Instructions for Norbactin (Norfloxacin)
Pharmacological properties:
Pharmacodynamics
An antibacterial drug of a fluoroquinolone series with a wide spectrum of bactericidal action, the mechanism of which is based on inhibition of the DNA gyrase of a bacterial cell, as a result of which the function of the DNA bacterium is disrupted.
Norbactin is active against a wide range of gram-positive and gram-negative microorganisms, including strains resistant to the action of penicillins, cephalosporins, aminoglycosides, tetracyclines, sulfonamides. The main part of the spectrum of action of Norfloxacin with possible geographical differences in sensitivity is the effect on Neisseria gonorrhoeae (including strains producing penicillinase).
Norfloxacin is generally effective against pathogens that cause urinary tract infections such as E. coli, Enterobacter spp., Klebsiellae, Proteus spp., Pseudomonas aeruginosa and Serratia marcescens . In addition, Norfloxacin may be effective against enteritis-causing pathogens such as E. coli, Salmonella enteritis, and Campylobacter spp.
Norfloxacin is moderately active against certain strains of Ureaplasma urealyticum . Resistance is to be expected from Enterococcus faecalis and Enterococcus faecium.
Norfloxacin is ineffective against obligate anaerobic pathogens such as Actinomyces spp., Bacterioides spp., Clostridium spp. (with the exception of certain strains of C. perfringens ) and Peptostreptococcus spp. as well as Stenotrophomonas maltophilia and Chlamidia trachomatis . There is a partial cross-resistance of Norfloxacin with other fluoroquinolones. No cross-resistance with structurally unrelated drugs such as penicillins, cephalosporins, tetracyclines, macrolide, aminoglycosides and sulfonamides, 2,4-dihydropyrimidines or combinations of these substances (co-trimoxazole). Methicillin-resistant staphylococci are mostly resistant to the action of fluoroquinolones.
Norbactin Pharmacokinetics:
Norfloxacin is rapidly absorbed in the gastrointestinal tract after oral administration, the absolute bioavailability of the drug is 30-40%. Food intake slows down the absorption of the drug. The maximum concentration in blood plasma is reached within 1-2 hours after oral administration at a dose of 400 mg. The half-life of the drug is about 4 hours, it increases with renal failure and with an increase in the dose of the drug. About 14% of the drug binds to blood plasma proteins. Norfloxacin creates high concentrations in the tissues of the urogenital tract, in urine and bile. Approximately 30% of the dose is excreted unchanged in the urine for 24 hours. About 30% of the dose is excreted in the feces.
Norbactin Indications:
Treatment of infections caused by microorganisms sensitive to Norfloxacin :
acute and chronic (complicated or uncomplicated) infections of the upper and lower parts of the urinary system (cystitis, pyelitis, cystopyelitis, pyelonephritis); urinary tract infections associated with surgery and urological procedures or urolithiasis.
Prevention of infections caused by gram-negative bacteria in patients with weakened immunity and severe neutropenia.
Norbactin Application:
Norbactin is used in adults.
The drug is taken with liquid on an empty stomach or with food. It is better to take it 2 times a day (morning and evening), but you can take it once a day (at the same time).
Dosage depends on the sensitivity of pathogenic microorganisms to the drug and the severity of the disease, therefore, before starting treatment, the sensitivity of pathogens to Norfloxacin is determined . However, treatment can be started before the results of the sensitivity test are available. In this case, before the start of the planned therapy, it is necessary to select material for laboratory diagnostics in order to be able to change the treatment in the absence of sensitivity of pathogens to Norfloxacin .
Norfloxacin Indication:
Dosage Duration of use
Uncomplicated acute cystitis 400 mg 2 times a day 3 days
Urinary tract infections 400 mg 2 times a day 7-20 daysone
Chronic recurrent urinary tract infections 400 mg 2 times a day up to 12 weeks 2
Prevention of gram-negative infections in immunocompromised patients with severe neutropenia 400 mg 2-3 times a day All period
neutropenia 3
Some symptoms of urinary tract infections (burning during urination, fever, pain) stop after 1–2 days, but treatment is continued as recommended; 2 if the desired therapeutic effect is achieved within the first 4 weeks, the dose of Norbactin can be reduced to 1 tablet per day; 3 there are currently no data on the duration of treatment over 8 weeks.
Renal insufficiency . Norbactin can be used for renal failure. With creatinine clearance ≤30 ml / min / 1.73 m 2, the dose of Norbactin should not exceed 1 tablet per day.
Elderly patients. In the absence of renal failure, there is no need to adjust the dose of Norbactin.
Contraindications Norbactin:
A history of hypersensitivity to Norfloxacin and other components of the drug, as well as to other drugs of the fluoroquinolone group, severe renal failure, age up to 18 years, pregnancy and lactation, tendonitis or tendon ruptures associated with the use of quinolones.
