Comprehensive Guide to Enoxacin: Uses, Dosage, and Precautions

Overview of Enoxacin

Enoxacin functions by targeting the DNA gyrase enzyme in bacteria, which is crucial for DNA replication and cell division, thereby exhibiting bactericidal properties. It is particularly effective against a range of bacterial strains, making it a valuable treatment for certain infections.

Indications and Dosage

Enoxacin is prescribed for the following conditions:

• Uncomplicated Urinary Tract Infections (UTIs): Effective against E. coli, Staphylococcus epidermidis, and S. saprophyticus. The recommended dosage for adults is 200 mg orally every 12 hours for 7 days.
• Severe or Complicated UTIs: Targets infections caused by E. coli, Proteus mirabilis, Pseudomonas aeruginosa, and others. Adults should take 400 mg every 12 hours for 14 days.
• Uncomplicated Gonorrhea: A single 400 mg dose is advised. Follow-up treatment with doxycycline is recommended to address potential chlamydial co-infection.

For patients with renal impairment, dosage adjustments are necessary, particularly if the creatinine clearance is 30 ml/minute or less. Initial doses remain the same, but subsequent doses should be reduced by 50%.

How Enoxacin is Supplied

Enoxacin is available in film-coated tablets at two strength levels:

• 200 mg
• 400 mg

Potential Adverse Reactions

Patients taking enoxacin may experience a range of side effects, including:

• Central Nervous System: Headaches, tremors, confusion, and in rare cases, seizures.
• Gastrointestinal: Nausea, diarrhea, and abdominal pain.
• Hematologic: Eosinophilia.
• Hepatic: Elevated liver enzymes.
• Dermatological: Rash and photosensitivity.

Drug Interactions

Enoxacin's effectiveness can be diminished when taken with certain substances. Notable interactions include:

• Antacids and Iron Supplements: These can reduce the absorption of enoxacin. It is recommended to administer enoxacin at least 2 hours before or after taking these products.
• Caffeine: Enoxacin may increase caffeine's effects; monitoring is advised.
• Theophylline and Cyclosporine: Levels of these drugs can be elevated, requiring cautious use.

For a comprehensive list of interactions and detailed drug information, refer to resources like Drugs.com and WebMD.

Special Considerations and Warnings

• Contraindications: Enoxacin should not be used by patients allergic to it or other fluoroquinolones.
• CNS Disorders: Caution is advised for those with conditions like cerebral arteriosclerosis or epilepsy.
• Renal and Hepatic Function: Regular monitoring is necessary, and dosage adjustments may be required.
• Pregnancy and Pediatrics: The safety of enoxacin in children and pregnant women has not been established. It has been linked to cartilage erosion in animal studies.

Patient Education

Patients should be instructed to:

• Take the medication as prescribed, even if symptoms improve.
• Avoid caffeine and ensure adequate hydration to prevent crystalluria.
• Be cautious of sun exposure and use protective measures to prevent photosensitivity reactions.

Conclusion

Enoxacin is a powerful antibiotic with specific applications for treating bacterial infections. Proper adherence to dosing schedules and awareness of potential interactions and side effects can enhance treatment efficacy while minimizing risks. Always consult healthcare providers for personalized advice and treatment adjustments based on individual health conditions.