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Cipro pneumonia

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    Cipro pneumonia


    Winter is almost here, and a typical phone call to the pharmacy will likely involve questions about antibiotics to treat pneumonia. When doctors call, it is usually because the patient has multiple drug allergies and/or drug interactions that make antibiotic selection difficult. Based on Infectious Disease Society of America/American Thoracic Society guidelines, I have organized the information in a chart that makes sense to me. This chart is my sole creation, and I encourage others to formulate their own charts if they do not understand or like mine. I organized my chart from the least-aggressive drug regimen to the most aggressive. Once a bacterium is identified in the cultures, de-escalation occurs to avoid unnecessary adverse effects, costs, and possible drug resistance. What is significant for retail pharmacists is that the guidelines are for doxy or a macrolide but never both at the same time. If a prescription comes across for a z-pack and doxy, that would be a red flag to call the doctor. looking to buy clomid Mild/moderate: 500 mg PO q12hr or 400 mg IV q12hr for 7-14 days Severe/complicated: 750 mg PO q12hr or 400 mg IV q8hr for 7-14 days Limitations-of-use: Reserve fluoroquinolones for patients who do not have other available treatment options for acute bacterial exacerbation of chronic bronchitis Acute uncomplicated: Immediate-release, 250 mg PO q12hr for 3 days; extended-release, 500 mg PO q24hr for 3 days Mild/moderate: 250 mg PO q12hr or 200 mg IV q12hr for 7-14 days Severe/complicated: 500 mg PO q12hr or 400 mg IV q12hr for 7-14 days Limitations-of-use: Reserve fluoroquinolones for patients who do not have other available treatment options for uncomplicated urinary tract infections Dry powder for inhalation: Orphan designation for patients with NCFB who suffer from frequent severe acute pulmonary bacterial exacerbations which lead to further inflammation, airway, and lung parenchyma damage Indication for treatment and prophylaxis of plague due to Yersinia pestis in pediatric patients from birth to 17 years of age 15 mg/kg PO q8-12hr x10-21 days; not to exceed 500 mg/dose, OR 10 mg/kg IV q8-12hr x 10-21 days; not to exceed 400 mg/dose Postexposure therapy IV: 10 mg/kg q12hr for 60 days; individual dose not to exceed 400 mg PO: 15 mg/kg q12hr for 60 days; individual dose not to exceed 500 mg Change antibiotic to amoxicillin as soon as penicillin susceptibility confirmed Nausea (3%) Abdominal pain (2%) Diarrhea (2% adults; 5% children) Increased aminotransferase levels (2%) Vomiting (1% adults; 5% children) Headache (1%) Increased serum creatinine (1%) Rash (2%) Restlessness (1%) Acidosis Allergic reaction Angina pectoris Anorexia Arthralgia Ataxia Back pain Bad taste Blurred vision Breast pain Bronchospasm Diplopia Dizziness Drowsiness Dysphagia Dyspnea Flushing Foot pain Hallucinations Hiccups Hypertension Hypotension Insomnia Irritability Joint stiffness Lethargy Migraine Nephritis Nightmares Oral candidiasis Palpitation Photosensitivity Polyuria Syncope Tachycardia Tinnitus Tremor Urinary retention Vaginitis Acute generalized exanthematous pustulosis (AGEP), erythema multiforme, exfoliative dermatitis, fixed eruption, photosensitivity/phototoxicity reaction Agitation, confusion, delirium Agranulocytosis, albuminuria, serum cholesterol and TG elevations, blood glucose disturbances, hemolytic anemia, marrow depression (life threatening), pancytopenia (life threatening or fatal outcome), potassium elevation (serum) Anaphylactic reactions (including life-threatening anaphylactic shock), serum sickness like reaction, Stevens-Johnson syndrome Anosmia, hypesthesia Constipation, dyspepsia, dysphagia, flatulence, hepatic failure (including fatal cases), hepatic necrosis, jaundice, pancreatitis Hypertonia, hypotension (postural), increased INR (in patients treated with Vitamin K antagonists), QT prolongation, torsade de pointes, ventricular arrhythmia Methemoglobinemia Myasthenia, exacerbation of myasthenia gravis, myoclonus, nystagmus, peripheral neuropathy that may be irreversible, phenytoin alteration (serum), polyneuropathy, psychosis Myalgia, tendinitis, tendon rupture, toxic epidermal necrolysis (Lyell’s Syndrome), twitching Infections: Candiduria, vaginal candidiasis, moniliasis (oral, gastrointestinal, vaginal), pseudomembranous colitis Renal calculi Vasculitis Because the risk of these serious side effects generally outweighs the benefits for patients with acute bacterial sinusitis, acute exacerbation of chronic bronchitis, and uncomplicated UTIs, that fluoroquinolones should be reserved for use in patients with these conditions who have no alternative treatment options Use in pregnancy, though generally contraindicated for all quinolones, is allowed for life-threatening situations; limited data from use of ciprofloxacin in pregnancy show no higher rate of birth defects than background Do not use oral suspension in nasogastric tube; to prepare, add microcapsules to diluent Commonly seen adverse reactions include tendinitis, tendon rupture, arthralgia, myalgia, peripheral neuropathy, and central nervous system effects (hallucinations, anxiety, depression, insomnia, severe headaches, and confusion); these reactions can occur within hours to weeks after starting therapy, including in patients of any age or without pre-existing risk factors; discontinue therapy immediately at first signs or symptoms of any serious adverse reaction; in addition, avoid use of fluoroquinolones, in patients who have experienced any serious adverse reactions associated with fluoroquinolones (see Black Box Warnings) Peripheral neuropathy: sensory or sensorimotor axonal polyneuropathy affecting small and/or large axons resulting in paresthesias, hypoesthesias, dysesthesias, and weakness reported; peripheral neuropathy may occur rapidly after initiating and may potentially become permanent In prolonged therapy, perform periodic evaluations of organ system functions (eg, renal, hepatic, hematopoietic); adjust dose in renal impairment; superinfections may occur with prolonged or repeated antibiotic therapy; discontinue use immediately if signs and symptoms of hepatitis occur Not first drug of choice in pediatrics (except in anthrax), because of increased incidence of adverse events in comparison with control subjects, including arthropathy; no data exist on dosing for pediatric patients with renal impairment (ie, Cr Cl Distributed widely throughout body; tissue concentrations often exceed serum concentrations, especially in kidneys, gallbladder, liver, lungs, gynecologic tissue, and prostatic tissue; cerebrospinal fluid (CSF) concentration is 10% in noninflamed meninges and 14-37% in inflamed meninges; crosses placenta; enters breast milk Protein bound: 20-40% Vd: 2.1-2.7 L/kg Additive: Aminophylline, amoxicillin, amoxicillin-clavulanate, amphotericin, ampicillin-sulbactam, ceftazidime, cefuroxime, clindamycin, floxacillin, heparin, piperacillin, sodium bicarbonate, ticarcillin Y-site: Aminophylline, ampicillin-sulbactam, azithromycin, cefepime, dexamethasone sodium phosphate, furosemide, heparin, hydrocortisone sodium succinate, magnesium sulfate(? ), methylprednisolone sodium succinate, phenytoin, potassium phosphates, propofol, sodium bicarbonate(? ), sodium phosphates, total parenteral nutrition formulations, warfarin Solution: Compatible with most IV fluids Additive: Amikacin, aztreonam, dobutamine, dopamine, fluconazole, gentamicin, lidocaine, linezolid, metronidazole (ready-to-use form is compatible; hydrochloride form in vial is incompatible), midazolam, potassium chloride, tobramycin Y-site: Amiodarone, calcium gluconate, clarithromycin, digoxin, diphenhydramine, dobutamine, dopamine, linezolid, lorazepam, midazolam, promethazine, quinupristin/dalfopristin, tacrolimus The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

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    Dec 5, 2017. The worst kind of pneumonia, high risk for multidrugresistant. hospital-acquired pneumonia, or ventilator-associated pneumonia VAP, Zosyn. amoxicillin with augmentin Ciprofloxacin and amoxycillin were compared in the treatment of respiratory infections pneumonia, acute bronchitis, exacerbation of chronic lung disease in a. Brand and Other NamesCipro, Cipro XR, more. ProQuin XR. Nosocomial Pneumonia. Cipro XR may be taken with or without meal; drink fluids liberally.

    Quinolone antibiotics (including ciprofloxacin) may cause serious and possibly permanent tendon damage (such as tendonitis, tendon rupture), nerve problems in the arms and legs (peripheral neuropathy), and nervous system problems. Get medical help right away if you have any of the following symptoms: pain/numbness/burning/tingling/weakness in your arms/hands/legs/feet, changes in how you sense touch/pain/temperature/vibration/body position, severe/lasting headache, vision changes, shaking (tremors), seizures, mental/mood changes (such as agitation, anxiety, confusion, hallucinations, depression, rare thoughts of suicide). Tendon damage may occur during or after treatment with this medication. Stop exercising, rest, and get medical help right away if you develop joint/muscle/tendon pain or swelling. Your risk for tendon problems is greater if you are over 60 years of age, if you are taking corticosteroids (such as prednisone), or if you have a kidney, heart, or lung transplant. This medication may make a certain muscle condition (myasthenia gravis) worse. Tell your doctor right away if you have new or worsening muscle weakness (such as drooping eyelids, unsteady walk) or trouble breathing. IV: 400 mg IV every 12 hours Oral: 500 mg orally every 12 hours Duration of therapy: 60 days Comments: -Therapy should be started as soon as possible after suspected/confirmed exposure. Use: For treatment of inhalational anthrax (postexposure) to reduce incidence/progression of disease after exposure to aerosolized Bacillus anthracis US CDC recommendations: -IV: 400 mg IV every 8 hours -Oral: 500 mg orally every 12 hours Duration of Therapy: Postexposure prophylaxis for B anthracis infection: 60 days Systemic anthrax: -With possible/confirmed meningitis: At least 2 to 3 weeks or until patient is clinically stable (whichever is longer) -When meningitis has been excluded: At least 2 weeks or until patient is clinically stable (whichever is longer) -Patients exposed to aerosolized spores will require prophylaxis to complete an antimicrobial regimen of 60 days from onset of illness. Cutaneous anthrax without systemic involvement: -Bioterrorism-related cases: 60 days -Naturally acquired cases: 7 to 10 days Comments: -The preferred drug for pregnant women -Recommended as a preferred oral drug for postexposure prophylaxis and for the treatment of cutaneous anthrax without systemic involvement -Recommended as the preferred IV drug for the treatment of systemic anthrax -Recommended for all strains (regardless of penicillin susceptibility or if susceptibility unknown) when used for postexposure prophylaxis, systemic anthrax when meningitis has been excluded, or cutaneous anthrax without systemic involvement -Recommended for use with a protein synthesis inhibitor when used for systemic anthrax; the addition of a bactericidal beta-lactam is recommended with possible/confirmed meningitis. -Systemic anthrax includes anthrax meningitis, inhalation anthrax, injection anthrax, gastrointestinal anthrax, and cutaneous anthrax with systemic involvement, extensive edema, or lesions of the head or neck. -Current guidelines should be consulted for additional information. IV: 400 mg IV every 12 hours Oral: 500 mg orally every 12 hours Duration of therapy: 60 days Comments: -Therapy should be started as soon as possible after suspected/confirmed exposure. Use: For treatment of inhalational anthrax (postexposure) to reduce incidence/progression of disease after exposure to aerosolized Bacillus anthracis US CDC recommendations: -IV: 400 mg IV every 8 hours -Oral: 500 mg orally every 12 hours Duration of Therapy: Postexposure prophylaxis for B anthracis infection: 60 days Systemic anthrax: -With possible/confirmed meningitis: At least 2 to 3 weeks or until patient is clinically stable (whichever is longer) -When meningitis has been excluded: At least 2 weeks or until patient is clinically stable (whichever is longer) -Patients exposed to aerosolized spores will require prophylaxis to complete an antimicrobial regimen of 60 days from onset of illness. Cutaneous anthrax without systemic involvement: -Bioterrorism-related cases: 60 days -Naturally acquired cases: 7 to 10 days Comments: -The preferred drug for pregnant women -Recommended as a preferred oral drug for postexposure prophylaxis and for the treatment of cutaneous anthrax without systemic involvement -Recommended as the preferred IV drug for the treatment of systemic anthrax -Recommended for all strains (regardless of penicillin susceptibility or if susceptibility unknown) when used for postexposure prophylaxis, systemic anthrax when meningitis has been excluded, or cutaneous anthrax without systemic involvement -Recommended for use with a protein synthesis inhibitor when used for systemic anthrax; the addition of a bactericidal beta-lactam is recommended with possible/confirmed meningitis. -Systemic anthrax includes anthrax meningitis, inhalation anthrax, injection anthrax, gastrointestinal anthrax, and cutaneous anthrax with systemic involvement, extensive edema, or lesions of the head or neck.

    Cipro pneumonia

    Use of oral ciprofloxacin in community-acquired pneumonia. - NCBI, Efficacy and safety of ciprofloxacin in patients with respiratory. - NCBI

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    To examine the efficacy and tolerability of oral fluoroquinolones in the treatment of mild to moderate community-acquired pneumonia, acute exacerbations of. doxycycline and sun Apr 28, 2017. Chest infections, such as pneumonia, acute bronchitis and lung infections in cystic fibrosis or COPD. Ear, nose and throat infections such as. Dec 14, 2018. INTRODUCTION — Community-acquired pneumonia CAP is defined as an acute infection of the pulmonary parenchyma in a patient who has.

     
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