▶Promixin(Profile Pharma Ltd)
Colistimethate sodium 1000000 unitPromixin 1 million unit
powder for solution for injection vials| 10 vialP£ 30. 00 DT =
£ 18. 00 (Hospital only)
Inhalation powder
▶Colobreathe(Teva UK Ltd)
Colistimethate sodium 1662500 unitColobreathe 1 , 662 , 500 unit
inhalation powder capsules| 56 capsuleP£ 968. 80
Powder for nebuliser solution
▶ColiFin(Pari Medical Ltd)
Colistimethate sodium 1000000 unitColiFin 1 MIU powder for
nebuliser solution unit dose vials| 56 unit doseP£ 180. 53
Colistimethate sodium 2000000 unitColiFin 2 MIU powder for
nebuliser solution unit dose vials| 56 unit doseP£ 261. 72
▶Promixin(Profile Pharma Ltd)
Colistimethate sodium 1000000 unitPromixin 1 million unit
powder for nebuliser solution unit dose vials| 30 unit doseP
£ 168. 00 DT = £ 168. 00ANTIBACTERIALS›QUINOLONES
Quinolones 31-Oct-2017
Overview
Ciprofloxacin below is active against both Gram-positive and
Gram-negative bacteria. It is particularly active against
Gram-negative bacteria, includingSalmonella,Shigella,
Campylobacter,Neisseria, andPseudomonas. Ciprofloxacin
has only moderate activity against Gram-positive bacteria
such asStreptococcus pneumoniaeandEnterococcus faecalis;
it should not be used for pneumococcal pneumonia. It is
active againstChlamydiaand some mycobacteria. Most
anaerobic organisms are not susceptible.
Nalidixic acid is licensed for urinary tract infections or
gastro-intestinal infections caused by Gram-negative
organisms, other than Pseudomonas species, sensitive to
nalidixic acid.
ManyStaphylococciare resistant to quinolones and their
use should be avoided in MRSA infections.
Ofloxacin eye drops p.^677 are used in ophthalmic
infections.
There is much less experience of the other quinolones in
children; expert advice should be sought.Quinolones f
IMPORTANT SAFETY INFORMATION
The CSM has warned that quinolones may induce
convulsionsin patients with or without a history of
convulsions; taking NSAIDs at the same time may also
induce them.
TENDON DAMAGE
Tendon damage (including rupture) has been reported
rarely in patients receiving quinolones. Tendon rupture
may occur within 48 hours of starting treatment; cases
have also been reported several months after stopping a
quinolone. Healthcare professionals are reminded that:
.quinolones are contra-indicated in patients with a
history of tendon disorders related to quinolone use;
.the risk of tendon damage is increased by the
concomitant use of corticosteroids;
.if tendinitis is suspected, the quinolone should be
discontinued immediately.lCONTRA-INDICATIONSHistory of tendon disorders related
to quinolone use
lCAUTIONSCan prolong the QT interval.children or
adolescents (arthropathy has developed in weight-bearing
joints in younganimals).conditions that predispose to
seizures.diabetes (may affect blood glucose).exposure to
excessive sunlight should be avoided (discontinue ifphotosensitivity occurs).G6PD deficiency.history of
epilepsy.myasthenia gravis (risk of exacerbation)
CAUTIONS, FURTHER INFORMATIONQuinolones cause
arthropathy in the weight-bearing joints of immature
animalsand are therefore generally not recommended in
children and growing adolescents. However, the
significance of this effect in humans is uncertain and in
some specific circumstances short-term use of
ciprofloxacin may be justified in children.
lSIDE-EFFECTS
▶Common or very commonAppetite decreased.arthralgia.
asthenia.constipation.diarrhoea.dizziness.dyspnoea.
eye discomfort.eye disorders.fever.gastrointestinal
discomfort.headache.hearing impairment.hepatic
disorders.myalgia.nausea.QT interval prolongation.
rhabdomyolysis.skin reactions.sleep disorders.taste
altered.vision disorders.vomiting
▶UncommonAnaemia.anxiety.arrhythmias.chest pain.
confusion.depression.drowsiness.dry eye.eosinophilia.
eye inflammation.flatulence.hallucination.
hyperhidrosis.hypersensitivity.hypotension.leucopenia
.neutropenia.pain.paraesthesia.renal failure.seizure.
smell altered.tendon disorders.thrombocytopenia.
tremor.vertigo
▶Rare or very rareAgranulocytosis.angioedema.arthritis.
coordination abnormal.haemolytic anaemia.
hyperglycaemia.hypoglycaemia.muscle weakness.
myasthenia gravis aggravated.nephritis tubulointerstitial
.pancreatitis.photosensitivity reaction.polyneuropathy.
pseudomembranous enterocolitis.psychotic disorder.
severe cutaneous adverse reactions (SCARs).stomatitis.
suicidal tendencies.syncope.vasculitis
▶Frequency not knownPeripheral neuropathy (sometimes
irreversible)
SIDE-EFFECTS, FURTHER INFORMATIONThe drug should be
discontinued if psychiatric, neurological, or
hypersensitivity reactions (including severe rash) occur.
lALLERGY AND CROSS-SENSITIVITYUse of quinolones
contra-indicated in quinolone hypersensitivity.
lPREGNANCYAvoid in pregnancy—shown to cause
arthropathy inanimalstudies; safer alternatives are
available.eiiiiFaboveCiprofloxacin 26-Apr-2018
lINDICATIONS AND DOSE
Fistulating Crohn’s disease
▶BY MOUTH
▶Child: 5 mg/kg twice daily
Severe respiratory-tract infections, gastro-intestinal
infection
▶BY MOUTH
▶Neonate: 15 mg/kg twice daily.▶Child: 20 mg/kg twice daily (max. per dose 750 mg)
▶BY INTRAVENOUS INFUSION
▶Neonate: 10 mg/kg every 12 hours, to be given over
60 minutes.▶Child: 10 mg/kg every 8 hours (max. per dose 400 mg),
to be given over 60 minutes
Pseudomonal lower respiratory-tract infection in cystic
fibrosis
▶BY MOUTH
▶Child: 20 mg/kg twice daily (max. per dose 750 mg)
▶BY INTRAVENOUS INFUSION
▶Child: 10 mg/kg every 8 hours (max. per dose 400 mg),
to be given over 60 minutes348 Bacterial infection BNFC 2018 – 2019
Infection5