic prostatitis suggest that infection and inflammation trigger a cascade of pathological reactions: morphological changes in the tissue of the prostate gland (RV) with a violation of its angioarchitectonics, persistent immune inflammation, hypersensitization of the autonomic nervous system, etc. Even after the elimination of the infectious agent, the listed pathological processes can persist, accompanied by severe clinical symptoms. Long-term ABT is recommended by many researchers as a component of the complex treatment of chronic prostatitis categories II, III, IV according to the classification of the US National Institutes of Health (NIH, 1995).

Acute prostatitis (category I according to NIH, 1995) in 90% of cases develops without previous urological manipulations, and in about 10% of cases it becomes a complication of urological interventions (pancreatic biopsy, catheterization Bladder, urodynamic research, etc.). The basis of treatment is a graded ABT for 2-4 weeks.

The vast majority of pathogens of bacterial prostatitis belong to the gram-negative microbes of the intestinal group (E. coli, Klebsiella spp., Proteus spp., Enterobacter spp., Etc.). Etiological factors can also be C. trachomatis, U. urealiticum, S. aureus, S. saprophyticus, Trichomonas spp., Pseudomonas spp., Anaerobes, etc. The drugs of choice for the treatment of prostatitis are PCs, which best penetrate the tissue and secretion of the pancreas and cover the main spectrum of causative agents of prostatitis. The condition for successful ABT in prostatitis is its sufficient duration - for at least 4 weeks, followed by bacteriological control.

Ofloxacin can be successfully used for the treatment of prostatitis, since it is highly active against chlamydia, and against mycoplasmas and ureaplasmas, its effectiveness is comparable to that of other PCs and doxycycline. In chronic prostatitis, ofloxacin is prescribed orally at 400 mg 2 times a day for 3-4 weeks. In acute prostatitis, stepwise therapy is carried out: the drug is first prescribed intravenously at 400 mg 2 times a day, switching to oral administration after normalization of body temperature and clinical improvement of the condition.

Pancreatic cancer and UTI

Molecular and genetic studies of recent years indicate that prostatitis can initiate the development of pancreatic cancer. Chronic inflammation activates carcinogenesis by damaging the cell genome, stimulating cell proliferation and angiogenesis. Research on the effectiveness of antibacterial and anti-inflammatory therapy in the prevention of pancreatic cancer is being actively pursued.

Inflammatory changes in the pancreas can lead to an increase in the level of prostate-specific antigen (PSA) in the blood. According to current recommendations, an increase in PSA levels is higher age norms is an indication for pancreatic biopsy. However, in the absence of changes suspicious for pancreatic cancer during digital rectal examination, it is possible to use antibacterial and anti-inflammatory therapy for 3-4 weeks, followed by control of the PSA level. If it normalizes, a pancreatic biopsy is not performed.

Benign RV hyperplasia and UTI

Benign RV hyperplasia

(BPH) and lower urinary tract infection symptoms are very common among men. The mainstay of medical treatment for BPH is a-blockers and 5a-reductase inhibitors. However, it is generally known that BPH is almost always accompanied by prostatitis, which often makes a significant contribution to clinical symptoms. Therefore, ABT in some cases is advisable for BPH. With a confirmed inflammatory process, ABT should be prescribed for a period of 3-4 weeks. The drugs of choice are PCs, taking into account the spectrum of their antimicrobial action and pharmacokinetic characteristics.

Prophylaxis for urological interventions

UTIs most often become a complication of such interventions as transrectal pancreatic biopsy, bladder catheterization, complex urodynamic examination, etc. According to modern standards, antibacterial prophylaxis of UTIs is mandatory before invasive urological interventions. This is because the cost and associated risks of antibiotic prophylaxis are much less than the risk and cost of treating UTIs. For the prevention of infectious complications in most transurethral manipulations, as well as in transrectal pancreatic biopsy, it is sufficient to prescribe one dose of PC 2 hours before the intervention (for example, 400 mg of ofloxacin).

An unresolved urological problem is catheter-associated infection. Colonies of microorganisms form the so-called biofilms on foreign materials, inaccessible to the action of ABP and antiseptics. ABP cannot eliminate the already formed biofilm, but there is evidence that prophylactic administration of PC (for example, ofloxacin, ciprofloxacin or levofloxacin) can prevent or slow down its formation.

Conclusion

Fluoroquinolones have been used successfully for many years to treat urinary tract infections. Ofloxacin meets the principles of rational antibiotic therapy of UTI, its use is advisable for the treatment and prevention of UTI - cystitis, pyelonephritis, prostatitis. The presence of oral and parenteral dosage forms of ofloxacin makes its use convenient in outpatient practice and in hospital.

Recommended reading
Laurent O.B., Sinyakova L.A., Kosova I.V. Treatment and prevention of chronic recurrent cystitis in women // Consilium medicum. 2004. Vol. 6. No. 7. P. 460–465.
Modern clinical guidelines on antimicrobial therapy / Ed. Strachunsky L.S. Smolensk, 2004.
Padeiskaya E.N., Yakovlev V.P. Antimicrobial drugs group of fluoroquinolones in clinical practice. M., 1998.
V.P. Yakovlev The place of ofloxacin in outpatient practice: experience of 15 years of use // Infections and antimicrobial therapy. 2000. T. 2. No. 5. P. 154-156.
V.P. Yakovlev Pharmacokinetic properties of ofloxacin // Antibiotics and chemotherapy. 1996. T. 41. No. 9. P. 24–32.
Granier N. Evaluation de la toxicite des quinolones en pediatrie // Les Quinolones en Pediatrie. Paris, 1994. P. 117-121.
Kahlmeter G. An international survey of the antimicrobial susceptibility of pathogens from uncomplicated urinary tract infections: the ECO-SENS project // J. Antimicrob. Chemother. 2003. V. 51. No. 1. P. 69–76.
Karlowsky J. A., Kelly L. J., Thornsberry C. et al. Trends in antimicrobial resistance among urinary tract infection isolates of Escherichia coli from female outpatients in the United States // Antimicrob. Agents Chemother. 2002. V. 46. No. 8. P. 2540–2545.
Kaygisiz O., Ugurlu O., Kosan M. et al. Effects of antibacterial therapy on PSA change in the presence and absence of prostatic inflammation in patients with PSA levels between 4 and 10 ng / ml // Prostate Cancer Prostatic Dis. 2006. V. 9. No. 3. P. 235–238.
Sugar L.M. Inflammation and prostate cancer // Can. J. Urol. 2006. V. 13. No. 1. P. 46–47.
Terris M. Recommendations for prophylactic antibiotic use in genitourinary surgery // Contemp. Urology 2001. No. 9. P. 12-27.
Warren J.W., Abrutyn E., Hebel J.R. et al. Guidelines for antimicrobial treatment of uncomplicated acute bacterial cystitis and acute pyelonephritis in women. Infectious Diseases Society of America (IDSA) // Clin. Infect. Dis. 1999. V. 29. No. 4. P. 745–758.

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

Ciprofloxacin

To classical fluoroquinolones, which have broad indications for use in respiratory infections of the lower respiratory tract and ENT pathology, includes Ciprofloxacin. Clinical experience application 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 for diseases caused by pneumococci.

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

Indications

As 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. For what diseases of the respiratory system and diseases of the ear, throat, nose, this drug from the group of classic fluoroquinolones is used:

Sharp and Chronical bronchitis(at the stage of exacerbation).
Pneumonia caused by various pathogenic microorganisms.
Inflammation of the middle ear, sinuses, throat, etc.

Contraindications

Like most drugs, Ciprofloxacin has its own 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). The exception is children with pulmonary cystic fibrosis who have developed infectious complications.
Pulmonary anthrax.

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

Progressive atherosclerotic lesion blood vessels brain.
Severe cerebral circulation disorders.
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 gravis.
Serious malfunction of the kidneys and / or liver.
Advanced age.

Side effects

According to clinical practice, adverse reactions in the prevailing majority of patients taking fluoroquinolones are infrequent. Let's list the undesirable effects that occur in about 1 in 1000 patients taking Ciprofloxacin:

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

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

special instructions

With extreme caution, Ciprofloxacin is prescribed to patients who are already taking medications that lead to an extension of the QT interval:

Antiarrhythmic drugs.
Antibiotics from the macrolide group.
Tricyclic antidepressants.
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 is recorded that drugs that reduce acidity in the gastrointestinal tract (antacids), and containing 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 drug overdose, the development of headache, dizziness, weakness, convulsive attacks, dyspeptic disorders, functional disorders from the kidneys and liver. There is no specific antidote. The stomach is washed, activated charcoal is given. If necessary, symptomatic therapy is prescribed. Closely monitor the patient's condition until complete recovery.

Levofloxacin

Levofloxacin belongs to the third generation fluoroquinolones. Possesses 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.

Food intake does not affect the absorption of Ciprofloxacin or Levofloxacin. Modern fluoroquinolones can be taken either before or after meals.

Indications

Levofloxacin is a broad-spectrum antibacterial drug. It is actively used for 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 a new generation of fluoroquinolones, this drug can not be prescribed in all cases. What are the contraindications to the use of Levofloxacin:

Allergic reaction to the drug or its analogues from the fluoroquinolone group.
Serious kidney problems.
Epileptic seizures.
Tendon lesions associated with previous fluoroquinolone therapy.
Children and adolescents.
Periods of bearing a child and breastfeeding.

Levofloxacin should be prescribed with extreme caution in elderly patients.

Side effects

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

Problems with the functioning of the gastrointestinal tract (nausea, vomiting, diarrhea, etc.).
Headache.
Dizziness.
Allergic reactions (skin rash, itching, etc.).
The level of essential liver enzymes rises.
Drowsiness.
Weakness.
Pain in muscles and joints.
Tendon damage (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), with the exception of extremely severe cases. When using antibacterial drugs for the treatment of elderly patients, it should be borne in mind that this category of patients may have impaired renal function, which is a contraindication for prescribing fluoroquinolones.

During therapy with Levofloxacin, patients who have previously suffered a stroke or severe traumatic brain injury may develop epileptic seizures (convulsions). If you suspect the presence of pseudomembranous colitis, you must immediately stop taking Levofloxacin and prescribe the optimal course of therapy. In such situations, it is strongly discouraged to use drugs that inhibit intestinal motility.

Although rare, there may be cases of tendon inflammation (tendonitis) when using Levofloxacin. Older patients are more prone to this kind of adverse reactions. Concomitant use of glucocorticosteroids significantly increases the risk of tendon ruptures. If there is a suspicion of tendon lesions (inflammation, ruptures, etc.), fluoroquinolone therapy is discontinued.

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 response (for example, driving). In addition, due to the risk of developing photosensitization, refrain from excessive exposure of the skin to ultraviolet rays.

Which drug should you choose?

How to determine which is better than 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 is one that is not only effective, but also less toxic and available. 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. Nevertheless, 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 sensitive 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 intestines 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 prescribed 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 second or third generation fluoroquinolones complain of headache, dizziness, weakness, increased fatigue, and sleep disturbance.

In elderly patients, especially with glucorticosteroid therapy, tendon ruptures are possible. Due to the risk of developing joint lesions, fluoroquinolones are limited in use during periods of gestation and breastfeeding, as well as in childhood.

Currently, for most patients, the price aspect is of paramount importance. A package 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.

At the same time, the final decision as to what is best for the patient, Ciprofloxacin or Levofloxacin, is made exclusively by the attending physician.

Levofloxacin: Analogs, Review of Essential Medicines 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 a man's unsatisfactory attitude to his health, poor ecology, poor-quality food, etc.

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

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

Levofloxacin analogs have the following properties:

They have a wide and active range of effects on the body.
They are able to quickly penetrate into the tissues of the prostate.
They show a high degree of activity and directed action.

Before taking the medicine, you should read all the information that the instructions for taking the medicine 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 release form, are presented on the market in large quantities.

Tavanic is the same effective antibiotic that is prescribed for a variety of diseases. Characterized high degree drug activity and impact on groups of harmful microorganisms, its use allows you to obtain positive treatment results 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, solution for injections, it will cost you 1620 rubles.

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

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

Eleflox, produced by 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 quickly responds to therapy.

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

Levofloxacin belongs to the group of fluoroquinols. The same group with the active substance levofloxacin includes:

All antibiotics in this group are very effective in the treatment of prostatitis. Therefore, your choice of a drug can only be influenced by the presence of an individual intolerance to the components of one of them, the severity of the disease at 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 can be expected, what contraindication in your case, may affect the choice of the 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 ingredient - levofloxacin, which quickly enters the bloodstream, then it is taken by the plasma and distributed to all tissues of the body.

The drug Levofloxacin has an active effect on various tissue areas 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 disease causing: anaerobic gram-positive and gram-negative, simple microorganisms and chlamydia. With all these "pests" the drug fights very effectively.

Tavanic is a latest generation antibiotic with high rates 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.

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 ingredient - 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 more quick action and the spectrum of its impact is much wider.

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

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

The average daily dose of the drug at each dose ranges from 500 ml to 1 g, depending on the form of the disease in which the prostate gland is located. 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 food intake, because the mucous membrane quickly absorbs the substances of the drug.

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

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

Levofloxacin or Ciprofloxacin: Comparative Evaluation of Drugs

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

The drug is prescribed by a doctor who calculates daily dose medicines.

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 is that the former 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 case on a case-by-case basis.

The main difference between the two antibiotics is the active substance: in the first drug 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 different degrees of sensitivity to ofloxacin, therefore, prostatitis therapy may be different due to the causes of the disease and the effectiveness of treatment may also differ.

Levofloxacin Astrafarm: 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 for effective treatment bacterial chronic prostatitis.

During therapy with Levofloxacin, positive dynamics is observed already in the middle of treatment, and this happens regardless of the form of the disease.

If we talk about Levofloxacin Astrafarm 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 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 in the active substance, features of the therapeutic effect and indications for admission

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

The drug Levofloxacin, analogs 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 it is prescribed for patients with otitis media, sinusitis, sinusitis, pharyngitis, etc. The active ingredient of this medication 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, as well as have more cheap 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 to use 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, solution for injection, as well as eye drops... As for the pharmacological effect, this drug is a potent antibiotic that helps to destroy pathogenic infectious foci.

Levofloxacin, like its main substitutes, is contraindicated in pregnancy, childhood, severe kidney and liver diseases. Elderly people need to take such a drug strictly under the supervision of a doctor.

Analogs

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

Analogs for the active ingredient of the drug.
Pharmaceutical group analogs.

By active substance

Analogues of Levofloxacin, which will be presented below, can be prescribed for the treatment of pneumonia, sinusitis, protracted bronchitis, all kinds of 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.

The most effective analogues of Levofloxacin (based on the active ingredient) are:

Levofloxacin, as well as generics, should be taken in the morning before meals. For 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 for the infection to be completely suppressed.

As for the side effects from analogs of Levofloxacin, compared to the drugs of the previous generation, 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, improved functioning of the heart, kidneys and digestive system.

According to the quinolone generation

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

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

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

The price for such an analogue of the drug is 340 rubles per pack (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 the drug Tavanik, which is produced by a French manufacturer. Many patients do not know whether Tavanic or Levofloxacin is better.

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

Tavanic or Levofloxacin (which is better for adults, the attending physician must 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 medicines are available over the counter.

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 to Levofloxacin, Moxifloxacin has the following advantages:

The drug has a broader 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 urinary tract infections.
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. It is allowed to use these drugs only as directed by a doctor, with strict adherence to the dosage. If treatment is necessary for children, it is important that the therapy is supervised by a specialist.

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

Articles

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

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

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

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

The question of the role of non-clostridic 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 probable 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 CP patients.

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

BRANDS of 19

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

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

They are distinguished by a high degree of effectiveness and have a wide spectrum of action. Among the most popular drugs are Ciprofloxacin and Levofloxacin.

These analogous 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 diseases. Respiratory infections are no exception.

Both drugs are successfully used in the treatment of progressive 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 against them.

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

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

Indications for use

The absolute indications for the use of Ciprofloxacin are:

acute bronchitis, and exacerbations of the disease in a chronic form;
severe tuberculosis;
pulmonary inflammation;
infections resulting from cystic fibrosis;
otitis media - otitis media;
sinusitis;
frontal;
pharyngitis;
tonsillitis;
complicated infections and inflammations of the urinary system;
chlamydia;
gonorrhea;
infectious diseases of the gastrointestinal tract;
infectious skin lesions, burns, ulcers and a number of others.

Medicine can be used in the treatment of postoperative infectious complications.

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

Ciprofloxacin has its own contraindications and side effects. In most cases, the drug is easily tolerated, but against the background of its administration, there may be:

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

The drug is not prescribed for women during pregnancy and lactation, as well as for children under 15 years of age. An antibiotic should be used with caution in case of 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 sensitive to Levofloxacin.

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

The drug is used for pulmonary tuberculosis. The spectrum of its action in this respect is completely identical to Ciprofloxacin. With 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 an infectious nature of the ENT organs;
infections developing against the background of cystic fibrosis;
inflammation of the genitourinary system: pyelonephritis, inflammation of the prostate, chlamydia;
abscesses of soft tissues;
furunculosis.

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

Levofloxacin has several forms of release. Today, drops, tablets and infusion solutions can be purchased in domestic pharmacies.

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, sleepy;
inflammation of the tendons;
acute liver failure;
depression;
rhabdomyolysis;
neutropenia;
hemolytic anemia;
asthenia;
exacerbation of porphyria;
exacerbation of epilepsy;
the development of a secondary infection.

Contraindications to taking the drug are:

a tendency to develop an allergic reaction to certain medicinal components, i.e., individual intolerance;
unhealthy kidneys;
epilepsy;
medicinal damage to the tendons associated with treatment with fluoroquinolone antibacterial drugs.

Levofloxacin is not prescribed for women during pregnancy and during breastfeeding, as well as for children and adolescents. Caution should be exercised by patients with renal pathologies and persons of a geriatric profile.

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

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

Due to the potential for photosensitivity, it is recommended that you stay in direct sunlight as little as possible.

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

In order not to be mistaken in the choice and purchase one of the above drugs, it is necessary to determine which one is better. The advice of a specialist will not be superfluous in solving this issue. 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 ingredient of Ciproflaxacin is ciproflaxacin; Levofloxacin contains the main component of Levofloxacin.

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

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

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

Photo 3. Packaging of Levofloxacin in the form of a solution for intravenous infusion with a dosage of 5 mg / ml. Manufacturer "Belmedpreparaty".

Both fluoroquinolones are well tolerated by the body, have excellent oral absorption and have been successfully used as an effective drug against tuberculosis. Levofloxacin shows great efficiency in this regard, because it is used in the form of intravenous injections.

The concentration of the active substance in the tablets is lower than in the second preparation. Levofloxacin is more often prescribed as the only drug for monotherapy. Eating is irrelevant during treatment. Both those and other tablets can be drunk both before and after meals.

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

attacks of nausea, accompanied by vomiting;
headache;
dizziness;
rapid fatigability, fatigue;
insomnia.

Contraindications for taking both drugs are identical.

Price difference

In terms of price, Ciprofloxacin is more readily available. One package of the medicine (500 mg) can be bought at a pharmacy for 80 rubles. Levofloxacin will cost at least 250 rubles per package. Both medicines are available with a prescription only.

Useful video

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

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An online magazine about tuberculosis, lung diseases, analyzes, diagnostics, medications and other important information about this.

To date, in otolaryngology and pulmonology, various antibacterial agents are considered one of the main drugs. Due to their high efficiency, drugs from the fluoroquinolone group 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 than levofloxacin or ciprofloxacin. To give a thorough answer, one should 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 for diseases caused by pneumococci.

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

Indications

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

Contraindications

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

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

Progressive atherosclerotic lesions of the blood vessels of the brain.
Severe cerebral circulation disorders.
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 gravis.
Serious malfunction of the kidneys and / or liver.
Advanced age.

Side effects

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

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

special instructions

With extreme caution, Ciprofloxacin is prescribed to patients who are already taking medications that lead to an extension of the QT interval:

Antiarrhythmic drugs.
Antibiotics from the macrolide group.
Tricyclic antidepressants.
Antipsychotics.

In case of an overdose of the drug, the development of headache, dizziness, weakness, convulsive attacks, dyspeptic disorders, functional disorders of the kidneys and liver is possible. There is no specific antidote. The stomach is washed, activated charcoal is given. If necessary, symptomatic therapy is prescribed. Closely monitor the patient's condition until complete recovery.

Levofloxacin

Levofloxacin belongs to the third generation fluoroquinolones. Possesses 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 susceptible to more modern drugs such as Levofloxacin.

Food intake does not affect the absorption of Ciprofloxacin or Levofloxacin. Modern fluoroquinolones can be taken either before or after meals.

Indications

Levofloxacin is a broad-spectrum antibacterial drug. It is actively used for 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 a new generation of fluoroquinolones, this drug can not be prescribed in all cases. What are the contraindications to the use of Levofloxacin:

Allergic reaction to the drug or its analogues from the fluoroquinolone group.
Serious kidney problems.
Epileptic seizures.
Tendon lesions associated with previous fluoroquinolone therapy.
Children and adolescents.
Periods of childbearing and breastfeeding.

Levofloxacin should be prescribed with extreme caution in elderly patients.

Side effects

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

Problems with the functioning of the gastrointestinal tract (nausea, vomiting, diarrhea, etc.).
Headache.
Dizziness.
Allergic reactions (skin rash, itching, etc.).
The level of essential liver enzymes rises.
Drowsiness.
Weakness.
Pain in muscles and joints.
Tendon damage (inflammation, tears, etc.).

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

special instructions

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.

Which drug should you choose?

Efficiency.
Safety.
Availability.

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

At the same time, the final decision as to what is best for the patient, Ciprofloxacin or Levofloxacin, is made exclusively by the attending physician.

Treatment of inflammation of the prostate gland is carried out in a comprehensive manner. One of the ways is antibiotic therapy. Ciprofloxacin helps to quickly destroy the infection that caused prostatitis. Reviews of people who took the drug indicate that the drug is tolerated normally, in many cases there are no side effects if the dosage and duration of administration are not violated.

But no matter how effective the drug is, one should not forget that only a doctor can prescribe it!

Why the drug is popular

Prostatitis ranks first among male diseases. Every second representative of the stronger sex is diagnosed with inflammation of the prostate or adenoma. Moreover, the disease is insidious in that it can be asymptomatic.

It is imperative to carry out prevention for men who are at risk, namely, with:

sedentary lifestyle;
lack of regular sexual intercourse;
promiscuous sex life;

Special attention should be paid to their health to men who have crossed the threshold of the 45th birthday.

Ciprofloxacin is a broad-spectrum antibiotic.

It is prescribed for the treatment of not only inflammation of the prostate gland, but also multiple pathologies of the genitourinary system caused by bacteria.

Most often, an antibacterial agent is used to treat advanced stages of inflammation of the prostate gland.

Treatment with pills helps to eradicate such an infection:

streptococci;
colibacillus;
staphylococci;
chlamydia;
gonococci;
gardnerella;
mycoplasma;
ureaplasma.

Available in the form of tablets, solution for injection. The drug contains the main component - ciprofloxacin hydrochloride and additional trace elements. Effective treatment in a complex, for example, pills, physiotherapy, rectal suppositories, prostate massage.

The advantageous sides of Ciprofloxacin:

During administration, the optimal therapeutic concentration in the prostate is achieved.
Stops the development and growth of multiple types of bacterial infection.
The tablets are well tolerated by men.

The action of the drug is based on stopping DNA synthesis in the cells that cause prostatitis. Begins to act immediately after taking the first pill.

Another advantage active substance medication - suppression not only of active harmful microorganisms, but in a dormant state. This is especially true during therapy for inflammation, which may be asymptomatic.

Ciprofloxacin has analogues for the treatment of inflammation:

Tsiprolet.
Tsiprobay.
Cyprinol.
Alcipro.
Afenoxin.
Basigen.
Betacyprol.
Vero-Ciprofloxacin.
Zindolin 250.
Ifypro.
Quintor.
Quipro.
Liprokhin.

Are there any contraindications

Like any drug, Ciprofloxacin has contraindications. As an antibacterial agent, it can cause an allergic reaction.

Antibiotic treatment is not prescribed for:

diseases of the ligaments and tendons;
allergies to constituent components;
concomitant use of Tizanidine;
epilepsy, neuroses.

The medicine is prescribed only by a doctor.

The scheme and duration of admission depends on the presence of minor pathologies, the age of the patient, the presence of allergies, the stage and type of the disease.

In addition, to prescribe the drug, it is necessary to undergo an examination and find out what bacteria caused the inflammation.

Self-treatment can lead to complications. The specified duration must be respected. Many men, after taking the pill for several days and feeling relief, a decrease in symptoms, stop taking it. In this case, the infection may not yet be completely suppressed, the treatment will be incomplete.

The tablets have a prolonged action. Another common mistake is taking a double dose of medication. Many believe that this will make recovery faster. But this is an absolute delusion. A person will receive nothing, except for side effects.

It is forbidden to take alcohol while taking an antibacterial agent. Ethanol molecules completely stop the action of the components of Ciprofloxacin.

The full effect will not come, the infection will not be suppressed.

In case of an overdose, the following conditions may occur:

upset stool;
nausea and vomiting;
pain in the stomach;
sleep disturbance;
increased heart rate;
allergic dermatitis on the skin, urticaria.

During treatment, in parallel, you need to take drugs that restore the intestinal microflora. The only drawback of an antibiotic is the ability to destroy beneficial bacteria in the body along with a pathogenic infection. It is also useful to take fermented milk products to restore intestinal flora.

Take with caution if non-steroidal anti-inflammatory drugs (except for acetylsalicylic acid) are prescribed in parallel. In this case, convulsive states may develop.

Opinion about the drug

Vladimir, 58 years old, Moscow

Recently I fell ill with prostatitis. I am taking Ciprofloxacin. The tablets are well tolerated, without any side effects. On the third day, urination was restored, the need to get up at night to use the toilet disappeared.

Alexander 39 years old, St. Petersburg

One of the advantages is the inexpensive cost of the drug, but at the same time it is very effective. There is no unpleasant aftertaste. The doctor prescribed Vitaprost to take during the treatment.

Natalia, 41 years old, Moscow

My husband was taking these pills for prostatitis. I won't say anything bad. There were no side effects. Recently I got sick with cystitis. I was surprised when my doctor also prescribed Ciprofloxacin. The cystitis symptoms disappeared within 2 days.

Nikolay, 37 children, Moscow

In addition to the fact that the instructions for use can be read only under a magnifying glass, I cannot say anything bad about the drug. Prescription pills are available.

Andrey Ivanovich, 48 years old, urologist, Moscow

Oksana, 39 years old, St. Petersburg

These tablets are prescribed for diseases of the genitourinary system. My husband was appointed in 2014. I drank, there were no side effects.

Evgeniy, 45 years old, Moscow

Before starting the treatment of prostatitis with these pills, I read the reviews and decided to undergo tests for allergies and antibiotics. There are no allergies, as well as side effects.

Dmitry, 41 years old, Moscow

A good antibiotic. Helped me with prostatitis.

Alexander, 44 years old, Moscow

Tell me, can you drink these pills with chronic prostatitis?

Evgeny Alexandrovich, urologist, Moscow

If inflammation occurs against the background of an infection, then the doctor may prescribe Ciprofloxacin, if the etiology is non-infectious, then there is no point in drinking an antibiotic.

Prostatitis is a common prostate disorder that affects many men around the world. Inflammation of the organ is caused by a number of reasons, which is important to consider when determining the tactics of treatment for each specific patient. The scheme is drawn up on an individual basis and very often it is not possible to do without antibacterial drugs.

List of antibiotics for prostatitis: pros and cons
Eleflox

Tavanik

Tsifran

Tsiprobay

Cyprinol

Zanocin

Ofloxin

Unidox Solutab

Suprax

Cefotaxime

Ceftriaxone

Claforan

Amoxiclav

Flemoklav solutab

Augmentin

Flemoxin solutab

Gentamicin

When is antibiotic treatment indicated?

Prostatitis can be caused by bacteria, or it can be non-infectious. In the latter case, antibiotics are usually not required. They should be taken if prostatitis has an acute or chronic course against the background of bacterial damage to the prostate gland. In this case, the severity of the symptoms does not matter. Chronic bacterial prostatitis often occurs without any signs of inflammation. In addition, the appointment of antibacterial agents may be due to test therapy, even against the background of abacterial inflammation.

It is very important to observe all points of the diagnosis of prostatitis in order to find out the cause of the inflammation, identify the pathogenic agent and determine its individual sensitivity to a particular drug:

The first stage of diagnostic research. The first stage includes:

Blood sampling for clinical analysis.

Collection of urine for bacterial inoculation, for a three-glass sample.

Collection of scrapings of the urethral epithelium for the detection of STIs by PCR, including chlamydia, mycoplasmosis, gonorrhea, etc.

Sampling of prostate secretions for comprehensive examination.

Ultrasound examination of the prostate gland.

Taking blood to determine the level of PSA in it, which makes it possible to exclude prostate cancer.

The second stage of diagnostic studies: When the content of leukocytes in the prostatic secretion does not exceed 25, then testing with the drug Omnik (tamsulosin) is indicated. It is taken for a week, after which the secret is taken for analysis again.

The examination results determine the type of prostatitis

Abacterial prostatitis. When a leukocyte jump does not occur even while taking the Omnik drug, and bacteria are not detected in the crops, the inflammation of the prostate gland is defined as non-bacterial. This condition is called pelvic pain syndrome and requires symptomatic treatment.

At the same time, the patient is awaiting the result of tests for tuberculosis, which will be ready in at least 10 weeks. If they are positive, then the patient is placed in an anti-tuberculosis dispensary (in the urology department).

Tuberculous prostatitis. A prostate biopsy can be used to identify the disease. The infection most often affects not only the prostate gland, but also the epididymis, urinary system, seminal vesicles. Despite the fact that in Russian Federation tuberculosis becomes epidemic, and not only the lungs are affected, but also other organs, the diagnosis of this disease presents certain difficulties. The danger also lies in the fact that more and more special forms of the disease are caused by bacteria resistant to therapy.

Tuberculosis of the genitourinary system of men often develops latently, without giving acute symptoms. Laboratory tests can give a false negative result, especially if a man takes antibiotics for prostatitis from the fluoroquinlone group.

Symptoms that may indicate prostate tuberculosis are subfebrile condition, aching or burning pain in the perineum, in the lumbosacral region, increased fatigue. The age of patients in whom tuberculous prostatitis is most often detected is in the range between 20-40 years.

Bacterial infectious prostatitis. In the event that the analysis of prostate secretion indicates leukocytosis with an increase in the number of leukocytes of more than 25, and taking Omnik makes this indicator higher, then it makes sense to talk about bacterial or latent infectious prostatitis. Antibiotic therapy in this case is mandatory.

The PCR method allows you to identify the existing causative agents of genital infection after a day, so the doctor will be able to recommend taking this or that drug when you visit again. The drug of choice remains the agent for which the established flora has the maximum sensitivity, or an antibiotic is prescribed that is active against most pathogenic agents.

If the effect of the treatment is absent, then it is necessary to wait for the result of bacteriological inoculation, which makes it possible to more accurately determine the choice of the agent.

What antibiotics are most effective for prostatitis?

It is impossible to determine any specific antibiotic for bacterial prostatitis that would help all men without exception in treatment. It all depends on the sensitivity of the microbes that caused the disease in each case.

Self-therapy with the use of antibacterial and other means, self-diagnosis of the disease is impossible. An effective drug can be selected only when a specific bacterial agent is known, after doctors have established its susceptibility to drugs. Only the doctor decides how long the treatment will need to be carried out, what doses of the drug are needed for this. Most often, experts prescribe drugs with a wide spectrum of action.

If specific bacteria are not detected, then they recommend taking medications based on the culture of prostate secretions. There, nonspecific streptococci and staphylococci are most often identified.

Treatment involves an integrated approach and does not last for 30-60 days:

An antibacterial agent is prescribed.

The intake of NSAIDs is shown.

You should take funds aimed at normalizing blood circulation.

Immunostimulating therapy is being carried out.

The intake of vitamin complexes or monovitamins is prescribed.

In some cases, herbal medicine is prescribed.

Heat microwave therapy, prostate massage can be performed only when tuberculosis is excluded. Otherwise, the disease may worsen, which will worsen the patient's condition.

Sedative drugs, antidepressants are recommended for men with chronic prostatitis against the background of the development of depressive moods, with a deterioration in the quality of life. In this case, psychotropic drugs are auxiliary.

Depending on which pathogen is identified, one or another antibiotic for prostatitis is selected.

The sensitivity of pathogenic microorganisms to antibacterial drugs is presented in the table:

	Tetracycline drugs	Penicillin group drugs	Cephalosporins	Macrolides	Fluoroquinolones
Mycoplasma
Ureaplasma
Chlamydia
Gonococci
Enterococci
Enterobacteriaceae

Klebsiella
Pseudomanade

Tuberculosis bacteria
Colibacillus

It should not be ruled out that mycotic microorganisms are the cause of the development of inflammation of the prostate gland. Therefore, in complex therapy it is possible to prescribe the following drugs: Safotsid, Fluconazole, Azithromycin and Secnidazole.

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List of antibiotics for prostatitis: pros and cons

Preparations from the group of fluoroquinolones are prescribed by modern practicing urologists more often than others. They are highly effective in treating bacterial prostatitis. chronic course, however, they can have a negative effect on the functioning of the brain, cause mental disorders, and reduce the resistance of skin cells to ultraviolet light. Before starting treatment with fluoroquinolones, it is necessary to make sure that there is no Koch's bacillus in the body. Medicines of this group are used for the treatment of tuberculosis, but it should be complex with the inclusion of anti-tuberculosis drugs in the therapeutic regimen. Therapy with fluoroquinolones alone will cause the tuberculosis bacteria to develop drug resistance and it will be very difficult to get rid of them in the future. A situation is considered dangerous when a man underwent a course of treatment with fluoroquinolones, his condition returned to normal, and after 30-60 days deterioration occurred again. In this case, repeated taking of tuberculin samples is necessary.

The following antibiotics of this group are used:

Based on Levofloxacin (Eleflox, Tavanik);

Based on Ciprofloxacin (Tsifran, Tsiprobay, Tsiprinol);

Based on Ofloxacin (Zanocin, Ofloxin).

Preparations of the tetracycline group. In recent years, they have been used less and less, as they have a lot of side effects. The exception is Doxycycline (Unidox Solutab), which is somewhat easier for patients to tolerate.

Intramuscularly administered drugs from the group of Cephalosporins are Suprax, Cefotaxime, Ceftriaxone, Kefadim, Claforan, Cefspan and others.

Of the drugs of the penicillin series, Amoxiclav, Flemoklav solutab, Augmentin, Flemoxin solutab are prescribed.

As for macrolides, no studies have been conducted to confirm their effectiveness against bacterial prostatitis. However, if we reason logically, macrolides are agents with low toxicity, they have high activity against some bacteria, especially against mycoplasma and chlamydia. Therefore, theoretically, their use for inflammation of the prostate is possible. These are such agents as: Fromilid with the active ingredient Clarithromycin and Sumamed, or Zitrolide with the active ingredient Azithromycin.

In the treatment of prostatitis, it is very important that the drug can penetrate the tissues of the prostate and accumulate there in the organ. Such capabilities are possessed by drugs of the group of fluoroquinolones, macrolides and aminoglycosides (Gentamicin). If a patient comes with an acute stage of inflammation, then for its early elimination, it is possible to use several antibiotics for prostatitis at once.

Eleflox

Eleflox is an antibacterial drug from the group of fluoroquinolones with the main active ingredient Levofloxacin. The drug is available in tablets and in solution for infusion. Eleflox is the drug of choice in the treatment of prostatitis.

The main advantage of Eleflox is its high activity against gram-positive and gram-negative bacteria, which most often provoke the development of prostatitis. Among such microorganisms: Escherichia coli, Klebsiella, Proteus mirabilis, Fecal enterococcus, Pseudomonas aeruginosa, Ureaplasma, Chlamydia and Mycoplasma. Thanks to taking the drug Eleflox, improvement occurs after a few days.

Another advantage of the drug is its proven microbiological and clinical efficacy. It has a high pharmacokinetic profile and penetrates well into the tissues of the prostate gland, which is essential for successful treatment prostatitis.

Eleflox based on Levofloxacin is a second-generation fluoroquinolone drug, it is twice better tolerated by patients than the first-generation fluoroquinolones, and also shows high efficiency against penicillin-resistant bacterial strains. This is a significant advantage of the drug.

It was found that after taking the drug, its concentration in the prostate gland is 4 times higher than the concentration in blood plasma. As a result, the bacteria inhabiting the prostate tissue quickly die, since Eleflox causes profound changes in the cytoplasm, membranes and cell wall of pathogenic microorganisms.

The next advantage of the Eleflox drug is that it is available both in the form of tablets and in the form of a solution for infusion. Therefore, you can choose the method of taking the drug that will be optimal for a particular patient.

The main disadvantage of the drug is the presence of contraindications to its use. It is strictly forbidden to take it for the treatment of prostatitis in the event that a person has a suspicion of tuberculosis. The fact is that fluoroquinolones are included in the treatment regimen for tuberculosis, but effective therapy will require the simultaneous administration of several antibiotics at once. If a person infected with Koch's bacillus takes Eleflox to treat prostatitis, then anti-tuberculosis therapy may not work in the future. Other contraindications include epilepsy, hypersensitivity to fluoroquinolones in general, and age under 18.

One of the disadvantages of the drug is its high cost, which starts from 700 rubles and more for tablets, and from 420 rubles for a solution.

It is worth noting such a minus of the Eleflox drug as side effects that can develop against the background of its use. Among them are various allergic reactions, nausea, diarrhea, headaches, dizziness, increased heart rate, etc.

When treating with Eleflox, it should be remembered that it is capable of interacting with other drugs, which can also be attributed to its disadvantages. For example, when taken simultaneously with glucocorticosteroids, the risk of tendon rupture increases. Therefore, it is necessary to start treatment with this antibacterial drug only after a medical examination.

Tavanik is an antibacterial drug for the treatment of prostatitis with the main active ingredient Levofloxacin. Tavanic belongs to fluoroquinolones.

The main advantage of Tavanic is its broad spectrum of antibacterial activity. Moreover, it is effective against most bacteria that are the causative agents of infectious prostatitis. These are not only gram-positive and gram-negative microorganisms, ureaplasmas, mycoplasmas, gonococci, but also anaerobes. Escherichia coli, which very often causes inflammation of the prostate, is sensitive to the drug Tavanic.

Tavanic belongs to the second generation antibiotics-fluoroquinolones, that is, it shows a higher activity in terms of getting rid of various bacteria and is better tolerated by patients.

The drug is produced by the well-known group of companies Sanofi Aventis, which is one of the global leaders in the field of healthcare. This means that the drug meets all international safety requirements and has passed all the necessary clinical trials.

Another advantage of Tavanic is its high ability to penetrate and accumulate in the tissues of the prostate. Moreover, the intracellular concentration of the main active substance is 8-9 times higher than its extracellular concentration. This allows you to effectively use the drug Tavanik for the treatment of intracellular causative agents of prostatitis - chlamydia, ureaplasma and mycoplasma.

It is worth noting such a plus of the Tavanic drug as the presence of several dosage forms: it is available in tablets with various dosages and in the form of a solution for infusion.

The main disadvantage of Tavanic is the presence of contraindications to its use. These include: epilepsy, hypersensitivity to fluoroquinolones, age under 18, the presence of tendon lesions during treatment with quinolones. Do not prescribe a drug for the treatment of prostatitis in people with suspected tuberculosis. Therefore, if in doubt, it is necessary to take the appropriate tests.

The disadvantages of the drug include side effects. More often than others, there are: diarrhea, nausea, headache, drowsiness, sleep disturbances, asthenia, possibly an increase in hepatic transaminases. Other side effects are less common - fever, liver reactions, tendon ruptures, etc.

With caution, the drug should be taken against the background of treatment with other drugs. For example, with NSAIDs, glucocorticosteroids, vitamin K antagonists, cimetidine, etc.

The last drawback of the drug Tavanic can be considered its high cost. So, the price for 5 tablets with a dosage of 500 mg starts from 590 rubles. A bottle with a solution for infusion costs from 1250 rubles.

Tsifran is an antibacterial drug from the group of fluoroquinolones, with the main active ingredient Ciprofloxacin. Tsifran is the drug of choice in the treatment of prostatitis.

The main advantage of Tsifran is its high activity against bacteria that cause inflammation of the prostate gland. It is prescribed for prostatitis caused by microbes of the intestinal group (Escherichia coli, Klebsiella, Proteus, Enterobacter, etc.). Trichomonas, ureaplasma, Staphylococcus aureus, chlamydia trachomatis, anaerobic bacteria and other pathogenic flora that can provoke the development of inflammation of the prostate gland react well to Tsifran.

The advantage of the drug Cifran is that it begins to act very quickly. This is possible due to the high bioavailability of the medicinal substance, which in high concentrations accumulates in the tissues of the prostate. In such conditions, bacteria lose their vitality, and recovery occurs.

Due to the clinically proven efficacy of Tsifran in the treatment of prostatitis, it is prescribed not only to get rid of the acute, but also the chronic form of the disease. And also Tsifran fights more effectively with Pseudomonas aeruginosa, in comparison with preparations based on Levofloxacin.

The advantages of the drug include its relatively low cost, which is about 300 rubles.

Cifran, with the main active ingredient Ciprofloxacin, belongs to the first generation fluoroquinolones, while there are already 2 generation drugs. Therefore, when treating prostatitis with Cifran, there is a higher risk that the bacteria will be resistant to it. In addition, first-generation fluoroquinolones are less well tolerated by patients than second-generation drugs. This can be attributed to the disadvantages of the drug.

Tsifran has moderate activity against atypical causative agents of inflammation in the prostate gland, which somewhat limits its scope. The disadvantages of Tsifran can also include the presence of side effects, including: nausea, diarrhea, skin rash, mucosal candidiasis, hepatitis, eosinophilia, arthralgia, headaches, sweating, urticaria, taste disturbances, etc.

The drug should not be used for the treatment of children under 18 years of age, for the treatment of patients with pseudomembranous colitis. It is not prescribed for people with a history of hypersensitivity to fluoroquinolones.

Tsiprobay

Tsiprobay is the antibacterial drug of choice in the treatment of prostatitis. It belongs to the group of fluoroquinolones, the main active ingredient in it is Levofloxacin.

Tsiprobay is an antibacterial drug that has a detrimental effect on gram-positive and, to a greater extent, on gram-negative bacteria, which are common causative agents of prostatitis. It has been proven to be highly effective against chlamydia, mycoplasma, ureaplasma, gram-negative bacteria of the intestinal group, and anaerobes.

When taken orally, the drug is rapidly absorbed and well distributed throughout the tissues, accumulating in high concentrations in the prostate gland. This leads to the death of pathogenic flora and quick release from illness.

Another advantage of the drug is two forms of release: solution for infusion and tablets, which makes it possible to treat prostatitis more effectively, starting with intravenous administration of the drug, and then switching to oral administration.

The drug is produced by the well-known pharmaceutical company Bayer, which has been developing and selling medicines since 1863. Therefore, you can be sure that Tsiprobay is a high-quality antibiotic that has passed all the necessary clinical trials.

The price of the drug is relatively low; you will have to pay about 370 rubles for the packaging of tablets in a dosage of 500 mg.

Tsiprobay is a first generation fluoroquinolone. Therefore, the risk of developing resistance in bacteria to the drug is higher than to second-generation fluoroquinolones. This can be considered the main drawback of the drug.

The second disadvantage of the drug Tsiprobay is the presence of contraindications to its use, including: age under 18 years old, epilepsy, organic lesions brain, mental illness... The drug is prescribed with caution to the elderly.

The third drawback of the drug can be called the presence of side effects - these are fungal lesions of the mucous membranes, eosinophilia, impaired appetite, diarrhea and nausea, headache, taste distortion, sleep disturbance, etc.

Before starting treatment, you must definitely visit a doctor, since the drug is capable of interacting with other drugs, which can provoke an increase in side effects.

Cyprinol

Tsiprinol is an antibacterial drug with the main active ingredient Ciprofloxacin. Tsiprinol belongs to the group of first generation fluoroquinolones and is the drug of choice for the treatment of prostatitis.

The main advantage of the drug Tsiprinol is its pronounced bacteriostatic activity against most causative agents of prostatitis. The drug has a wide spectrum of action, inhibiting the enzyme DNA gyrase of bacteria, which leads to the impossibility of starting the process of protein synthesis in their cells. As a result, the pathogenic flora perishes.

The drug has low toxicity to humans, since DNA gyrase is absent in its cells.

Another plus of Tsiprinol is its high activity against bacteria that are resistant to aminoglycosides, penicillins, cephalosporins and tetracyclines. Prostatitis provoked by gram-negative bacteria (enterobacteriaceae, Escherichia coli, Shigella, Pseudomonas, Moxarella, Legionella, Listeria, etc.) responds well to treatment with Tsiprinol. Some gram-positive aerobes are sensitive to the drug: staphylococci and streptococci.

An important advantage of the drug is that it has a high bioavailability and accumulates in high concentrations in the tissues of the prostate gland. Tsiprinol is able to destroy bacteria that multiply and that are dormant.

Another advantage of the drug Tsiprinol is its affordable price... So. For 10 tablets of 500 mg, you will have to pay about 120 rubles.

The main disadvantage of the drug is that some bacteria may not be sensitive to it. For example, corynebacteria, bacteroids fragilis, some types of pseudomonas, treponema. Bacteria that are resistant to methicillin are resistant to Ciprinol. The drug is a first-generation fluoroquinolone, while second-generation antibiotics have been developed, which have a higher antimicrobial activity and are better tolerated by patients.

Another disadvantage of the drug is that it has a number of side effects. Most often, patients complain of nausea and diarrhea, although the development of a fungal infection, pseudomembranous colitis is possible, sometimes allergic reactions occur, up to angioedema and anaphylactic shock. Changes are possible on the part of metabolism, on the part of the nervous system, organs of vision, etc. However, the frequency of side effects is not high and most often Ciprinol is well tolerated by patients.

It is worth noting such a minus of the drug as contraindications to its use. It is strictly forbidden to prescribe Tsiprinol for the treatment of prostatitis in people with hypersensitivity to fluoroquinolones, in patients with chronic renal failure, in children and adolescents under 18 years of age.

Tsiprinol is able to interact with other drugs. For example, it cannot be taken with Tizanidine, as this can cause a drop in the level. blood pressure.

Zanocin is a broad-spectrum antibacterial drug with the main active ingredient - Ofloxacin. Zanocin belongs to the second generation fluoroquinolones.

Zanocin is the drug of choice in the treatment of prostatitis. The main active ingredient perfectly penetrates the tissues and secretions of the prostate gland and covers a huge range of causative agents of prostatitis.

An important advantage of Zanocin is its high activity against most gram-negative microbes of the intestinal group (Escherichia coli, Klebsiella, Proteus, Enterobacter), as well as against Pseudomonas, Trichomonas, Ureaplasma, Mycoplasma and other causative agents of prostatitis. Strains of bacteria that are sensitive to Zanocin are resistant to antibiotics of other groups.

The undoubted advantage of Zanocin is that it can be used for complex antibacterial therapy, that is, it is prescribed with cephalosporins, macrolides, beta-lactam antibiotics.

The drug is available in two forms: in tablets and in the form of a solution for infusion. At the same time, it has an equivalent bioavailability for oral and parenteral administration, so there is no need for dose adjustment. This is a significant plus of the drug, for example, compared with drugs based on Ciprofloxacin.

The price range of the drug is average. So, Zanocin tablets in a dosage of 400 mg can be purchased at a price of about 314 rubles.

Although Zanocin is the drug of choice for treating prostatitis, some strains of the bacteria may be resistant to it. For example, E. coli gives resistance to Zanocin in 4.3% of cases in Russia as a whole. In some regions this figure is higher, for example, in St. Petersburg it is 13%. Therefore, it is recommended to use drugs based on Ofloxacin in the treatment of uncomplicated prostatitis.

Another disadvantage of the drug is the presence of side effects, including: nausea, vomiting, diarrhea, fatigue, increased intracranial pressure, tachycardia, anemia, leukopenia, impaired renal function, etc.

The next drawback of a drug is its ability to interact with other drugs, which often leads to an increase in their side effects. For example, you can not combine the reception of Zanocin and Theophylline, as this will lead to a sharp drop in blood pressure. And the simultaneous administration of Zanocin with NSAIDs increases its side effects in relation to the central nervous system.

Zanocin is not indicated for the treatment of prostatitis in people who are hypersensitive to fluoroquinolones; it should not be used for the treatment of children and adolescents under the age of 18.

Ofloxin

Ofloxin is a broad-spectrum antibacterial drug belonging to the second generation of fluoroquinolones. The main active ingredient is Ofloxacin.

Another advantage of Ofloxin is its high bioavailability, which ranges from 95 to 100%. In addition, it does not differ between oral administration and parenteral administration, which does not require a dose change when changing the route of administration. This is quite relevant for the treatment of prostatitis, since it is the stepwise scheme that is often used.

The next advantage of the drug is that it perfectly enters the target organs. In this case, we are talking about the tissue and the secretion of the prostate gland.

Another advantage of the drug: Ofloxin does not have a pathogenic effect on bifidobacteria and lactobacilli, which means it does not contribute to the disturbance of the intestinal microflora.

It should be noted that, unlike most other fluoroquinolones, Ofloxin does not give any clinically significant effect of phototoxicity and does not interact with Theophylline.

The price of Ofloxin is very acceptable, for 10 tablets in a dosage of 200 mg, you will need to pay about 180 rubles.

The main disadvantage of Ofloxin is the presence of side effects, which occur on average in 4-8% of patients. Most often they are associated with disruption of the digestive tract, central nervous system and skin. Among them: nausea, vomiting, gastralgia, headaches, sleep disturbances, increased anxiety, skin rash and itching, urticaria, petechiae, papular rash, etc.

Another disadvantage of the drug is that it is not used to treat people with hypersensitivity to fluoroquinolones, for the treatment of children and adolescents under 18 years of age.

Some strains of Escherichia coli (about 4.3% of cases) are resistant to Ofloxin, which can lead to the ineffectiveness of the drug for the treatment of prostatitis. Some strains of gram-positive bacteria show moderate resistance to Ofloxin.

Unidox Solutab

Unidox Solutab is a broad-spectrum antibacterial drug from the tetracyclines group. The main active ingredient is Doxycycline.

Unidox Solutab is practically the only drug from the group of tetracyclines that modern proctologists use to treat prostatitis, since it is more easily tolerated by patients than others.

Unidox Solutab has antibacterial activity against ureaplasma, mycoplasma, chlamydia, klebsiella, enterobacteria, pseudomonas and Escherichia coli.

Another advantage of the drug is its high bioavailability, which is 100%. Already half an hour after the first dose, the dose of the drug will be concentrated in the prostate gland, which is necessary to provide a therapeutic effect.

Unidox Solutab is available in the form of dispersible tablets, which makes the drug very convenient to take.

The price of the drug is not very high and is about 350 rubles for a pack of 10 tablets.

The main disadvantage of the drug Unidox Solutab is that such possible causative agents of prostatitis are resistant to it as: Proteus, Serrata, some strains of Pseudomonas, acinetobacter, symbiotic enterococci. In addition, resistance to Unidox Solutab, which occurs during the treatment of prostatitis, will spread to other drugs from the tetracyclines group. Therefore, in some cases, it is required to replace the drug with a radically different antibiotic.

Another disadvantage of the drug is that it is not prescribed for the treatment of people with severe impairment of the kidneys and liver, with porphyrin disease, with hypersensitivity to tetracyclines.

Another disadvantage of the Unidox Solutab drug is side effects that may occur after taking it, among them: anorexia, nausea, diarrhea, enterocolitis, allergic reactions, liver damage, anemia, eosinophilia, increased ICP, etc.

Suprax is a broad-spectrum antibacterial drug from the group of cephalosporins (3rd generation of drugs). The main active ingredient is cefixime.

The main advantage of Suprax in the treatment of prostatitis is its high antibacterial activity against gram-negative bacterial strains. Suprax allows you to get rid of prostatitis caused by gonococci, enterobacteria, Proteus, Klebsiella and Escherichia coli.

Suprax is a drug for oral administration. It has three forms of release - in capsules, in tablets, in suspension, so it can be used for treatment not only in a hospital, but also at home.

The drug is produced by the well-known company Astellas, which is one of the 20 leading pharmaceutical companies in the world. Therefore, the drug has passed all the necessary clinical trials, which is its undoubted advantage.

Taking the drug Suprax does not have a pronounced effect on the human immune system, does not reduce the protective functions of the body, which is also its advantage over some other antibiotics.

Suprax does not have high permeability in the prostate tissue, which is a significant disadvantage of the drug in the treatment of prostatitis.

Another drawback of the drug is the insensitivity to it of such bacteria as: ureaplasma, mycoplasma, chlamydia, enterococci, pseudomonas, seratia, listeria. Therefore, if the prostatitis was caused by one of these microorganisms, therapeutic effect cannot be achieved. Or you will have to use Suprax in combination with other antibiotics.

Another drawback of the drug is its high cost. So, for a package with 6 capsules in a dosage of 400 mg, you will have to pay about 700-800 rubles.

It is worth noting such a lack of a drug as the presence of side effects. Allergic reactions, dry mouth, diarrhea, nausea, flatulence, vomiting, dizziness and headaches are possible.

Cefotaxime

Cefotaxime is a broad-spectrum antibiotic from the group of third-generation cephalosporins with the main active ingredient Cefotaxime.

The main advantage of the drug Cefotaxime is its extended spectrum of action compared to cephalosporins of previous generations, since it has increased resistance to beta-lactams. Therefore, Cefotaxime can be prescribed for the treatment of complicated prostatitis.

The drug is active against most bacteria that provoke prostatitis, including: Escherichia coli, gonococci, enterobacteria, Klebsiella, Proteus, Staphylococcus. Cefotaxime can help get rid of the disease, even when there is no effect from treatment with tetracyclines, penicillins and aminoglycosides. It is often used in the complex therapy of prostatitis.

It should also be noted such a plus of the drug as the absence of contraindications to its use, with the exception of a hypersensitivity reaction to cephalosporins.

The price of the drug is not high, so a bottle with 1 g of active ingredient can be purchased for 20-40 rubles.

One of the disadvantages of the drug can be called the fact that it is allowed to be used only for parenteral administration. The drug is not available in tablets or capsules, which means that oral administration is not available.

Treatment with Cefotaxime is carried out only in a hospital setting.

Another disadvantage of Cefotaxime is the presence of side effects, including: local reactions to drug administration, skin rashes, gastrointestinal disorders, pseudomembranous colitis, headaches, etc.

Ceftriaxone

Ceftriaxone is a broad-spectrum antibiotic from the group of third-generation fluoroquinolones.

The main advantage of the drug is that it has a pronounced bactericidal effect. It can be used to treat prostatitis caused by gram-positive and gram-negative bacteria.

Another plus of Ceftriaxone is its increased resistance to beta-lactamase enzymes produced by most pathogenic microorganisms. This means that the drug will be effective even in the case where other antibacterial agents (penicillins and even cephalosporins of previous generations) cannot cope.

When administered parenterally, the drug penetrates well into the tissues and fluids of the prostate. Moreover, the drug has practically no contraindications, with the exception of the possibility of a hypersensitivity reaction to cephalosporins.

The price for Ceftriaxone is not high. The average cost of 1 bottle with 1 g of active ingredient varies between 22-30 rubles.

One of the disadvantages of the drug is that it can only be used for parenteral use. Therefore, Ceftriaxone treatment is carried out only in a hospital setting.

Another disadvantage of the drug is the possibility of side effects after its administration. These include: diarrhea, nausea, vomiting, eosinophilia, allergic dermatitis, urticaria, headaches, congestion in the gallbladder.

Claforan

Claforan is a broad-spectrum antibiotic from the group of third-generation cephalosporins. The main active ingredient is Cefotaxime.

The main advantage of the drug Claforan in the treatment of prostatitis is that it has bactericidal properties in relation to gram-negative and gram-positive pathogenic flora. Unlike some other cephalosporins, Claforan has a detrimental effect on bacteria that synthesize beta-lactamase. Therefore, it can be used to treat patients who have not responded to therapy with tetracyclines and other antibiotics.

The drug is produced by the well-known pharmaceutical company Sanofi Aventis, which means that it has a high degree of purification.

The drug has practically no contraindications. It should not be used only for the treatment of patients with hypersensitivity to cephalosporins in general.

One of the main disadvantages of the drug is that it can be used exclusively for parenteral administration. Therefore, treatment with Claforan is carried out only in a hospital setting.

It is also worth noting such a disadvantage of the drug as its relatively high price compared to other 3rd generation cephalosporins. So, 1 bottle with a dosage of 1 g will cost from 155 rubles.

The disadvantages of the drug include the possibility of side effects, including: disruption of the digestive system (nausea, diarrhea, loss of appetite), allergic reactions, arrhythmia, encephalopathy, fever, soreness at the injection site, etc.

Amoxiclav

Amoxiclav is a broad-spectrum antibiotic with the main active ingredient amoxicillin + clavulanic acid. The drug belongs to the group of penicillins.

The main advantage of the drug Amoxiclav in the treatment of prostatitis is that it effectively fights bacteria that produce beta-lactamase enzymes. This allows for a pronounced bactericidal effect against a wide range of pathogenic microorganisms.

Today Amoxiclav is one of the the most effective antibiotics for the treatment of prostatitis among penicillins. It allows you to get rid of such bacteria that cause prostatitis as: gonococci, enterobacteria, enterococci, klebsiella, proteus, seratia, Escherichia coli and some others.

The drug was developed by the famous pharmaceutical company SmithKline Beecham Pharmaceuticals. Therefore, there is no need to worry about the quality and safety of the medicinal product.

Another advantage of the drug Amoxiclav is its selective activity against bacterial cells. That is, it recognizes pathogenic cells and destroys them, and healthy tissues are not damaged.

The advantage of the drug is its relatively low price. So, a package of 20 Amoxiclav tablets in a dosage of 500 mg can be purchased for 300-400 rubles.

The main disadvantage of the drug in the treatment of prostatitis can be considered its low effectiveness against such bacterial strains as: ureaplasma, mycoplasma, chlamydia and pseudomonas. Therefore, despite the fact that Amoxiclav is a semi-synthetic aminopenicillin protected by clavulanic acid, it may be ineffective in the treatment of prostatitis caused by atypical or resistant flora.

Another obvious disadvantage of Amoxiclav is that it can provoke a number of side effects, including: nausea, diarrhea, vomiting, heartburn, liver and kidney dysfunction, allergic reactions, fungal infections, etc.

Flemoklav solutab

Flemoklav Solutab is an antibiotic from the group of penicillins with the main active ingredient Amoxicillin + potassium clavulanate.

Flemoklav Solutab, like Amoxiclav, is a protected penicillin, which ensures its high antibacterial activity against most bacteria that can provoke the development of prostatitis.

An important advantage of Flemoklav Solutab is that it comes in the form of dispersible tablets. This makes it convenient for some patient groups. Moreover, this form of release has a gentle effect on the gastric mucosa and is more easily absorbed by the body.

It is impossible not to mention such a plus of the Flemoklav Solutab preparation, as its ability to fight beta-lactamase strains of bacteria that are resistant to a number of other antibiotics.

The disadvantages of Flemoklav Solutab are its high cost compared to other forms of penicillin production with clavulanic acid. So, 400-500 rubles will have to be paid for the packaging of the drug.

Also, the disadvantages of the drug include the presence of contraindications to its use, including: hypersensitivity to the components of the drug, jaundice, liver dysfunction, Infectious mononucleosis, lymphocytic leukemia.

It is worth noting such a minus of the drug as the presence of side effects that may occur while taking it. Most often, patients suffer from diarrhea and nausea, as well as from fungal infections that occur against the background of dysbiosis. It is also possible to develop allergic reactions, exanthema, candidiasis, hepatitis and other undesirable reactions.

Augmentin

Augmentin is a broad-spectrum antibiotic containing Amoxiclav and clavulanic acid.

The main advantage of Augmentin is its resistance to bacteria that produce beta-lactamase enzymes, which is possible due to clavulanic acid in its composition. Augmentin acts against many strains of gram-positive and gram-negative bacteria that can trigger the development of prostatitis.

The drug is available in tablets, in the form of a powder for the preparation of a suspension, in the form of a powder for intravenous and intramuscular administration. This is also an important advantage of Augmentin, as it makes it possible to use it for different groups of patients.

One of the disadvantages of the drug is its high cost, which, depending on the form of release of the drug, can reach 1800 rubles.

The disadvantages of Augmentin include its resistance to some atypical causative agents of prostatitis, including strains of mycoplasma, ureaplasma, chlamydia, pseudomonas, as well as some gram-negative anaerobes.

Separately, it should be noted the side effects that may occur while taking Augmentin. Most often, patients complain of diarrhea, nausea, and fungal infections. Although it is possible disruption of work on the part of such organs and systems as: the central nervous system, the lymphatic system, the immune system, liver, gall bladder, vessels, urinary tract, skin.

Flemoxin solutab

Flemoxin solutab is a broad-spectrum antibiotic based on Amoxicillin. The drug belongs to the group of penicillins.

Flemoxin solutab is active against a number of gram-negative and gram-positive bacteria that can cause prostatitis. These are some strains of staphylococci, streptococci. The drug is moderately active against enterococci, Proteus, Salmonella, Shigella.

The drug is available in the form of dispersible tablets, which makes it convenient to take for some categories of patients. In addition, the trihydrate is better absorbed by the gastrointestinal tract and does not irritate the gastric mucosa.

The drug is produced by Astellas, which has positively established itself on the pharmacological market. This means that the drug meets all global safety standards.

The drug is in the middle price range. It can be purchased at a price of 230 rubles and more, depending on the dosage.

The drug is not effective against bacteria producing beta-lactamase enzymes, against pseudomonas, enterobacter, ureaplasma, mycoplasma, chlamydia and some other pathogenic microorganisms. Therefore, the treatment of prostatitis with a monopreparation Flemoxin solutab may not be effective. This is the main disadvantage of the drug.

It is also worth noting the presence of side effects that may occur when taking it: taste changes, vomiting, diarrhea, nephritis, agranulocytosis, skin reactions, etc.

Gentamicin

Gentamicin is a broad-spectrum antibacterial drug from the aminoglycoside group.

The main advantage of the drug is its high antibacterial activity against gram-negative flora that can provoke the development of prostatitis, for example, against Salmonella, Enterobacter, Klebsiella, Proteus, Pseudomonas, etc.

The drug is rapidly absorbed into the bloodstream, and within an hour after its administration, its therapeutic concentration is observed in the plasma.

A significant advantage of the drug is its low price. So, a pack of 10 ampoules can be purchased for only 40-50 rubles.

One of the significant disadvantages of the Gentamicin preparation is its limited spectrum of action, that is, it will be ineffective against some strains of bacteria that cause prostatitis. Therefore, it is most often used in a complex treatment regimen for prostate inflammation.

The disadvantages of the drug include the fact that it is administered only parenterally. Oral administration of the drug is not available.

Also, the disadvantage of Gentamicin is its numerous side effects, including: vomiting, nausea, anemia, leukopenia, oliguria, renal failure, headaches, increased drowsiness, hearing impairment, etc.

The drug has contraindications for use, for example, neuritis auditory nerve, violations in the work of the kidneys.

Fluoroquinolone for chronic bacterial prostatitis

Good pharmacokinetics, high concentration in prostate tissue, good bioavailability. Equivalent pharmacokinetics for oral and parenteral administration (for ciprofloxacin, ofloxacin, levofloxacin, sparfloxacin). Ciprofloxacin and ofloxacin have a prolonged release form - OD tablets, which allow the active ingredient to be uniformly released throughout the day and thereby maintain an equilibrium concentration of the drug. Optimal for prostatitis should be considered levofloxacin (floracid), ciprofloxacin, sparfloxacin (especially in association with intracellular sexually transmitted infections), to a lesser extent - norfloxacin.

All fluoroquinolones showed high activity against typical and atypical pathogens, including Pseudomonas aeruginosa. The disadvantages include photo- and neurotoxicity. In general, fluoroquinolones can be considered as first-line drugs in the treatment of patients with chronic prostatitis, but only after the exclusion of tuberculosis.

levofloxacin (tavanic, floracid, eleflox) 500 mg / day;
ciprofloxacin (tsiprobay, tsiprinol) 500 mg / day;
ciprofloxacin (cifran OD) 1,000 mg / day;
ofloxacin (zanocin OD, ofloxin) 800 mg / day;
sparfloxacin (sparflo) 200 mg twice a day.

Trimethoprim

Penetrates well into the parenchyma of the prostate. Along with tablets, there is a form of the drug for intravenous administration. In modern conditions, the advantages include the low cost of trimethoprim. However, although the drug is active against the most significant pathogens, it does not act on Pseudomonas spp., Some enterococci and some representatives of the genus Enterobacteriaceae, which limits the use of this drug in patients with chronic prostatitis. Trimethoprim is available in combination with sulfamethoxazole (400 or 800 mg sulfamethoxazole + 80 or 160 mg trimethoprim; respectively, the tablet of the combined preparation contains 480 or 960 mg of the active substance).

co-trimaxazole (biseptol 480) 2 tablets twice a day.

Tetracyclines

Also available in two administration forms, they are highly active against chlamydia and mycoplasma, therefore their effectiveness is higher in chronic prostatitis associated with sexually transmitted diseases. Doxycycline (Unidox solutab), which has the best pharmacokinetic data and tolerance, is optimal.

doxycycline (unidox solutab) - 200 mg / day.

Macrolides

Macrolides (including azalides) should only be used under certain conditions, since there is only a small amount of scientific research confirming their effectiveness in prostatitis, and this group of antibiotics is inactive against gram-negative bacteria. But you should not completely abandon the use of macrolides, since they are quite active against gram-positive bacteria and chlamydia; accumulate in the parenchyma of the prostate in high concentrations and are relatively non-toxic. The optimal drugs in this group are clarithromycin (fromilid) and azithromycin. Recommended doses:

azithromycin (sumamed, zitrolide) 1000 mg / day for the first 1-3 days of treatment (depending on the severity of the disease), then 500 mg / day;
clarithromycin (fromilid) 500-750 mg twice a day.

Other drugs

The combined preparation safocid can be recommended. Its uniqueness lies in the fact that it contains a complete combined one-day course of treatment in one blister (4 tablets): 1 tab. fluconazole (150 mg), 1 tablet of azithromycin (1.0 g) and 2 tablets of secnidazole A, 1.0 g each.This combination, taken simultaneously, allows you to achieve a bactericidal effect against Trichomonas vaginalis, gram-positive and gram-negative anaerobes, including Gardnerella vaginalis (secnidazole), against Chl trachomatis, Mycoplasma genitalium, gram-positive and gram-negative microflora (azithromycin), as well as against fungi of the genus Candida (fluconazole).

Thus, safocid meets all WHO requirements for drugs used for the treatment of sexually transmitted infections, including the treatment of chronic prostatitis: efficiency is not less than 95%, low toxicity and good tolerance, the possibility of a single dose, oral administration, slow development of resistance to ongoing therapy.

Indications for taking safocid: combined uncomplicated infections of the genitourinary tract, sexually transmitted infections, such as gonorrhea, trichomoniasis, chlamydia and fungal infections accompanying them with specific cystitis, urethritis, vulvovaginitis and cervicitis.

In an acute uncomplicated disease, a single dose of the safocid complex is sufficient, in a chronic process, a full set is required for 5 days.

European guidelines for the management of patients with kidney infections, urinary tract and male genital organs, compiled by a team of authors headed by Naber K.G., insist that in case of bacterial chronic prostatitis, as well as in chronic prostatitis with signs of inflammation (categories II and III A), antibiotics should be prescribed for 2 weeks after establishing primary diagnosis... After that, the patient's condition is re-assessed, and antibiotic therapy is continued only with a positive result of the culture material taken before treatment, or if the patient shows a pronounced improvement against the background of antibiotic treatment. The recommended total duration of treatment is 4-6 weeks. Preferred oral therapy but the doses of antibiotics must be high.

The effectiveness of antibiotics in the so-called inflammatory syndrome of chronic pelvic pain (what we consider as latent chronic prostatitis) by the authors of the manual with reference to the studies of Krieger J.N. et al. also explained by the likely presence of bacterial microflora not detected by conventional diagnostic methods.

Here are several options for basic treatment of patients with acute prostatitis CIP and latent CIP.

Treatment regimen for acute prostatitis

ceftriaxone 1.0 g per 200 ml of 0.9% sodium chloride solution intravenously drip 2 times a day for 5 days, then intramuscularly for 5 days;
furazidine (furamag) 100 mg three times a day for 10 days;
paracetamol (Perfalgan) 100 ml intravenously drip at night every day for 5 days;
meglumine sodium succinate (Reamberin) 200 ml intravenously drip every other day, only 4 infusions;
tamsulosin 0.4 mg daily;
other symptomatic therapy - individually according to indications.

Treatment regimen for chronic infectious and latent infectious prostatitis

It is important - at the initial admission, the examination algorithm must be followed. First, a 3-glass urine sample with its bacteriological examination, then a digital rectal examination, obtaining a prostate secretion for its microscopy and culture. Sowing is designed to identify nonspecific microflora and mycobacterium tuberculosis; according to indications - sexually transmitted infections. If leukocytes less than 25 in the prostate secretion are found in the field of view, test therapy with tamsulosin (omnic) should be carried out for 5-7 days with repeated massage of the prostate and re-examination of its secretion. If the number of leukocytes does not increase, and the cultures are negative, the disease should be attributed to non-infectious prostatitis (chronic pelvic pain syndrome) and appropriate pathogenetic and symptomatic therapy should be carried out. If during the initial analysis more than 25 leukocytes are visualized in the field of view or their number increases after test therapy, the disease should be considered as infectious or latent infectious. In this case, antibiotic therapy becomes the basis of treatment - empirical at the beginning, and corrected after the results of bacteriological research are obtained.

Inflammation of the prostate is often caused by sexually transmitted infections. Accordingly, drug therapy is based on the intake of antibacterial agents. Basically, the patient is offered anti-inflammatory therapy, which will destroy the root cause of the prostate infection. Treatment of acute and chronic prostatitis is fundamentally different. Adaptive and competent treatment can only be prescribed by a qualified urologist who knows the patient's history.

What are the antibiotics for the treatment of prostatitis in men, what characterizes the course of the disease in chronic prostatitis, a list effective drugs from prostatitis, find out in this article.

Antibiotics for prostatitis in men: the role of drugs

Most men think that prostatitis is very difficult to treat, and drugs have a detrimental effect on the state of the body as a whole. In part, this is true if the disease is not treated in time. Acute prostatitis can be treated for up to two weeks, chronic if not treated in time for 14-28 days.

The role of antibiotics in the treatment of prostate inflammation is enormous. According to statistics, in 95% of cases, prostatitis is caused by an infection (virus, bacteria). It is the antibiotic that is capable of destroying the pathogenic microflora. Basically, when diagnosing a disease, a narrow group of antibiotics are prescribed. If the doctor could not establish the root cause of the disease, then for a start, the patient is prescribed a broad spectrum of drugs.

The antibiotic contributes to the suppression of pathogens, due to which inflammation began. It should be noted right away that such drugs really affect the functioning of the liver, kidneys, and heart. It is for this reason that it is worth first undergoing a detailed examination of the body, and then prescribing therapy.

As well as antibacterial treatment the doctor without fail prescribes vitamin complex for better work Gastrointestinal tract, liver and kidneys, since antibiotics have a lot of side effects.

But if you take the course correctly, you can cure prostatitis without loss and not make new pathologies.

Antibiotic treatment of chronic prostatitis: where to start therapy

Of course, a treatment course begins with a diagnosis. Why can't you self-medicate? The nature of the inflammation of the prostate can vary. Infections are also different. Inflammation of the prostate can be excited by:

Escherichia coli;
Staphylococci, gonococci, chlamydia (venereal microorganisms);
Fungi.

When diagnosing, the patient is offered to undergo a PCR examination. It helps to establish which pathogenic microbe led to the inflammation. And only after identifying it, antibiotic therapy of a narrow profile is prescribed, and in particular the drug to which the detected bacteria are most sensitive.

The urologist also prescribes a blood test, urine test, the patient should take a bacterial culture, etc. Only after a competently carried out diagnosis are selected antibacterial drugs that locally affect the root cause of the causative agent of inflammation. Indeed, today there are a lot of antibacterial drugs, which we will discuss below.

Antibiotic treatment for prostatitis: how to treat

Antibiotics are the most effective treatments for prostatitis.

Taking this kind of medication, the patient can already feel relief the next day, because the drugs quickly act on the affected focus, relieve swelling, lower the temperature, and improve urination.

But do not forget about some rules that cannot be neglected when treating diseases with antibiotics:

You can not interrupt the course of treatment. The prescriptions must be followed until the last day. Many men, feeling an improvement on days 5-7, refuse to take the pills. In this case, the patient is guaranteed a relapse;
If the selected antibiotic does not alleviate the condition on the third day, you should immediately contact your doctor so that he replaces the drug with another. The advantage of antibiotics is that the result of treatment is visible almost from the first days of taking the course;
If a patient asks for a second course of treatment for prostatitis, then the previously prescribed antibiotic can no longer be used. Therefore, it is worth remembering the names of the drugs in order to provide the correct information.

Treatment of chronic prostatitis is not an easy task, because you need to choose the right antibiotic that will most intensively affect the desired pathogenic microorganism. We provide a list of drugs that contribute to the speedy recovery of the patient.

Its effective composition has anti-inflammatory, antimicrobial and soothing effects. Thanks to bee venom, blood circulation is improved and cell regeneration is enhanced. “Cream-wax Zdorov” is absolutely safe, has no side effects and enhances the effectiveness of drug treatment.

Azithromycin for prostatitis

The active ingredient is azithromycin dihydrate. It is a broad spectrum antibiotic. It is used for ENT infections, bronchitis, cystitis. Azithromycin is also indicated for prostatitis of any form. When this drug enters the body, it immediately affects the pathogenic microflora, destroying the pathogenic bacteria. But he has contraindications:

Kidney disease;
Heart failure;
Liver disease.

In other cases, it is effective remedy in the fight against microorganisms that caused inflammation.

Amoxiclav

The drug is also often prescribed by a doctor for the treatment of chronic prostatitis. This remedy belongs to the group of penicillins. It effectively acts on the inflammatory focus, eliminating the swelling of the gland, relieving irritation. Amoxiclav for prostatitis is taken 1 tablet twice a day. It is also quite cheap compared to other antibiotics of the penicillin group.

Amoxicillin

This drug also belongs to the penicillin group and is used everywhere. This is the disadvantage of this drug. Disease-causing bacteria have become more resistant to amoxicillin due to its frequent use. Doctors rarely prescribe the presented drug, since it is an irrational remedy in the fight against such a pathology.

Doxycycline

It belongs to the group of tetracyclines and is used if the patient has allergic reaction on penicillin drugs. Doxycycline for prostatitis is prescribed when the pathogens are chlamydia or mycoplasma microorganisms. Moreover, this remedy is indicated for those who have been diagnosed with renal failure during the diagnosis. This drug gently affects the internal intestinal microflora, destroying pathogenic microbes.

Levofloxacin for prostatitis

It is a broad spectrum antibitic. Levofloxacin is used for prostatitis in any form (acute, chronic). It is prescribed when other drugs do not bring the desired effect, because this drug increases the chances of destroying microorganisms that have adapted to other antibiotics. Moreover, it is effective against a wide range of harmful bacteria. The components of the remedy, after 1.5 hours, penetrate into the focus of inflammation, relieving symptoms and killing microbes.

Ceftriaxone for prostatitis

This drug effectively fights against the bacterial nature of prostatitis. It is he who is the fastest-acting medicine in the treatment of such a pathology. Ceftriaxone for prostatitis has a wide range of actions:

With almost the first dose, it relieves acute inflammation.
It is also used to treat chronic inflammation.
Treats purulent inflammation.
Relieves puffiness, kills disease-causing agents.

Ceftriaxone for prostatitis is available in ampoule form. The only drawback is the painfulness of the injections, but the result of the drug appears already after a day.

It is worth noting that it strongly affects the microflora of the gastrointestinal tract, therefore, active ingredients (yoghurts, linex) should be taken to normalize the intestinal tract.

Monural for prostatitis

Monural for prostatitis is available in powder form. It is used for difficult urination, as well as to eliminate burning sensation in the urethra. The drug is used in combination and is not an independent drug. It helps relieve the symptoms of inflammation.

Tavanic with prostatitis

This is a German antibacterial drug that acts on gram-positive microorganisms (staphylococci, enterococci), etc. also effectively destroys gram-negative bacteria (Escherichia coli). It is used quite often, as it quickly affects the focus of inflammation.

Cyprolet with prostatitis

This tool also belongs to the antibacterial group that can cope with E. coli, staphylococci, gonococci, etc. Cyprolet with prostatitis is very effective if the cause of the inflammation is the above-described pathogenic microorganism. The drug has bactericidal and anti-inflammatory properties, therefore it is used for acute and chronic prostatitis.

Ciprofloxacin for prostatitis

This drug stops the growth of pathogenic organisms, has a qualitative effect on gram-positive and negative bacteria, and has an excellent therapeutic effect in the prostate. main feature drug - minimal side effects.

Natural remedy for the prevention and treatment of prostatitis

This best remedy from prostatitis, which strikes the disease from both sides at once. Due to the unique formula and concentration active ingredients, vitamins, inflammation is removed, an erection is restored, prostatitis does not return. The male body works like a Swiss watch

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

Due to the structure and mechanism of action, the drug has a high bactericidal activity in relation to 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 is successfully used to treat various diseases. The drug is used to treat infectious pathologies of the respiratory tract(including pneumonia, bronchitis). The drug is widely used in otorhinolaryngology for the treatment of sinusitis, pharyngitis, otitis media, laryngitis, tracheitis.

Photo 1. Packaging of 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 venereal profile, the drug is used to treat gonorrhea, chlamydia. An antibacterial drug is prescribed to prevent the development of infectious pathologies with immunodeficiencies(including with HIV).

V ophthalmic practice the drug shows high efficiency in the fight against conjunctivitis, keratitis, blepharitis, iritis, complications after trauma to 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:

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

The drug is contraindicated in children under the age of 18, since the growth of the skeleton has not yet been completed by this moment. Patients diagnosed with atherosclerosis of the cerebral arteries, impaired blood circulation in the brain, chronic illness the kidneys should limit the appointment of the antibiotic to the minimum dosage.

Side effects

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

condition anorexia;
sensation nausea;
defecation disorders(more often in the form of diarrhea);
bloating;
pain in the abdominal area;
overactive liver enzymes;
excess bilirubin;
development jaundice due to cholestasis.

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

cephalalgia;
convulsive trembling;
dizzy;
difficulty in movement;
sensation numbness in the limbs;
increased anxiety;
depressive disorders;
sensation double vision;
changes perception of taste.

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

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

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

inflammation vessels;
increase frequency of myocardial contractions;
significant pressure drop up to collapse.

On the part of the skin, the following side reactions may occur:

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

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

decrease in leukocytes;
development agranulocytosis;
development anemia;
decreased platelets;
decrease in the work of all sprouts of hematopoiesis.

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

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

The manifestation of allergic diseases is possible in the form of:

hives;
Quincke's edema;
skin rash;
allergic pneumonitis;
allergic jade;
anaphylaxis(rarely).

Compound

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

Levofloxacin

Levofloxacin - a synthetically created antibiotic fluoroquinolone. The active substance of the drug is isomeric analog ofloxacin.

Compound

One Levofloxacin tablet consists of 250 mg levofloxacin hemihydrate.

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

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;
infectious skin lesions;
infections of the gastrointestinal tract.

Contraindications

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

A drug contraindicated children and adolescents.

Side effects

From the gastrointestinal tract side reactions such as changes in the act of defecation (in the form of diarrhea), flatulence, and abdominal pain may occur. These effects are rare and manifest in 1% cases.

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

Fatigue appears, work capacity and stress resistance decrease.

From the musculoskeletal system pains of muscle and articular origin may be noted. A pain syndrome of this nature is subjectively felt by a person as body aches.

Negative effects on the part of the cardiovascular system manifest themselves infrequently and are expressed in vascular inflammation, 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, vascular inflammation is possible.

Rarely occur allergic diseases in the form of urticaria and skin rash. Extremely rare anaphylaxis and angioedema.

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

Levofloxacin or Ofloxacin: which is better

Levofloxacin activity against microorganisms twice as much than Ofloxacin. The period of half excretion of the substance from the body lasts about 6 o'clock, and Ofloxacin - around 5.

The drugs differ in dosage. For the purpose of treating infectious pathologies of the respiratory tract, it is prescribed. For the treatment of a similar pathology, it is required 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 range of effects; it also belongs to fluoroquinols. Medication has a bactericidal effect.

Compound

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

Photo 3. Packaging of Ciprofloxacin in the form of tablets with a dosage of 500 mg. Producer "Actavis".

Indications

Indications for prescribing a medication 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 medicine should not be used to treat patients. in status epilepticus... Lack 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 medication is contraindicated in children and adolescents. For older people, there is a high risk of renal disease while taking an antibiotic.

Side effects

The patients Ciprofloxacin is most commonly tolerated without adverse effects. Allergic manifestations (itching, rash) are rarely noted, rarely develops Quincke's edema.

Photo 4. Quincke's edema in a woman. May cause suffocation in some cases.

Appetite may disappear, soreness in the epigastrium, diarrhea, and malaise may be felt. Sometimes sleep is disturbed, cephalgic syndrome develops. Perception of taste and odors may be impaired.

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

Differences between Ciprofloxacin and Ofloxacin

Ciprofloxacin is a first generation fluoroquinolone medication. Unlike Ofloxacin, its spectrum of action narrower since 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, it is prescribed 200 mg Ofloxacin twice a day... For the treatment of a similar pathology, it is required 400 mg Ciprofloxacin once a day... Ciprofloxacin contains fewer side effects than Ofloxacin.

Ofloxin and Ofloxacin: are they the same thing or is there a difference?

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

Compound

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

Photo 5. Packaging of Ofloxin in the form of tablets with a dosage of 400 mg. Manufacturer "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);
sexually transmitted infections (gonorrhea, chlamydia).

Contraindications

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

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

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

Side effects

Adverse reactions are manifested in the form dyspeptic disorders, loss of appetite, epigastric pain, diarrhea. In the blood plasma, the concentration of bilirubin increases. Anemic conditions may develop with increased fatigue, apathy.

The reaction speed slows down during complex work. Sleep is disturbed, dizzy, hallucinations are extremely rare.
Ofloxin and Ofloxacin - complete structural analogs, and there is no difference between them.

Comparison of drugs: rational choice of antibiotics from the group of fluoroquinolones

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 smaller dose of the drug is needed, therefore the choice of Levofloxacin preferred.

Ciprofloxacin is the first generation of fluoroquinolones, it less efficient to use than Ofloxacin and Levofloxacin, since more microorganisms managed to form resistance to it. With regard to tuberculosis and severe infectious pathologies the highest effect is shown by Odnoklassniki