Abaktal®
Abaktal® is used as monotherapy or in combination therapy with other antimicrobial agents.
For mixed infections, for perforative processes in the abdominal cavity, for severe bacterial infections of the gastrointestinal tract, the drug Abactal® is combined with drugs that are active against anaerobes (metronidazole, clindamycin).
During treatment, patients should receive plenty of fluids (to prevent crystalluria).
Photosensitivity
Due to the possible occurrence of a photosensitivity reaction, during treatment with Abactal®, you should not be exposed to UV radiation or prolonged exposure to direct sunlight. If any changes appear on the skin, treatment should be stopped. Direct sunlight should be avoided for 4 days after stopping therapy, otherwise it is recommended to use protective clothing or a protective cream (with a high level of UV protection).
Liver failure
For patients with severe liver disease, dose adjustment is required in proportion to the degree of damage (see section "Dosage and Administration").
Musculoskeletal system
Tendinitis that occurs during treatment with pefloxacin can lead to tendon rupture (eg, Achilles tendon). Sometimes bilateral tendinitis may develop within 48 hours after starting treatment with Abactal®, as well as several months after stopping treatment with the drug.
Risk factors for the development of tendinitis during fluoroquinolone therapy include: age over 60 years, renal failure, dialysis, concomitant therapy with glucocorticosteroids, dyslipidemia. If initial signs of tendinitis occur, treatment with pefloxacin should be discontinued, weight-bearing on the affected limb should be avoided, and a doctor should be consulted.
To reduce the risk of tendinopathy:
- It is recommended to treat elderly patients after a careful assessment of the balance of benefits and risks. The risk can be reduced by using half doses of the drug;
- the use of pefloxacin is contraindicated in patients with a history of tendinitis; it is recommended to avoid use in patients receiving glucocorticosteroids or engaged in intense physical exercise.
The risk of rupture is higher in patients who begin to walk after prolonged bed rest.
When initiating pefloxacin therapy, it is recommended to monitor the Achilles tendon for pain and swelling, especially in patients at risk. If these symptoms are detected, pefloxacin should be discontinued, stress should not be placed on the affected tendons and they should be supported with a suitable orthosis or orthopedic shoes, even if the lesion is unilateral. You should seek advice from a specialist.
Dysglycemia
In patients with diabetes mellitus taking oral hypoglycemic agents (for example, glibenclamide) or insulin, the risk of developing hypo-/hyperglycemia increases when using pefloxacin. In such patients, monitoring of blood glucose concentrations is required.
Nervous system disorders
Sensory and sensorimotor peripheral neuropathy, which may have a rapid onset, has been reported in patients receiving fluoroquinolones, including pefloxacin. If the patient develops symptoms of neuropathy, the use of pefloxacin should be discontinued (minimizes the possible risk of developing irreversible changes). Pefloxacin should be used with caution in patients with myasthenia gravis.
Pefloxacin should be used with caution in elderly patients with cerebrovascular accident, organic brain changes or stroke.
Pefloxacin should be used with caution in patients with a history of seizures and conditions predisposing to their development, in patients with porphyria.
Visual disorders
If visual acuity decreases or other effects on the organ of vision are observed, you should immediately consult an ophthalmologist.
Gastrointestinal tract
Diarrhea (especially if severe, persistent and/or bloody) during or after use of Abactal® may be a symptom of Clostridium difficile
, the most severe form of which is pseudomembranous colitis. If pseudomembranous colitis is suspected, the use of Abactal should be stopped immediately and symptomatic treatment (eg, oral vancomycin) should be given. In this condition, drugs that reduce peristalsis are contraindicated.
Heart disorders
QT interval prolongation has been reported in patients receiving fluoroquinolones. Although pefloxacin may be classified as a fluoroquinolone that has either a very low potential or insufficient information to evaluate its potential to cause QT prolongation, caution should be exercised when coadministering pefloxacin with drugs known to prolong the QT interval (eg , antiarrhythmic drugs of classes IA and III; antipsychotic drugs (pimozide, haloperidol, phenothiazine derivatives); tricyclic antidepressants, some antimicrobial drugs (erythromycin, sparfloxacin, moxifloxacin, antimalarial drugs, macrolides); some antihistamines (astemizole), as the risk of developing life-threatening arrhythmias.
Glucose-6-phosphate dehydrogenase deficiency
The development of hemolytic reactions has been reported when using fluoroquinolones in patients with glucose-6-phosphate dehydrogenase deficiency. Although hemolysis has not been reported with pefloxacin, the use of this antibiotic should be avoided in these patients and the use of an alternative treatment option if available is recommended.
Sustainability
As with other antibiotics, the use of pefloxacin, especially long-term, can lead to the proliferation of insensitive microorganisms. Re-evaluation of the patient's condition is mandatory. If a secondary infection develops during treatment, appropriate measures should be taken.
Effect on laboratory tests
False-positive results may occur when determining opiates in urine. Positive results may need to be confirmed using more specific methods.
Pefloxacin does not affect tests that measure urine glucose levels.
Hypersensitivity
Hypersensitivity and allergic reactions, including anaphylactic reactions, may result from the use of pefloxacin and may be life-threatening.
If a hypersensitivity reaction develops, pefloxacin should be discontinued and appropriate therapy should be initiated.
Special precautions when disposing of unused medicinal product
There is no need for special precautions when disposing of unused Abactal®.
ABACTAL (tablets)
doesn’t prescribe, doesn’t have the right and prescribes all sorts of nonsense.
I literally started drinking Cytovir myself the next morning, and all the days while I was drinking it, my temperature rose daily to 38.5. I knocked her down every evening, because her condition was so severe that I had to take an antipyretic. On the 6th day I went to the doctor, they did a fluorography (strange, usually in such cases they should do an x-ray, but oh well). The doctor listened to me, heard something and prescribed me to take Flemoxin in the maximum dosage. Also a very controversial appointment. First, I told her right away that I do not have a viral infection, she writes ARVI according to a template without any tests (that’s where we get ARVI statistics from - diagnoses are written by pointing a finger at the sky). Amoxicillin (flemoxin) is the weakest antibiotic of the penicillin series, and even when prescribing it, it is necessary to test the sensitivity of pathogenic bacteria to it. Plus, I took expectorants for 10 days and was discharged to work after a 10-day sick leave. What can I say. After such “treatment” I still cough, except that today is the first day less. The nose becomes stuffy, clots form, including blood clots. I again went to a paid clinic, where they examined me a little, did a blood test, and said that the analysis did not show inflammation (although I had a temperature of 37.5 again). So they prescribed Erespal (I took Erispirus) and the antimicrobial drug Abaktal. Diagnosis of rhinopharygitis and laryngitis-tracheitis. Everything is inflamed. This is a drug from the group of fluoroquinolones, which are mistakenly attributed to the group of antibiotics, although from a pharmacological point of view this is not so. Although doctors mistakenly call them antibiotics. Well, okay, I’ll still call them fluoroquinolones, and for me this is important, since they are hundreds of times more powerful than antibiotics (which all come from penicillin, and fluoroquinolones are a different chemical group).
I keep thinking, I’ll finish off the infection, the drug is powerful, and you don’t have to take it for all 5 days, like antibiotics. That is, the duration of treatment depends on recovery. At the time I started taking Abactal, I just had terrible tachycardia on Ascoril, but I started taking Abactal anyway. I immediately washed it down with bifilact so as not to get dysbacteriosis. But what can I say? My body had enough for three tablets, evening, morning and evening, I took it every 12 hours. The next morning before work, I woke up with severe poisoning of the body, I began to feel very sick...
The indications are very broad, and this is understandable.
The instructions for the drug are extensive and there may be many side effects. This means that the drug has been well studied.
It didn’t have a strong effect on the intestines, but it cleared me up. But the condition was terrible. It’s good that I had validol in capsules and domperidone at home, which relieved the attack of nausea in an hour, I recovered and went to work. And I even returned to normal, only at work I added more no-shpa and started drinking the probiotic Bak-set. Plus a packet of phosphalugel and by lunchtime I came to my senses and even wanted to eat. Naturally, I didn’t drink Abaktal anymore. Not only am I sick, I haven’t been able to get better for a month, plus I had tachycardia from Ascoril for 4 days, plus symptoms of poisoning from Abactal... In the end, I gave up on everything, the temperature remains 37-37.2, I feel bad and from today I only left Viferon gel nasally, I’ll try to apply it to the nasal mucosa 5 times a day. We are flying to Thailand on the 9th, and there I will either get better at once or completely collapse. But I definitely need to change the climate for a while, in the Leningrad region I’m dying...
The three abactal tablets I took had no effect on the course of my disease. Obviously, if I took it for 5 days, I might have felt the effect. But side effects did not allow me to complete the course. I started coughing less only today, because I took the last three Terpincode tablets (not at once, of course), this time they helped me, I really began to cough less. But I still feel a slight fever and my ligaments are inflamed, my voice is slightly changed, plus rhinitis. You say, you’re a pharmacist, you can cure yourself... To be honest, I’m at a dead end... I always relied on my immunity and it always helped me, but it turns out that the blood test is good, that is, the body has no immune response at all? I took vitamins for a total of three months from mid-September and January, and all to no avail. The body doesn't want to fight. Next time I will insist on taking smears and selecting the appropriate drug for the infection. And such treatment either drove the infection even deeper, or was completely wrong. Without identifying the pathogen, it is meaningless! Even with the most powerful antimicrobial drugs.
Bottom line, if you have been prescribed abactal, it means you are already resistant to other drugs or your condition is serious. Taking it in some cases is a vital necessity, but if side effects occur, the drug should be stopped. After it, other antimicrobial drugs may no longer be effective; at least two to a month should pass. Otherwise, resistance to infection develops.
Do not prescribe it yourself under any circumstances; take it only as prescribed by your doctor.
