Gatilin

"Gatilin" is a drug from the fluoroquinolone group, which is a broad-spectrum antibacterial agent active against a large number of different pathogenic microorganisms.

Indications Gatilin

The drug "Gatilin" is effective in infectious and inflammatory diseases of the respiratory and genitourinary systems caused by microorganisms sensitive to the main active substance of the antibiotic.

It is used to treat acute bronchitis, exacerbations of chronic bronchitis (an inflammatory process in the bronchi involving an infectious component) and in the treatment of the acute stage of sinusitis (inflammation in the paranasal sinuses that occurs as a complication after infectious diseases and injuries to the nose).

Another indication for the use of the drug for the treatment of inflammatory processes affecting the respiratory organs is community-acquired (or community-acquired) pneumonia. In plain language, this is inflammation of the lungs that began under the influence of an infectious agent (pneumococci, staphylococci, streptococci, etc., about 10-11 varieties in total), which happens outside the hospital.

As for the urinary system, the indications for the use of the drug "Gatilin" are complicated (severe pyelonephritis with obstruction, catheter-associated UTI, etc.) and uncomplicated (primary cystitis, acute pyelonephritis, etc.) urinary tract infections.

The drug is also used to treat sexually transmitted diseases. For example, in the treatment of uncomplicated gonorrheal urethritis (an inflammatory process in the urethra due to an infectious lesion of its walls) and cervitis (inflammation in the vaginal segment of the uterus) of the same nature, which are caused by gonococcal infection, uncomplicated rectal gonorrhea in women.

[ 1 ]

Release form

The antibiotic "Gatilin" can be found on pharmacy shelves in the form of:

• solution for intravenous infusions in 100 ml containers containing 200 mg of active substance,
• solution for intravenous infusions in containers containing 400 mg of active substance,
• tablets 200 mg,
• tablets 400 mg.

The tablet form, depending on the dosage, may be called "Gatilin-200" or "Gatilin-400".

"Gatilin-200" is presented in the form of white, biconvex, round tablets with a protective shell, containing 200 mg of the active substance.

"Gatilin-400" - white oblong tablets with a protective coating and a break line on one side, which contain 400 mg of an antimicrobial agent.

The main active ingredient of the drug is a substance with a pronounced antimicrobial effect - gatifloxacin.

The excipients in tablet forms are: starch, monocrystalline cellulose, calcium hydrogen phosphate, sodium methyl and propyl parabens, magnesium salt and stearic acid, sodium starch glycolate, talc, dibutyl phthalate, polyethyleneglycol-6000, titanium dioxide and hydroxypropyl methylcellulose.

In the infusion solution, gatifloxacin is supplemented with anhydrous glucose, concentrated hydrochloric acid and water for injection, which is distilled (purified from all impurities) water. If the solution contains 400 mg of the active substance, then sodium hydroxide is additionally added to it.

Pharmacodynamics

The main active ingredient of the drug, gatifloxacin, is an antimicrobial agent with pronounced activity against a relatively large number of pathogenic microorganisms. Gatifloxacin copes well with both gram-negative and gram-positive bacteria.

The list of pathogenic microorganisms sensitive to gatifloxacin includes: various strains of staphylococcal infection, streptococci, various types of enterobacteria, proteus, phasobacteria, clostridia, chlamydia, mycoplasma bacteria, mycobacterium tuberculosis, Helicobacter pylori and many others.

The antibacterial action of the drug is based on inhibition of the production of DNA gyrase, which is an essential enzyme involved in the processes of cell division and synthesis of molecules with the same DNA, transfer of information from DNA to RNA, correction of breaks and chemical damage in bacterial DNA molecules.

Gatifloxacin also reduces the production of another important enzyme in the body of bacteria, topoisomerase IV, which is responsible for the correct separation of chromosomal DNA during cell division.

[ 2 ], [ 3 ], [ 4 ], [ 5 ]

Pharmacokinetics

Rapid absorption of gatifloxacin from the digestive tract allows taking tablets regardless of food intake. The bioavailability of the active substance is slightly less than 100% (more precisely 96%), and its maximum concentration in the blood is observed 1.5-2 hours after taking the tablets.

Gatifloxacin is characterized by rapid distribution in various fluids and tissues of the body, and its concentration in the tissues of the “target” organs will exceed the content of the antibiotic in the blood serum.

The drug is excreted from the body mainly by the kidneys, and only 5% is excreted with feces. More than 70% of the active substance is excreted in its original form during the first 2 days.

The half-life of the drug can vary between 7-14 hours, and it does not depend on the dosage of the drug or the method of its administration.

[ 6 ], [ 7 ]

Dosing and administration

Since taking Gatilin can cause severe allergic reactions in case of hypersensitivity to it, doctors strongly recommend conducting a skin test for drug tolerance before the first use of the drug.

The drug is recommended to be taken once a day, preferably at the same time. Food intake does not affect the effectiveness of the drug. A single (also daily) dose of the drug for most pathologies is 400 mg (1 tablet of "Gatilin-400" or 2 tablets of "Gatilin-200"), and the course of treatment can vary from 7 to 14 days.

For uncomplicated urinary tract infections, the treatment regimen is different. The doctor may prescribe a 3-day course of "Gatilin-200" (1 tablet per day) or a single dose of a "shock" dose of 400 mg.

A single dose of 400 mg of the drug is also effective in the treatment of such pathologies as gonorrheal urethritis in men, as well as proctitis and cervicitis in women.

The kidneys are primarily responsible for eliminating the drug from the body, which means that when prescribing an effective and safe dose of the drug, it is necessary to take into account individual indicators of the rate of blood flow through this important excretory organ (creatinine clearance). If this indicator is normal (40 ml per minute) or slightly overestimated, no dose adjustment is required. If creatinine clearance is below the average (for example, in case of renal failure), the dosage should be different: the initial dose remains the same - 400 mg, and all subsequent doses are limited to a dosage of 200 mg.

Dose adjustment is required not only in the case of low creatinine clearance, but also when the patient is on hemodialysis or continuous ambulatory peritoneal dialysis, which are methods of extrarenal blood purification in severe kidney pathologies.

Taking tablets with the same effectiveness and dosage can be replaced by intravenous administration using a dropper. In this case, the rate of administration of the drug is 400 mg in 40-60 minutes.

[ 14 ], [ 15 ], [ 16 ]

Use Gatilin during pregnancy

The use of the drug "Gatilin" during pregnancy is unacceptable. During breastfeeding, antibiotic therapy is possible only when switching to milk formulas.

Contraindications

The antibiotic "Gatilin" is not recommended for use in patients with a history of hypersensitivity to the active substance of the drug (gatifloxacin), to any of the auxiliary components used to make the tablets and infusion solution.

Contraindications to the use of the drug include hypersensitivity to other drugs from the fluoroquinolone group.

The antibiotic is also not used in pediatric practice, i.e. for the treatment of patients under 18 years of age.

The drug in the form of an infusion solution is not used to treat patients diagnosed with diabetes mellitus due to the presence of glucose in its composition.

[ 8 ], [ 9 ], [ 10 ], [ 11 ], [ 12 ]

Side effects Gatilin

The drug "Gatilin" has not only many possible uses, but also side effects. This does not mean that all of them will occur during treatment with the drug. The most common side effects, which occur in more than 1% of patients, are headaches and dizziness, nausea often accompanied by vomiting, abdominal pain, bowel disorders in the direction of diarrhea.

Less frequently, other reactions from various organs and systems of the body are observed. Thus, the immune system can react to taking an antibiotic with fever, angioedema, inflammation in the vessels, eczema. In isolated cases, anaphylactic reactions are observed.

The skin may respond to the injection with itching, rash, increased sensitivity to sunlight, dryness and flaking. Sometimes patients develop signs of hyperhidrosis. Rarely, life-threatening allergic Stevens-Johnson syndrome may develop if the patient has a tendency to allergic reactions.

From the side of the central nervous system, one can observe increased excitability, anxiety, anxious or depressive state, sleep disturbances and body sensitivity, hand tremors, hallucinations, convulsions, fainting.

Taking the drug may affect taste, hearing and vision.

The cardiovascular system may also experience minor disruptions: increased heart rate, chest pain and swelling, vasodilation, increased or decreased blood pressure.

Oral administration of the drug may cause some unpleasant symptoms from the gastrointestinal tract: stomach pain, dyspepsia, bowel disorders (constipation or diarrhea), heartburn, increased gas production, vomiting. The antibiotic may cause the development of such pathologies as gastritis, pancreatitis, stomatitis, glossitis, cause the formation of ulcerative and fungal lesions of the oral cavity.

The musculoskeletal system will in rare cases remind you of itself with pain in the muscles and joints, inflammation of the tendons and an increased likelihood of their rupture under load.

The urinary system can give the following symptoms: inflammation or dysfunction of the kidneys, up to acute failure of their functions, urination disorders, the appearance of salt crystals and blood in the urine (above the norm). However, such disorders are very rare.

In addition, taking the drug may be accompanied by other reactions from various organs and systems of the body: back pain, abnormal blood laboratory parameters, nosebleeds and uterine bleeding, various rashes on the skin and mucous membranes, shortness of breath, hallucinations, impaired consciousness and thinking, changes in blood glucose levels, etc.

Side effects may occur with varying frequency and in the case of combination therapy with different drugs.

[ 13 ]

Overdose

With intravenous drip administration in a medical facility, the probability of overdose is negligible, which cannot be said about oral administration of the drug without the supervision of a doctor or inadequate prescription of an effective and safe dose for the situation. To avoid unpleasant consequences, it is necessary to constantly monitor the patient's condition (laboratory indicators, ECG, etc.), especially with long-term use of the drug (more than 7-10 days).

An overdose of the drug "Gatilin" is primarily indicated by disturbances in the functioning of the central nervous system. They can be characterized by confusion, convulsions or psychosis. In some cases, fainting is observed. Other side effects of the drug may also increase, indicating intoxication.

Effective first aid measures include gastric lavage and dehydration measures (prevention of dehydration by introducing a sufficient amount of liquid into the body or taking special medications, such as Regidron).

Next, the doctor must prescribe effective therapy aimed at relieving unpleasant symptoms and further supporting the body.

Purification of blood from excess gatifloxacin by hemodialysis or peritoneal dialysis is considered ineffective. The purification period in this case is too long, and the result is insufficient (no more than half of the entire dose of the drug can be removed in 14 hours).

Interactions with other drugs

The drug "Gatilin" can be taken without consequences in parallel with the sleeping pill "Midazolam", the bronchodilator "Theophylline", the hypoglycemic drug "Apo-glyburide", used for type 2 diabetes mellitus, and their analogues by the active substance. Their simultaneous administration does not affect the pharmacological properties of the drugs. No correction of their doses is required.

The same can be said about the drugs "Cimetidine" (antiulcer agent) and "Calcium carbonate". They can be taken together with gatifloxacin drugs without dose adjustment.

However, interactions between gatifloxacin and some other drugs may have undesirable consequences.

The cardiac drug "Digoxin", used in ischemic heart disease, has little effect on the pharmacokinetics of gatifloxacin, but simultaneous therapy with the drugs can cause an increase in the level of "Digoxin" in the patient's blood, which will lead to an overdose of the drug. Therefore, it is necessary to monitor laboratory parameters and the patient's condition in order to notice the phenomenon of intoxication in time.

The drug "Probenecid", used for elevated urea levels in the blood, as well as its analogues in terms of active substance, can accelerate the elimination of gatifloxacin from the patient's body, reducing its effectiveness.

When taking Gatilin and the anticoagulant Warfarin simultaneously, no noticeable changes in blood clotting parameters were observed. However, it is still advisable to monitor the blood clotting rate, since other antibiotics from the quinolone group can affect this parameter.

"Gatilin" may contribute to the development of various CNS disorders when taken in parallel with NSAIDs.

Caution should also be exercised when prescribing antiarrhythmic drugs during therapy with Gatilin. Such drugs of classes III and IA are dangerous to take simultaneously with gatifloxacin due to the increased risk of cardiac arrhythmia.

For the same reason and due to insufficient study of drug interactions, it is not recommended to take tricyclic antidepressants, antipsychotic drugs, erythromycin, phenothiazine and its derivatives, cisapride in parallel with gatifloxacin.

It is not recommended to take gatifloxacin and Didanosine, used to treat HIV infection, together with some microelements (for example, in vitamin-mineral complexes or drugs to reduce the acidity of gastric juice). We are talking about compounds of iron, zinc, aluminum, magnesium.

[ 17 ], [ 18 ], [ 19 ]

Storage conditions

To preserve the medicinal properties of the drug throughout its shelf life (2 years), as well as to prevent other undesirable consequences, such as swallowing tablets by a child, damage to the container with the infusion solution, etc., it is necessary to comply with the storage conditions of the drug specified in the instructions.

Storing the drug "Gatilin" at an appropriate temperature (no more than 25 degrees) out of reach of children and sunlight will help protect you and your family from unforeseen situations.

Special instructions

In some patients, taking Gatilin may cause changes in the cardiogram, in particular an increase in the QT interval, especially with long-term antibiotic therapy. For this reason, the drug is not prescribed to patients who already have an increased QT interval, as well as in hypercalcemia.

Caution should be exercised when prescribing gatifloxacin to patients with bradycardia and acute myocardial ischemia.

In case of hypersensitivity to the drug, therapy with "Gatilin" is strictly not prescribed, since there have been cases of severe consequences: anaphylactic shock and even death. Any skin rashes and other allergic manifestations are a signal to discontinue the drug.

Dose adjustment and monitoring of the patient's condition are inevitable in renal failure.

Gatifloxacin, like other quinolones, can cause the development of convulsive syndrome, therefore it is prescribed with special caution to patients with a history of CNS pathologies (mental disorders, epilepsy, severe vascular atherosclerosis).

Taking gatifloxacin increases the risk of tendon rupture, especially in the presence of corticosteroids in the elderly. If such a symptom occurs, the drug should be discontinued.

The drug should also be discontinued in the event of such undesirable symptoms as loss of skin sensitivity, convulsive syndrome, increased intracranial pressure, psychosis, as well as if there is trembling in the hands, sleep disturbances with nightmares and insomnia, hallucinations, delirium, depression.

Taking Gatilin, like other antibiotics, should be accompanied by taking medications that normalize the intestinal microflora. Otherwise, there is a high probability of developing antibiotic-associated or pseudomembranous colitis of varying severity.

While taking gatifloxacin, you should avoid drinking alcohol and staying in direct sunlight for long periods of time.

Caution should also be exercised when using the infusion solution. It should not be used if the container is damaged, sediment is present, or the liquid is cloudy.

The drug affects reaction speed, so during therapy you should refrain from driving a car or performing work that requires special attention.

Shelf life

Shelf life is 2 years.