Препарат Абактал применяется при антибактериальной терапии следующих заболеваний, вызванных чувствительными к пефлоксацину микроорганизмами: Инфекции центральной нервной системы (ЦНС) (бактериальный менингит, вызванный менингококками или грамотрицательными бактериями, в том числе послеоперационный или посттравматический). Инфекции верхних дыхательных ...
Гиперчувствительность к фторхинолонам. Пациенты с дефицитом глюкозо-6-фосфатдегидрогеназы (гемолитическая анемия). Дефицит лактазы, непереносимость лактозы, синдром глюкозо-галактозной мальабсорбции. Детский возраст до 18 лет. Беременность и период лактации. С осторожностью: Нарушение функций центральной нервной системы (в т.ч. Эпилептический синдром ...
Синтетический антибактериальный препарат из группы фторхинолонов. Оказывает бактерицидное действие, ингибируя репликацию ДНК бактерий на уровне ДНК-гиразы. Абактал активен в отношении Staphylococcus aureus, Escherichia coli, Klebsiella spp., Enterobacter spp., Serratia spp., Proteus mirabilis, индол-положительные штаммы Proteus spp., Сitrobacter spp., Salmonella spp., Shigella spp., Haemophilus influenzae, Neisseria gonorrhoeae. К препарату умеренно чувствительны Streptococcus spp. (в т.ч. Streptococcus pneumoniae), Pseudomonas spp., Acinetobacter spp., Clostridium perfringens, Mycoplasma spp., Chlamydia spp. К препарату устойчивы грамотрицательные анаэробы, Spirochaeta spp., Mycobacterium tuberculosis.
Показания к применению
Препарат Абактал применяется при антибактериальной терапии следующих заболеваний, вызванных чувствительными к пефлоксацину микроорганизмами: Инфекции центральной нервной системы (ЦНС) (бактериальный менингит, вызванный менингококками или грамотрицательными бактериями, в том числе послеоперационный или посттравматический). Инфекции верхних дыхательных путей и ЛОР-органов (острый и хронический синусит, мастоидит). Инфекции нижних дыхательных путей (острый и обострение хронического бронхита, бронхоэктатическая болезнь, внебольничная и госпитальная пневмония, вызванные грамотрицательными бактериями или внутриклеточными возбудителями). Инфекции брюшной полости (холецистит, холангит, лечение и профилактика инфекционных осложнений панкреатита, местный и распространенный перитонит, в том числе послеоперационный). Осложненные и неосложненные инфекции почек и мочевыводящих путей (острый и обострение хронического пиелонефрита, инфекционные осложнения после операции на мочевыводящих путях). Инфекции органов малого таза у женщин (пельвиоперитонит, сальпингоофорит, тубоовариальный абсцесс, эндометрит, бартолинит). Инфекции репродуктивной системы у мужчин (орхит, орхоэпидидимит, простатит). Инфекции кожи и мягких тканей, вызванные пенициллиноустойчивыми штаммами стафилококка. Инфекции костей и суставов (в т.ч. остеомиелит, вызванный грамотрицательными микроорганизмами). Бактериальный эндокардит. Инфекции, передаваемые половым путем (гонорея, урогенитальный хламидиоз). Бактериальные инфекции желудочно-кишечного тракта, в т.ч. эшерихиоз, шигеллез, холера, сальмонеллез, брюшной тиф, паратифы А, В, С, иерсиниоз. Профилактика инфекций у больных с иммунодефицитом.
Противопоказания
Гиперчувствительность к фторхинолонам. Пациенты с дефицитом глюкозо-6-фосфатдегидрогеназы (гемолитическая анемия). Дефицит лактазы, непереносимость лактозы, синдром глюкозо-галактозной мальабсорбции. Детский возраст до 18 лет. Беременность и период лактации. С осторожностью: Нарушение функций центральной нервной системы (в т.ч. Эпилептический синдром неустановленной этиологии). Сочетанная печеночно-почечная недостаточность, печеночная недостаточность тяжелой степени.
Применение при беременности и в период грудного вскармливания
Абактал противопоказан к применению при беременности. При необходимости применения препарата в период лактации следует решить вопрос о прекращении грудного вскармливания.
Способ применения и дозы
Внутрь. Во избежание желудочно-кишечных расстройств таблетки следует принимать во время еды. Средняя доза составляет 800 мг в сутки. Препарат назначают по 1 таблетке (400 мг) два раза в сутки, каждые 12 часов. Максимальная суточная доза составляет 1200 мг. При лечении некоторых инфекций мочеполовой системы возможно назначение Абактала в дозе 1 таблетка (400 мг) один раз в сутки, утром или вечером. Для лечения неосложненной гонореи у мужчин и женщин назначается 800 мг препарата Абактал однократно. У пациентов с тяжелым нарушением функции печени выведение пефлоксацина значительно замедляется, поэтому рекомендованная суточная доза препарата составляет 400 мг каждые 24–48 часов после определения его сывороточных концентраций. У пациентов с нарушением почечной функции выведение пефлоксацина остается практически неизменным, поскольку наибольшая часть препарата выводится печенью. В связи с этим снижения дозы пефлоксацина для пациентов с нарушением функции почек не требуется. На начальных этапах лечения препарат Абактал может применяться парентерально; после достижения положительной динамики и при наличии показаний для продолжения терапии переходят на прием пероральной формы препарата.
Побочное действие
Со стороны нервной системы и органов чувств депрессия, головная боль, головокружение, повышенная утомляемость, бессонница, повышение судорожной готовности, чувство беспокойства, повышенная раздражительность, возбуждение, кошмарные сновидения, расстройства зрения, спутанность сознания, галлюцинации, тремор, судороги (в том числе эпилептические припадки). Со стороны пищеварительной системы тошнота, рвота, диарея, боль в животе, изменения вкуса, снижение аппетита, метеоризм, псевдомембранозный колит, транзиторное повышение активности печеночных трансаминаз, а также щелочной фосфатазы и концентрации билирубина, холестатическая желтуха, гепатит, некроз печени. Со стороны мочеполовой системы кристаллурия, гломерулонефрит, дизурия, интерстициальный нефрит. Аллергические реакции кожная сыпь, кожный зуд, крапивница, гиперемия кожи, фотосенсибилизация (как к солнечному свету, так и к ультрафиолетовому излучению (УФ)), фотоонихолизис, отек Квинке, бронхоспазм, артралгии. Со стороны системы крови и органов кроветворения лейкопения, нейтропения, тромбоцитопения (при применении в высоких дозах), агранулоцитоз, эозинофилия. Со стороны скелетно-мышечной системы миалгии и/или артралгии, артропатии, тендинит, разрыв ахиллова сухожилия. Прочие тахикардия, кандидоз, удлинение интервала Q-T.
Передозировка
Симптомы: тошнота, рвота, спутанность сознания, психическое возбуждение; в тяжелых случаях - потеря сознания, судороги. Лечение: промывание желудка, активированный уголь. Необходимо обеспечить медицинский контроль состояния пациента, достаточное поступление жидкости в организм больного; при необходимости проводят симптоматическую терапию. Гемодиализ не является эффективным методом удаления производных хинолона из организма.
Особые указания
Раствор для инъекций применяют только в условиях стационара. Вследствие возможной фотосенсибилизации в период лечения Абакталом следует избегать УФ-облучения и попадания прямых солнечных лучей в течение 6 суток после прекращения терапии. При появлении аллергической реакции или изменений со стороны ЦНС, а также при подозрении на тендинит следует немедленно отменить препарат. Факторы риска по развитию тендинитов на фоне терапии фторхинолонами включают: возраст старше 60 лет, почечная недостаточность, проведение диализа, сопутствующая терапия ГКС, дислипидемия. Пациент должен быть предупрежден о необходимости отменить препарат при появлении начальных признаков тендинита, исключить нагрузку на пораженную конечность и обратиться к врачу. Могут наблюдаться ложноположительные результаты при определении глюкозы в моче методом восстановления меди (с использованием сульфата меди), поэтому следует использовать ферментативные методы анализа. Препарат можно применять в комбинации с бета-лактамными антибиотиками, метронидазолом, ванкомицином и рифампицином. Необходимо соблюдать осторожность при одновременном назначении пефлоксацина и изониазида. Влияние на способность к вождению автотранспорта и управлению механизмами: На фоне применения Абактала следует соблюдать осторожность при занятии потенциально опасными видами деятельности, требующими повышенного внимания и быстроты психомоторных реакций.
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1 таблетке содержится: Активное вещество: пефлоксацина мезилата дигидрат 558.5 мг, что соответствует содержанию пефлоксацина 400 мг. Вспомогательные вещества: лактозы моногидрат - 79.5 мг, крахмал кукурузный - 32 мг, повидон - 32 мг, карбоксиметилкрахмал натрия - 32 мг, тальк - 27 мг, кремния диоксид коллоидный безводный - 2 мг, магния стеарат - 7 мг. Состав оболочки: гипромеллоза - 13.166 мг, титана диоксид - 2.09 мг, тальк - 854 мкг, макрогол 400 - 1.79 мг, воск карнаубский - 100 мкг."}}]},{"id":2,"name":"Фармакологические свойства","slug":"pharmacologic_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Синтетический антибактериальный препарат из группы фторхинолонов. Оказывает бактерицидное действие, ингибируя репликацию ДНК бактерий на уровне ДНК-гиразы. Абактал активен в отношении Staphylococcus aureus, Escherichia coli, Klebsiella spp., Enterobacter spp., Serratia spp., Proteus mirabilis, индол-положительные штаммы Proteus spp., Сitrobacter spp., Salmonella spp., Shigella spp., Haemophilus influenzae, Neisseria gonorrhoeae. К препарату умеренно чувствительны Streptococcus spp. (в т.ч. Streptococcus pneumoniae), Pseudomonas spp., Acinetobacter spp., Clostridium perfringens, Mycoplasma spp., Chlamydia spp. К препарату устойчивы грамотрицательные анаэробы, Spirochaeta spp., Mycobacterium tuberculosis."}}]},{"id":3,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Препарат Абактал применяется при антибактериальной терапии следующих заболеваний, вызванных чувствительными к пефлоксацину микроорганизмами: Инфекции центральной нервной системы (ЦНС) (бактериальный менингит, вызванный менингококками или грамотрицательными бактериями, в том числе послеоперационный или посттравматический). Инфекции верхних дыхательных путей и ЛОР-органов (острый и хронический синусит, мастоидит). Инфекции нижних дыхательных путей (острый и обострение хронического бронхита, бронхоэктатическая болезнь, внебольничная и госпитальная пневмония, вызванные грамотрицательными бактериями или внутриклеточными возбудителями). Инфекции брюшной полости (холецистит, холангит, лечение и профилактика инфекционных осложнений панкреатита, местный и распространенный перитонит, в том числе послеоперационный). Осложненные и неосложненные инфекции почек и мочевыводящих путей (острый и обострение хронического пиелонефрита, инфекционные осложнения после операции на мочевыводящих путях). Инфекции органов малого таза у женщин (пельвиоперитонит, сальпингоофорит, тубоовариальный абсцесс, эндометрит, бартолинит). Инфекции репродуктивной системы у мужчин (орхит, орхоэпидидимит, простатит). Инфекции кожи и мягких тканей, вызванные пенициллиноустойчивыми штаммами стафилококка. Инфекции костей и суставов (в т.ч. остеомиелит, вызванный грамотрицательными микроорганизмами). Бактериальный эндокардит. Инфекции, передаваемые половым путем (гонорея, урогенитальный хламидиоз). Бактериальные инфекции желудочно-кишечного тракта, в т.ч. эшерихиоз, шигеллез, холера, сальмонеллез, брюшной тиф, паратифы А, В, С, иерсиниоз. Профилактика инфекций у больных с иммунодефицитом."}}]},{"id":4,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Гиперчувствительность к фторхинолонам. Пациенты с дефицитом глюкозо-6-фосфатдегидрогеназы (гемолитическая анемия). Дефицит лактазы, непереносимость лактозы, синдром глюкозо-галактозной мальабсорбции. Детский возраст до 18 лет. Беременность и период лактации. С осторожностью: Нарушение функций центральной нервной системы (в т.ч. Эпилептический синдром неустановленной этиологии). Сочетанная печеночно-почечная недостаточность, печеночная недостаточность тяжелой степени."}}]},{"id":5,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Абактал противопоказан к применению при беременности. При необходимости применения препарата в период лактации следует решить вопрос о прекращении грудного вскармливания."}}]},{"id":6,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Внутрь. Во избежание желудочно-кишечных расстройств таблетки следует принимать во время еды. Средняя доза составляет 800 мг в сутки. Препарат назначают по 1 таблетке (400 мг) два раза в сутки, каждые 12 часов. Максимальная суточная доза составляет 1200 мг. При лечении некоторых инфекций мочеполовой системы возможно назначение Абактала в дозе 1 таблетка (400 мг) один раз в сутки, утром или вечером. Для лечения неосложненной гонореи у мужчин и женщин назначается 800 мг препарата Абактал однократно. У пациентов с тяжелым нарушением функции печени выведение пефлоксацина значительно замедляется, поэтому рекомендованная суточная доза препарата составляет 400 мг каждые 24–48 часов после определения его сывороточных концентраций. У пациентов с нарушением почечной функции выведение пефлоксацина остается практически неизменным, поскольку наибольшая часть препарата выводится печенью. В связи с этим снижения дозы пефлоксацина для пациентов с нарушением функции почек не требуется. На начальных этапах лечения препарат Абактал может применяться парентерально; после достижения положительной динамики и при наличии показаний для продолжения терапии переходят на прием пероральной формы препарата."}}]},{"id":7,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Со стороны нервной системы и органов чувств депрессия, головная боль, головокружение, повышенная утомляемость, бессонница, повышение судорожной готовности, чувство беспокойства, повышенная раздражительность, возбуждение, кошмарные сновидения, расстройства зрения, спутанность сознания, галлюцинации, тремор, судороги (в том числе эпилептические припадки). Со стороны пищеварительной системы тошнота, рвота, диарея, боль в животе, изменения вкуса, снижение аппетита, метеоризм, псевдомембранозный колит, транзиторное повышение активности печеночных трансаминаз, а также щелочной фосфатазы и концентрации билирубина, холестатическая желтуха, гепатит, некроз печени. Со стороны мочеполовой системы кристаллурия, гломерулонефрит, дизурия, интерстициальный нефрит. Аллергические реакции кожная сыпь, кожный зуд, крапивница, гиперемия кожи, фотосенсибилизация (как к солнечному свету, так и к ультрафиолетовому излучению (УФ)), фотоонихолизис, отек Квинке, бронхоспазм, артралгии. Со стороны системы крови и органов кроветворения лейкопения, нейтропения, тромбоцитопения (при применении в высоких дозах), агранулоцитоз, эозинофилия. Со стороны скелетно-мышечной системы миалгии и/или артралгии, артропатии, тендинит, разрыв ахиллова сухожилия. 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При появлении аллергической реакции или изменений со стороны ЦНС, а также при подозрении на тендинит следует немедленно отменить препарат. Факторы риска по развитию тендинитов на фоне терапии фторхинолонами включают: возраст старше 60 лет, почечная недостаточность, проведение диализа, сопутствующая терапия ГКС, дислипидемия. Пациент должен быть предупрежден о необходимости отменить препарат при появлении начальных признаков тендинита, исключить нагрузку на пораженную конечность и обратиться к врачу. Могут наблюдаться ложноположительные результаты при определении глюкозы в моче методом восстановления меди (с использованием сульфата меди), поэтому следует использовать ферментативные методы анализа. Препарат можно применять в комбинации с бета-лактамными антибиотиками, метронидазолом, ванкомицином и рифампицином. Необходимо соблюдать осторожность при одновременном назначении пефлоксацина и изониазида. 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