Gatifloxacin + Ornidazole

Usage

Gatifloxacin + Ornidazole is a combination antibiotic used to treat various bacterial and parasitic infections, especially those of the gastrointestinal tract. It is prescribed for conditions such as acute bacterial diarrhea, traveler’s diarrhea, intestinal and hepatic amebiasis, anaerobic bacterial infections, and giardiasis.

• Pharmacological Classification: Antibiotic (fluoroquinolone and nitroimidazole classes)

• Mechanism of Action: Gatifloxacin inhibits bacterial DNA gyrase and topoisomerase IV, enzymes essential for bacterial DNA replication and repair. Ornidazole damages bacterial/parasitic DNA, leading to cell death. The combination covers a broad spectrum of aerobic and anaerobic pathogens.

Alternate Names

While “Gatifloxacin + Ornidazole” is the standard generic name, there are no widely recognized international variations.

• Brand Names: Gatri OZ, Gatrid OZ, Gatimore OZ, Ornigat, Gatiwiz OZ, Gaticim OZ, Intragat O, Walagat OZ, Garnid, Gatipax OZ, Gatiquin OZ

How It Works

• Pharmacodynamics: Gatifloxacin disrupts bacterial DNA synthesis, while Ornidazole directly damages DNA, leading to bacterial and parasitic cell death.

• Pharmacokinetics: Both drugs are absorbed orally. Gatifloxacin is primarily excreted renally, while Ornidazole undergoes significant hepatic metabolism before renal excretion.

• Mode of Action:

  • Gatifloxacin: Inhibits DNA gyrase and topoisomerase IV, disrupting bacterial DNA replication and repair.
  • Ornidazole: Forms reactive metabolites that damage DNA, proteins, and cell membranes of anaerobic bacteria and parasites.

• Receptor binding, enzyme inhibition, or neurotransmitter modulation:

  • Gatifloxacin: Inhibits DNA gyrase and topoisomerase IV.
  • Ornidazole: Interacts with microbial DNA.

• Elimination pathways:

  • Gatifloxacin: Primarily renal excretion.
  • Ornidazole: Hepatic metabolism followed by renal excretion.

Dosage

Standard Dosage

Adults:

• 400 mg Gatifloxacin + 1000 mg Ornidazole orally, once daily. Duration depends on the infection, typically 3 to 10 days for diarrhea and dysentery.

Children:

Not recommended for children under 18.

Special Cases:

• Elderly Patients: Use with caution due to potential age-related decline in renal function. Monitor renal function.

• Patients with Renal Impairment: Dosage adjustment may be required in severe renal impairment.

• Patients with Hepatic Dysfunction: Use with caution as Ornidazole undergoes significant hepatic metabolism. Dosage adjustment might be needed.

• Patients with Comorbid Conditions: Use with caution in patients with diabetes, cardiovascular disease, or other conditions that may interact with the drug.

Clinical Use Cases

Dosage information for these specific clinical settings is not available. Standard dosages are generally applied, and adjustments may be made based on individual patient factors and severity of infection.

• Intubation
• Surgical Procedures
• Mechanical Ventilation
• Intensive Care Unit (ICU) Use
• Emergency Situations

Dosage Adjustments

Dosage modifications are necessary for renal/hepatic impairment. For severe renal impairment, reduce the dose or increase the dosing interval. For hepatic dysfunction, careful monitoring is recommended, and dose adjustment may be necessary.

Side Effects

Common Side Effects:

Nausea, vomiting, diarrhea, headache, dizziness, metallic taste, dryness in mouth, loss of appetite, stomach pain.

Rare but Serious Side Effects:

Allergic reactions (rash, hives, itching, swelling, shortness of breath), tendonitis, tendon rupture, liver damage, seizures, peripheral neuropathy, QT interval prolongation.

Long-Term Effects:

Chronic complications from prolonged use are rare but can include peripheral neuropathy.

Adverse Drug Reactions (ADR):

Severe allergic reactions (anaphylaxis), severe skin reactions, QT prolongation.

Contraindications

• Hypersensitivity to gatifloxacin, ornidazole, quinolones, or nitroimidazoles.
• History of tendinitis or tendon rupture with quinolone use.
• Myasthenia gravis.
• Central nervous system diseases.
• Peripheral nervous system diseases.

Drug Interactions

• Antacids, sucralfate, iron, calcium, zinc supplements
• Theophylline, warfarin, cyclosporine
• Antidiabetic agents (e.g., metformin, gliclazide)
• Alcohol can exacerbate side effects.

Pregnancy and Breastfeeding

• Pregnancy Safety Category: C (use only if benefits outweigh risks).
• Fetal risks: Potential for adverse effects on the developing fetus.
• Drug excretion in breast milk: Both drugs are secreted into breast milk; use is not recommended while breastfeeding.

Drug Profile Summary

• Mechanism of Action: Gatifloxacin: Inhibits DNA gyrase and topoisomerase IV. Ornidazole: Damages microbial DNA.
• Side Effects: Nausea, vomiting, diarrhea, headache, dizziness; rarely, tendonitis, seizures, allergic reactions.
• Contraindications: Hypersensitivity, tendinitis history with quinolones, myasthenia gravis.
• Drug Interactions: Antacids, metal ions, warfarin, theophylline, some antidiabetic agents.
• Pregnancy & Breastfeeding: Category C; not recommended during breastfeeding.
• Dosage: Adults: 400 mg + 1000 mg once daily. Adjustments needed for renal/hepatic impairment.
• Monitoring Parameters: Renal function, liver function tests, signs of allergic reactions, tendon pain.

Popular Combinations

Not applicable. This is already a combination product.

Precautions

• Pre-screening for allergies, liver/kidney disease is crucial.
• Caution in pregnant/breastfeeding women.
• Avoid alcohol.
• Monitor for tendon pain or inflammation.

FAQs (Frequently Asked Questions)

Q1: What is the recommended dosage for Gatifloxacin + Ornidazole?

A: Adults: 400 mg Gatifloxacin + 1000 mg Ornidazole once daily.

Q2: What are the common side effects?

A: Nausea, vomiting, diarrhea, headache, dizziness.

Q3: Can it be used in children?

A: No, it’s generally not recommended for patients under 18.

Q4: What are the serious side effects to watch out for?

A: Allergic reactions, tendonitis, liver damage, seizures.

Q5: Are there any drug interactions I should be aware of?

A: Yes, it interacts with antacids, metal supplements, warfarin, theophylline, and some antidiabetic drugs.

Q6: Can it be used during pregnancy or breastfeeding?

A: Pregnancy Category C – use with caution if benefits outweigh risks. Avoid during breastfeeding.

Q7: What should I do if a dose is missed?

A: Take the missed dose as soon as you remember, unless it’s close to the next dose. Don’t double the dose.

Q8: Can patients operate machinery while taking this medication?

A: Use caution as dizziness may occur.

Q9: What is the duration of treatment?

A: Depends on the infection but typically 3-10 days for diarrhea and dysentery.

Q10: What are the key monitoring parameters for this combination?

A: Renal function, liver function tests, signs of hypersensitivity, and tendon pain.