Antibacterial drugs

Tetracyclines are used principally in the treatment of infections caused by susceptible Rickettsia, Chlamydia, Mycoplasma, and a variety of uncommon gram-negative and gram-positive bacteria.

Sulfisoxazole and its derivatives share the actions and uses of the sulfonamides. The relative solubility of the drug in alkaline and slightly acidic urine makes the drug particularly useful for the treatment of urinary tract infections. A combination product containing sulfisoxazole acetyl and erythromycin ethylsuccinate is commercially available for the treatment of acute otitis media caused by susceptible strains of Haemophilus influenzae in children and is usually active against ampicillin-resistant strains of the organism.

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Sulfamethizole shares the actions and uses of the other antibacterial sulfonamides. Sulfamethizole is used principally in the treatment of urinary tract infections caused by sulfonamide-susceptible organisms.

Sulfadiazine is administered orally. Patients should be instructed to drink one full glass (250 mL) of water with each dose of the drug and at frequent intervals throughout the day while they are receiving sulfadiazine. The usual adult dosage of sulfadiazine is 2-4 g initially, followed by 2-4 g daily administered in 3-6 equally divided doses.

Sulfonamides, synthetic derivatives of p-aminobenzenesulfonamide (sulfanilamide), are classified as anti-infectives if they possess antibacterial activity that is antagonized by p-aminobenzoic acid or p-aminobenzoyl glutamic acid.

Norfloxacin is administered orally. The drug should be given with a glass of water at least 1 hour before or at least 2 hours after a meal or ingestion of milk or other dairy products.

Lomefloxacin is used orally in adults for the treatment of mild to moderate lower respiratory tract infections (acute bacterial exacerbations of chronic bronchitis) and uncomplicated or complicated urinary tract infections caused by susceptible organisms. The drug also is used orally for perioperative prophylaxis in patients undergoing transrectal prostate biopsy or transurethral surgical procedures.

Lomefloxacin hydrochloride is administered orally. Lomefloxacin hydrochloride may be administered without regard to meals. Food decreases the rate of GI absorption of the drug, but only decreases the extent of absorption by 12%. Dosage of lomefloxacin, which is available for oral use as the hydrochloride, is expressed in terms of lomefloxacin.

Gemifloxacin is used for the treatment of acute bacterial exacerbation of chronic bronchitis caused by susceptible strains of Streptococcus pneumoniae, Haemophilus influenzae, H. parainfluenzae, or Moraxella catarrhalis. In several randomized, double-blind, active-controlled studies in patients with acute exacerbation of chronic bronchitis, clinical response (defined as sufficient improvement in or resolution of signs and symptoms at day 13-24 without further need for anti-infectives) was achieved in 86-94% of those receiving oral gemifloxacin (320 mg once daily for 5 days) and in 93, 85, or 85% of those receiving oral amoxicillin and clavulanate potassium (500 mg of amoxicillin 3 times daily for 7 days), oral clarithromycin (500 mg twice daily for 7 days), or oral levofloxacin (500 mg once daily for 7 days), respectively. In several controlled and uncontrolled studies in patients with clinically and radiographically documented CAP, clinical response was achieved in 89-92% of patients receiving oral gemifloxacin (320 mg once daily) for 7 days.