I. Avelox Fact File

Avelox was introduced by Bayer Pharmaceuticals.

Bayer is a wholly owned subsidiary of Bayer AG, based in Leverkusen, Germany, one of the largest industrial concerns in the world. Comprised of about 350 companies, the Bayer Group has subsidiaries or agents in approximately 150 countries.

Bayer's products are as follows:

Bayer HealthCare

• Animal Health
• Biological Products
• Consumer Care
• Diagnostics
• Pharmaceutical

Bayer MaterialScience

• Coating, Adhesive & Sealant Raw Materials
• Inorganic Basic Chemicals
• Polycarbonates
• Polyurethanes
• Thermoplastic Polyurethanes (TPU)

Bayer CropScience

• CropScience

II. Avelox Medication

Fast-acting and reliable, Avelox (moxifloxacin hydrochloride), a fluoroquinolone, is a synthetic broad-spectrum antibacterial agent that has been approved for safe and effective treatment of respiratory tract infections (RTIs) in adults 18 years of age and older, including: Acute Bacterial Sinusitis (ABS), Acute Bacterial Exacerbation of Chronic Bronchitis (ABECB), and Community-Acquired Pneumonia (CAP). Avelox has a wide spectrum of activity that covers the key common community respiratory pathogens.

Avelox has excellent coverage against Gram-positive cocci while retaining good activity against Gram-negative bacteria and atypical pathogens. In addition, it has good in-vitro activity against anaerobes.

Bacterial infections: Infomation

Bacterial infections are caused by the presence and growth of microorganisms that damage host tissue. The extent of infection is generally determined by how many organisms are present and the toxins they release.

Worldwide, bacterial infections are responsible for more deaths than any other cause. Symptoms can include inflammation and swelling, pain, heat, redness, and loss of function. The most important risk factors are burns, severe trauma, low white blood cell counts, patients on immunotherapy treatment, and anyone with malnutrition or vitamin deficiency.

Bacteria are generally spread from an already infected person to the newly infected person. The most common invasion routes are inhalation of airborne bacteria, ingestion into the stomach from dirty hands or utensils, or through contaminated food or water, direct contact with an infected area of another person's body, contaminated blood, or by insect bite.

The first of the body's three primary lines of defense includes naturally occurring chemicals such as the lysozymes found in tears, gastric acid of the stomach, pancreatic enzymes of the bowel, and fatty acids in the skin. The body's immune response becomes involved only if the infective organism manages to invade the body. Nonspecific immune response--the body's second line of defense--consists primarily of inflammation, whereas specific immune response--the third line of defense--relies on the activation of lymphocytes, which send T- and B-cells to try to recognize the specific type of organism involved. T-cells marshal cytotoxic cells, which are sent to destroy the organism, and B-cells produce the antibodies--immunoglobulins--that can destroy specific types of bacteria.

Antibiotics/ Antibacterial: Information

The ideal antibacterial or antimicrobial compound displays a selective toxicity. This means that it is harmful to the microbe (the bacteria, fungi or virus) without being harmful to the host (you). In reality, many antimicrobials have a relative toxicity. Antimicrobial is a broader category that includes antifungal, antiviral, antiprotozoal or antibacterial compounds. Antibacterials specfically act against bacterial cells.

The actual mechanism of antibacterial compounds is not always known. In general terms, most of these drugs act by altering or inhibiting one of the following cellular structures/processes:

• cell wall synthesis
• permeability of the cell membrane
• protein synthesis
• nucleic acid synthesis

(Explanation for diagram: Different antibiotics destroy bacteria in different ways. Some short-circuit the processes by which bacteria receive energy. Others disturb the structure of the bacterial cell wall, as shown in the illustration above. Still others interfere with the production of essential proteins.)

Classes of Antibacterials

1. Penicillins
   
   The penicillin class of antibiotics is a diverse, yet highly essential class of antibiotics. The penicillin class includes penicillin G, penicillin V, amoxicillin, ampicillin, nafcillin, ticarcillin (combined with clavulanic acid = Timentin), Augmentin (amoxicillin and clavulanic acid), Zosyn, and many, many others. Penicillins work by damaging the cell wall of the bacteria.
   
   Penicillin and all of its derivatives come from a mold, Penicillium notatum, which is toxic bluish-green mold often found on old bread. The mold must be carefully processed to produce the penecillin. This compound was discovered by Alexander Fleming in 1929 and was made famous during World War II. These antibiotics are used to treat a variety of infections including strep throat, upper respiratory infections, salmonella (food poisoning), gonorrhea, chlamydia, and many other infections.
   
2. Cephalosporins
   
   Cephalosporins are another widely used class of antibiotics. They are similar to penicillins in structure, but in general, can treat a broader range of infections. For example, these antibiotics are used to treat strep throat, cellulitis, E. coli infections, pneumonia, upper respiratory infections, sinus infections, and gonorrhea. Cephalosporins act by disrupting the bacterial cell wall.
   
   A few of the medications in this class include:
   - cephalexin (Keflex)
   - cefazolin (Ancef or Kefzol)
   - cefaclor (Ceclor)
   - loracarbef (Lorabid)
   - ceftriaxone (Rocephin)
   - cefotaxime (Claforan)
   
3. Sulfa Drugs
   
   Sulfa drugs are the oldest antibiotics available and are also among the best. Sulfa was first used in 1930's. Sulfa drugs include sulfamethoxazole, a component of Bactrim, sulfasoxazole, and many others. These drugs are used to treat a variety of infections including urinary tract infections, upper respiratory infections, and pneumonia. Sulfa compounds work by inhibiting nucleic acid (DNA, RNA) synthesis.
   
4. Tetracyclines
   
   Tetracyclines are antibiotics often used to treat penicillin-resistant infections. Tetracyclines are often used to treat gonorrhea, chlamydia, lyme disease, rocky mountain spotted fever, and pneumonia.
   
   Tetracyline antibiotics include doxycycline, tetracycline, and minocycline. These compounds are antimicrobial because of their inhibition of bacterial protein synthesis. They bind to the cellular organelles called ribosomes, and interfere with the assembly of bacterial amino acids into proteins.
   
   It is important to take tetracyclines at least 1 hour before or 2 hours after taking an antacid, drinking milk, or taking iron. Antacids, milk (due to its calcium content), and iron decrease the absorption of tetracyclines.
   
   Tetracyclines can cause bone deformities in children, and should not be given to anyone under the age of 8. The most common side effects of tetracyclines include diarrhea, loss of appetite, nausea, vomiting, and sore mouth. Tetracyclines may increase sensitivity to the sun, so avoid prolonged exposure and wear sunscreen when taking such compounds.
   
5. Macrolides
   
   Macrolides are a class of drugs that are entirely different from penicillins, but are often used to treat many of the same diseases. Penicillins work by damaging the cell wall of the bacteria. In contrast, macrolides inhibit protein synthesis but by a different mechanism than tetracycline. The structural differences in macrolides also make them ideal alternatives to penicillin in patients who have penicillin allergies.
   
   Macrolides are often used to treat pneumonia, whooping cough, diphtheria, upper respiratory infections, bronchitis, sinus infections, and many other diseases. Examples of macrolides include:
   - erythromycin
   - clarithromycin (Biaxin)
   - azithromycin (Zithromax or Z-pak)
   
   Common side effects with Macrolides include: stomach upset, diarrhea, loss of appetite, and nausea and vomiting.
   
6. Fluoroquinolones
   
   Fluoroquinolones are broad-spectrum anti-infectives. They are used to treat a variety of infections, including strep throat, pneumonia, severe upper-respiratory infections, several of the STDs, and some of the severe hospital-acquired infections. Examples of some of the fluoroquinolones are ciprofloxacin (Cipro) and levofloxacin (Levaquin). Ciprofloxacin has been used to treat persons exposed to anthrax in recent bioterrorism events in the US.
   
   Common side effects with Fluoroquinolones include: diarrhea, difficulty sleeping, dizziness, drowsiness, headache, and nausea. To help reduce the side effects, try to take these medications 1 hour before or 2 hours after taking an antacid or drinking milk.
   
7. Intravenous (IV) Antibiotics
   
   Aminoglycosides
   
   This class of antibiotics is only available as IV infusions because they are not well absorbed orally. However, they can also be given as a injection into the muscle (such as bicep or thigh).
   
   Aminoglycosides are used to treat a variety of infections, including endocarditis, cellulitis, bronchitis, pneumonia, meningitis, pyelonephritis, severe urinary tract infections, and many other infections. These drugs work by inhibiting bacterial protein synthesis. Examples of aminoglycosides include gentamicin, tobramycin, and amikacin.
   
   Although these drugs are important agents and often are "life-saving" they must be closely monitored due to the potential for serious toxicity. It is important to inform your doctor immediately if any of the following symptoms are noticed while taking an aminoglycoside: difficulty hearing, dizziness, increased thirst, loss of balance, muscle weakness, nausea, pain or difficulty passing urine, or ringing in the ears. In particular, these compounds can be toxic to components of the nervous system, kidneys and ears.

Glycopeptides

Currently, there is only one drug in this class of antibacterials: vancomycin (Vancocin). Intravenous vancomycin is used to treat a variety of severe infections, such as penicillin-resistant pneumonia, methicillin-resistant Staphylococcus aureus-a serious bacterial infection that is extremely difficult to treat, and other serious infections.

Vancomycin is also available orally, but the oral form of the drug is not absorbed well. Because it remains largely in the gut, vancomycin is one of two antibiotics used to treat pseudomembranous colitis, an inflammation of the large and small intestine caused by the effects of other antibiotics.

The most common side effects of oral vancomycin are nausea and vomiting.

Intravenous vancomycin is given primarily under the direct supervision of a healthcare provider. Common side effects from the IV include nausea, vomiting, and pain at the injection site.

Streptogrammins

This is the newest class of antibiotics on the market. Currently, there is only one drug in this class of antibacterials: the combination drug Quinupristin/Dalfopristin (Synercid).

Synercid was specifically designed to treat infections that vancomycin is unable to treat. For example, Synercid was designed to treat vancomycin-resistant enterococcus (VRE), a life-threatening, hospital-acquired infection. Synercid is currently reserved for severe infections, and is available only as an IV.

Side effects of Antibiotics

Some of the more common side effects of Antibiotics may include:

• Soft stools or diarrhea
• Mild stomach upset
• You should notify your doctor if you have any of the following side effects:
• Vomiting
• Severe watery diarrhea and abdominal cramps
• Allergic reaction (shortness of breath, hives, swelling of your lips, face, or tongue, fainting)
• Vaginal itching or discharge
• White patches on your tongue.

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III. Useful links

http://www.cdc.gov/

http://www.fda.gov/

http://www.fda.gov/cder/ogd/

http://www.nih.gov/

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi

http://www.health.gov.on.ca/

National Library of Medicine

World Health Organization

http://www.mayoclinic.com/index.cfm

MedicineNet.com

Drugdigest.org

Healthsquare.com

http://www.avelox.com/

Pharmacy sites

http://www.roche.com/home/company/com_hist.htm

http://www.healthdigest.org/Bactrim-DS(Oral)_2006_PRO.php

http://www.hsforum.com/stories/storyReader$1509

http://www.hsforum.com/stories/storyReader$1504

http://www.people.vcu.edu/~urdesai/atc.htm#Process%20of%20clotting

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