Ofloxacin

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Ofloxacin is a second generation quinolone antibiotic, a class of drugs that kill infection-causing bacteria.[1] It is sold under the brand name Floxin. Ofloxacin is often found as a pollutant in sewage sludge.

Why It's Prescribed

Ofloxacin is prescribed to treat bacterial infections including bronchitis, pneumonia, and infections of the skin, bladder, urinary tract, reproductive organs, and prostate (a male reproductive gland).[2]

Labeled uses include:[3] Acute Gonococcal Cervicitis, Acute Gonococcal Endometritis, Acute Gonococcal Urethritis, Acute Lower Genitourinary Gonorrhea, Bronchitis, Bronchitis with Bacterial Exacerbations, Chlamydia Cervicitis, Chlamydia Trachomatis Pelvic Inflammatory Disease, Chlamydia Trachomatis Urethritis, Citrobacter Complicated UTI, Citrobacter Cystitis, Complicated E. Coli UTI, Complicated Proteus UTI, Complicated UTI with Pseudomonas Aeruginosa, E. Coli Cystitis, E. Coli Prostatitis, Enterobacter Cystitis, Gram-Negative Aerobic Bacillary Pneumonia, Haemophilus Influenzae Chronic Bronchitis, Haemophilus Influenzae Pneumonia, Klebsiella Complicated UTI, Klebsiella Cystitis, Lower Respiratory Infections, Mixed Gonococcal and Chlamydia Infection of the Cervix, Mixed Gonococcal and Chlamydia Infection of the Urethra, Nongonococcal Urethritis, Pelvic Inflammatory Disease with Neisseria Gonorrhea, Pneumonia, Proteus Cystitis, Pseudomonas Aeruginosa Cystitis, Skin and Skin Structure Infection, Skin and Skin Structure Proteus Infection, Skin and Skin Structure Streptoccous Pyogenes Infection, Staphylococcus Aureus Skin and Skin Structure Infection, Streptococcal Pneumonia, Streptococcus Pneumoniae Chronic Bronchitis, Urinary Tract Infections

Additionally, unlabeled uses include:[4] Post-Exposure Anthrax Prevention, Prevention of Traveler's Diarrhea, Prevention of Ventilator-Associated Pneumonia, Traveler's Diarrhea

Form, Route, and Dosage

Ofloxacin is available as a tablet to take orally.[5] It is generally prescribed to adults in dosages ranging from 200mg to 800mg per day.[6]

Risks

Side Effects

Patients taking Ofloxacin sometimes suffer side effects, including the following:[7]

  • nausea
  • diarrhea
  • constipation
  • gas
  • vomiting
  • stomach pain or cramps
  • change in ability to taste food
  • loss of appetite
  • dry mouth
  • headache
  • dizziness
  • excessive tiredness
  • pain, swelling, or itching of the vagina
  • severe diarrhea (watery or bloody stools) that may occur with or without fever and stomach cramps (may occur up to 2 months or more after your treatment)
  • rash
  • itching
  • hives
  • difficulty breathing or swallowing
  • swelling of the face, lips, tongue, or throat
  • hoarseness
  • loss of consciousness
  • fever
  • blistering or peeling skin
  • yellowing of the skin or eyes
  • dark urine
  • muscle or joint pain
  • pale skin
  • shortness of breath
  • unusual bruising or bleeding
  • fast, pounding, or irregular heartbeat
  • fainting
  • seizures
  • confusion
  • hallucinations (seeing things or hearing voices that do not exist)
  • nightmares
  • difficulty falling asleep or staying asleep
  • uncontrollable shaking of a part of the body
  • depression
  • thoughts about killing or harming yourself
  • anxiety
  • not trusting others or feeling that others want to harm you
  • restlessness
  • pain, numbness, burning, tingling, or weakness in the hands, arms, legs, or feet
  • vision changes

Overdoses

Patients may overdose on ofloxacin if they take too much of it. Symptoms of overdose include:[8]

  • drowsiness
  • nausea
  • dizziness
  • hot and cold flushes
  • numbness and swelling of the face
  • slurred speech
  • confusion

Warnings

Patients taking ofloxacin are at an increased risk of developing tendinitis.[9]

As a Pollutant

Because humans and animals often do not fully metabolize pharmaceuticals in their body, they can excrete drugs or their breakdown products, which may the enter the environment.[10]

In Sewage Sludge

Ofloxacin has been found in sewage sludge. In the Targeted National Sewage Sludge Survey, a 2009 test of 84 samples of sewage sludge from around the U.S., the EPA found ofloxacin in 83 samples (99%) in concentrations ranging from 73.9 to 58,100 parts per billion.[11] There are no federal regulations governing how much of this drug may be present in sewage sludge applied to land as fertilizer.

Breakdown in the Environment

In 2000, a study examined the antibiotics ciprofloxacin, ofloxacin, and metronidazole to see if they biodegraded and if their genotoxicity (i.e. ability to damage DNA, potentially causing mutations or cancer) was eliminated. None of the drugs broke down and their genotoxicity was not eliminated.[12]

A 2004 study looked at the ability of 18 antibiotics to biodegrade in a closed bottle test.[13] The antibiotics tested were: Amoxicillin, Benzylpenicillin sodium salt, Ceftriaxone disodium, Cefuroxime sodium salt, Chlortetracycline hydrochloride, Clarithromycin, Clindamycin, Erythromycin, Gentamicin sulfate, Imipenem, Metronidazole, Monensin sodium salt, Nystatin, Ofloxacin, Sulfamethoxazole, Tetracycline, Trimethoprim naphthoate, and Vancomycin hydrochloride. The study concluded: "None of the antibiotics was readily biodegradable. Elimination in the environment by other mechanisms may happen, but will not completely mineralize the active compounds. The results of CFU determination showed that some of antibiotics have an inhibitory effect on the bacterial population. Our findings underline the need for more detailed investigating effects on antibiotics in the environment."

Articles and resources

Related SourceWatch articles

References

  1. Ofloxacin: MedlinePlus Drug Information, Accessed September 2, 2010.
  2. Ofloxacin: MedlinePlus Drug Information, Accessed September 2, 2010.
  3. Ofloxacin Oral: Dosage, Uses, and Warnings, Accessed September 2, 2010.
  4. Ofloxacin Oral: Dosage, Uses, and Warnings, Accessed September 2, 2010.
  5. Ofloxacin: MedlinePlus Drug Information, Accessed September 2, 2010.
  6. Ofloxacin Oral: Dosage, Uses, and Warnings, Accessed September 2, 2010.
  7. Ofloxacin: MedlinePlus Drug Information, Accessed September 2, 2010.
  8. Ofloxacin: MedlinePlus Drug Information, Accessed September 2, 2010.
  9. Ofloxacin: MedlinePlus Drug Information, Accessed September 2, 2010.
  10. O.A.H. Jones, N. Voulvoulis, and J.N. Lester, Human Pharmaceuticals in Wastewater Treatment Processes, Environmental Science and Technology, 2005.
  11. Targeted National Sewage Sludge Survey Report, US EPA website, Accessed August 28, 2010.
  12. Klaus Kümmerer, al-Ahmad A, Mersch-Sundermann V., "Biodegradability of some antibiotics, elimination of the genotoxicity and affection of wastewater bacteria in a simple test", Chemosphere, April 2000.
  13. Radka Alexy, Tina Kümpel and Klaus Kümmerer, "Assessment of degradation of 18 antibiotics in the Closed Bottle Test", Chemosphere, November 2004.

External resources

External articles