Usage
Pazufloxacin is prescribed for various bacterial infections. It is a fluoroquinolone antibiotic indicated for infections of the urinary tract, respiratory tract (including pneumonia and lung abscess), skin and soft tissues, female genital tract, abdomen (including peritonitis, liver abscess, and gallbladder infections), tonsils, sinuses, nose, and throat. It is also used for secondary infections following injuries, burns, and post-operative wounds.
Pazufloxacin inhibits bacterial DNA gyrase and topoisomerase IV. By blocking these enzymes, pazufloxacin prevents bacterial DNA replication and repair, leading to bacterial cell death.
Alternate Names
Pazufloxacin mesylate is the generic name. Brand names include Pazibid, Pazumac, Pazace, Pazflo, Pruflox, Prutis, Prutop, Puribact, and Superquin (availability may vary by region).
How It Works
Pharmacodynamics: Pazufloxacin exerts its bactericidal effect by inhibiting bacterial DNA gyrase and topoisomerase IV. These enzymes are essential for bacterial DNA replication, transcription, repair, and recombination. The inhibition results in the inability of bacteria to replicate and ultimately leads to their death. Pazufloxacin exhibits a broad spectrum of activity against gram-positive, gram-negative, and anaerobic bacteria, including some drug-resistant strains. It shows potent activity against Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Klebsiella spp., Enterobacter spp., and many other clinically relevant pathogens.
Pharmacokinetics: Pazufloxacin is available for both intravenous (IV) and oral administration. After IV administration, the drug is widely distributed throughout the body. It is primarily eliminated through renal excretion. The half-life allows for twice-daily dosing in most cases.
Dosage
Standard Dosage
Adults:
The usual recommended dose for most infections is 400-500 mg intravenously every 12 hours, administered as an infusion over 30-60 minutes. The dose may be reduced to 300 mg twice daily depending on the severity of the infection and the patient’s age and condition. Oral administration is also possible when feasible, using similar dosages.
Children:
Dosage in children is typically weight-based and must be determined by a doctor. Consult pediatric dosing guidelines for specific age and weight ranges. Pediatric safety needs to be carefully considered.
Special Cases:
- Elderly Patients: Dosage adjustments may be needed due to age-related decline in renal function.
- Patients with Renal Impairment: Reduce dosage based on creatinine clearance or glomerular filtration rate.
- Patients with Hepatic Dysfunction: Cautious use is advised. Monitor liver function tests.
- Patients with Comorbid Conditions: Consider adjustments based on the specific comorbidity and its potential interaction with pazufloxacin.
Clinical Use Cases
Dosage adjustments may be necessary depending on the specific clinical context: Consult specialized guidelines for:
- Intubation
- Surgical Procedures
- Mechanical Ventilation
- Intensive Care Unit (ICU) Use
- Emergency Situations
Side Effects
Common Side Effects
Nausea, vomiting, diarrhea, allergic reactions (rash, itching), abnormal liver function tests, stomach pain, injection site reactions (pain, swelling, redness), headache.
Rare but Serious Side Effects
Clostridium difficile colitis, QT interval prolongation, tendonitis, tendon rupture (especially Achilles tendon), seizures, psychosis, severe allergic reactions (anaphylaxis), Stevens-Johnson syndrome.
Long-Term Effects
Peripheral neuropathy, chronic tendon problems.
Contraindications
Hypersensitivity to pazufloxacin or other fluoroquinolones, epilepsy or history of seizures, myasthenia gravis, pregnancy (especially first trimester), breastfeeding (if alternative treatment is available).
Drug Interactions
Antacids, iron supplements, calcium supplements, sucralfate, theophylline, warfarin, nonsteroidal anti-inflammatory drugs (NSAIDs) (increased risk of seizures), drugs that prolong the QT interval.
Pregnancy and Breastfeeding
Pazufloxacin is generally contraindicated during pregnancy, especially in the first trimester, due to the potential risk of fetal harm. If use is unavoidable during breastfeeding, monitor the infant for potential side effects such as diarrhea and thrush.
Drug Profile Summary
- Mechanism of Action: Inhibits bacterial DNA gyrase and topoisomerase IV.
- Side Effects: Nausea, vomiting, diarrhea, allergic reactions, headache, tendonitis, QT prolongation (rare).
- Contraindications: Hypersensitivity to fluoroquinolones, epilepsy, myasthenia gravis.
- Drug Interactions: Antacids, iron/calcium supplements, NSAIDs, warfarin, theophylline.
- Pregnancy & Breastfeeding: Contraindicated/Use with caution.
- Dosage: 400-500 mg IV every 12 hours (adults). Pediatric dose is weight-based.
- Monitoring Parameters: Liver function tests, renal function, signs of tendonitis, ECG (for QT prolongation), complete blood count.
Precautions
- Monitor for signs of tendonitis/tendon rupture.
- Avoid concomitant use of NSAIDs if possible.
- Adjust dosage in patients with renal/hepatic impairment.
- Caution in elderly patients.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Pazufloxazin?
A: 400-500 mg IV every 12 hours for adults. Pediatric dosing is weight-based and requires consultation with a doctor. Dosage adjustments may be necessary in renal/hepatic impairment, elderly patients, and specific clinical situations.
Q2: What are the most common side effects?
A: Nausea, vomiting, diarrhea, and headache.
Q3: What are the serious side effects of Pazufloxazin?
A: Tendon rupture, QT prolongation, C. difficile colitis, seizures.
Q4: Can Pazufloxazin be used during pregnancy or breastfeeding?
A: Generally contraindicated, especially during the first trimester of pregnancy. Use with caution during breastfeeding if benefits outweigh risks, and an alternative is unavailable.
Q5: What are the contraindications to using Pazufloxazin?
A: Hypersensitivity to pazufloxacin or other fluoroquinolones, epilepsy, myasthenia gravis.
Q6: What are the drug interactions with Pazufloxazin?
A: Antacids, iron or calcium supplements, NSAIDs (increased risk of seizures), warfarin, and theophylline.
Q7: How is Pazufloxazin administered?
A: Intravenous infusion over 30-60 minutes. Oral administration is possible when IV is not feasible.
Q8: How does Pazufloxazin work?
A: Pazufloxacin inhibits bacterial DNA gyrase and topoisomerase IV, preventing bacterial DNA replication and repair.
Q9: What infections is pazufloxacin used to treat?
A: Urinary tract infections, respiratory tract infections (including pneumonia), skin and soft tissue infections, abdominal infections, and certain other bacterial infections.
Q10: What should patients be advised regarding pazufloxacin therapy?
A: Patients should be advised to complete the entire course of therapy even if they feel better, to report any signs of tendon pain or swelling, and to inform their doctor of any other medications they are taking. They should also be informed about potential side effects and to seek medical attention if any severe reactions occur.
