Ofloxacin
Mechanism :
It is an antibacterial agent of the fluoroquinolone group. It useful against gram positive and gram-negative organisms. It is also used as an additional agent in the treatment of multidrug resistance tuberculosis.
Indication :
- Diarrhea
- UTI
- Typhoid
- Multidrug resistant tuberculosis.
- Drops: are used for the following conditions:
- Bacterial conjunctivitis
- Corneal ulcer
- Otitis externa
- Acute otitis media with tympanostomy tubes or chronic suppurative otitis media with perforated tympanic membrane.
Contraindications :
Prolonged QT interval, Hypokalemia, Myasthenia gravis, Hypersensitivity.
Dosing :
Oral:
10-15 mg/kg/day in 2 divided doses PO/IV. Max: 400 mg/dose.
Bacterial conjunctivitis, Corneal ulcer: Available as 0.3% ophthalmic solution.
>1 year:
Day 1 and 2 put 1-2 drops in affected eye every 2-4 hours. From day 3-7, put 1-2 drops, every 6 hours until clinical cure.
Otitis media:
Available as 0.3% otic drops
1-12 years: 5 drops in affected ear twice daily.
>12 years: 10 drops in affected ear twice daily.
Give for 1 week for acute otitis media with tympanostomy tubes and for 2 weeks for chronic suppurative otitis media with perforated tympanic membrane.
Adverse Effect :
Nausea, vomiting, abdominal pain, leukopenia, eosinophilia.
Ocular preparation: Ocular burning, eye pain, pruritus, stinging, tearing, dryness, blurred vision, foreign body sensation, photophobia, conjunctival hyperemia, chemical conjunctivitis/keratitis, periocular oedema.
Otic preparation: Application site reactions, pruritus, earache, rash, vertigo, taste perversion, dizziness, paresthesia.
Interaction :
Interaction Characteristics:
CYP1A2 inhibitor weak, alters GI flora, binds to polyvalent cations, hyperglycemia, hypoglycemia, lowers seizure threshold, photosensitivity, prolongs QT interval probable.
Contraindicated:
Amiodarone, BCG live intravesical, cisapride, disopyramide, dofetilide, dronedarone, ibutilide, pimozide, procainamide, quinidine (antiarrhythmic), sotalol, thioridazine, ziprasidone.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | 200–400 mg once daily |
| 10-20 | 200–400 mg once daily |
| <10 | 200 mg once daily |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Not significantly dialysed. Dose as in GFR<10 mL/min |
| HD | Dialysed. Dose as in GFR<10 mL/ min |
| HDF/High flux | Dialysed. Dose as in GFR<10 mL/ min |
| CAV/VVHD | Dialysed. Dose as in GFR=10– 20 mL/min |
Hepatic Dose :
Establishment of safety profile has not been done. In severe hepatic impairment half of maximum dose should not be exceeded.