IV Infusions for Acute Bacterial Prostatitis
In cases of acute bacterial prostatitis, IV infusions of certain antibiotics may be administered to rid the body of infection. Your physician will administer these IV infusions, and hospitalization may be required.
Antibiotics used in IV infusions for acute bacterial prostatitis include:
- Levaquin (levofloxacin [LEE-voe-FLOX-a-sin])
- Cipro I.V. (ciprofloxacin I.V. [SIP-roe-FLOX-a-sin])
- Rocephin (ceftriaxone [sef-try-ACK-son])
IV Infusion Warnings
Both Levaquin and Cipro I.V. and other flouroquinolones contain a black box warning such as the following:
WARNING:
Fluoroquinolones are associated with an increased risk of tendinitis and tendon rupture in all ages. This risk is further increased in older patients usually over 60 years of age, in patients taking corticosteroid drugs, and in patients with kidney, heart or lung transplants.
Fluoroquinolones may exacerbate muscle weakness in persons with myasthenia gravis. Avoid CIPRO/LEVAQUIN in patients with known history of myasthenia gravis.
Levaquin and other antibiotic medications should be administered with caution in patients who have a renal deficiency. In cases of renal problems, physicians should monitor patients carefully and provide laboratory studies prior to treatment.
Levaquin injection should not be put into the same IV line with any solution containing multivalent cations, such as magnesium.
Avoid quick or excessive IV infusion of Levaquin, as it may be associated with hypotension.
Supplements that contain iron, calcium, zinc, or magnesium prevent the body from absorbing Levaquin.
Fluoroquinolones may affect blood sugar in patients with diabetes.
Flexible containers should not be used in series connections. This may result in air embolism as a result of air extraction from the primary container.
Discuss any allergies to medications with your physician before treatment, particularly with regard to hypersensitivity to Cipro, any quinolone antibiotics, or any components of these drugs.
Cipro I.V. should not be administered simultaneously with Zanaflex (tizanidine).
Cipro I.V. and other fluoroquinolones are linked to an elevated risk of tendinitis and tendon rupture. If involving the Achilles tendon, a rupture may require surgery. Tendinitis and rupture in the shoulder, hand, biceps, thumb, as well as other tendons may also occur.
Patients at an increased risk of experiencing tendinitis or tendon rupture include:
- Elderly patients
- Patients taking corticosteroids
- Patients with kidney, heart, or lung transplants
- Patients with renal failure
- Patients who’ve had prior tendon disorders, including rheumatoid arthritis
Cipro and other quinolones may incite convulsions, increased intracranial pressure, and toxic psychosis. If this occurs, discontinue use.
Cipro and other quinolones should be administered cautiously in patients with CNS disorders such as epilepsy.
Severe or fatal reactions have occurred in patients who receive IV Cipro simultaneously with Theophylline.
Severe or fatal anaphylactic reactions have occurred in patients receiving quinolones.
Antibiotics, including Cipro, are known to cause clostridium difficile associated diarrhea (CDAD) ranging from mild diarrhea to fatal colitis.
Why Are IV Infusions Prescribed for Prostatitis?
If you have acute bacterial prostatitis, your physician may determine an IV infusion is necessary to rid the body of infection.
Levaquin is used intravenously if a physician determines a patient cannot tolerate an oral form of the dose.
Levaquin is administered in cases of chronic bacterial prostatitis due to the following bacteria:
- Ecoli
- faecalis
- Methicillin-susceptible staphylococcus epidermidis
Cipro is administered in cases of chronic bacterial prostatitis due to the following bacteria:
- E. coli
- Proteus mirabilis
How Should IV Infusions Be Used?
The standard Levaquin injection dose is 500 mg every 24 hours for 28 days. It is administered by slow infusion over the course of an hour each time.
Single-use vials of Levaquin should be diluted before use. The diluted solution should be 5 mg/mL prior to use. The following solutions are compatible with Levaquin:
- Sodium chloride injection
- Dextrose injection
- Dextrose/NaCl injection
- Dextrose in lactated ringers
- Plasma-lyte dextrose injection
- Dextrose, sodium chloride, and potassium chloride injection
- Sodium lactate injection
Levaquin injection is also available as a premixed solution in 5% dextrose for single-use. In this case, no further dilution is required.
If using Levaquin injection in premixed flexible containers, your physician should squeeze the inner bag to check for tiny leaks. If leaks are present or if the seal has been previously broken, the solution should be discarded.
Standard Cipro I.V. infusion dose for acute bacterial prostatitis is 400 mg every 12 hours for 28 days.
Cipro injection concentrate must be diluted before use. This drug must be diluted with a compatible IV solution for a concentration of 1 to 2 mg/mL.
Compatible IV solutions for Cipro include:
- Sodium chloride injection
- Dextrose injection
- Sterile water
- Dextrose injection
- Dextrose and sodium chloride
- Ringer’s lactate
Premixed Cipro in flexible containers does not need any additional dilution.
The prescribed dose of Cipro should be infused over the course of an hour. Other medications should be administered separately if using the same IV line.
Discard any unused portion of IV infusion concentrate.
Other Uses for IV Infusions
IV infusions of Cipro are used to treat the following:
- Acute sinusitis
- Bone and joint infections
- Intra-abdominal infections
- Empirical therapy for febrile neutropenic patients
- Lower respiratory tract infections
- Nosocomial pneumonia
- Skin infections
- Urinary tract infections
IV infusions of Levaquin are used to treat the following:
- Pneumonia
- Acute bacterial sinusitis
- Acute bacterial bronchitis
- Skin infections
- Urinary tract infections
- Acute pyelonephritis (bacterial kidney infection)
- Inhalational anthrax
Do I Need To Follow Special Precautions?
Levaquin injection should only be provided intravenously.
Be sure to maintain sufficient hydration while receiving intravenous Levaquin to prevent urine from becoming highly concentrated.
IV infused drugs should be visually examined before use; your physician should look for particles and discoloration whenever the solution and container allow.
Minimal data is available regarding the compatibility of Levaquin injection and other IV medications; other IV drugs should not be administered simultaneously in the same line. The line should be flushed with a compatible solution prior to and following use with Levaquin injection.
Preparation of the IV solution of Levaquin must be sterile.
Do not use a solution that is cloudy or if precipitation is present.
Treatment of Cipro I.V. should be discontinued if a patient experiences tendon pain, swelling, inflammation or rupture.
Before using Cipro, inform your physician if you are allergic to it or other quinolones. Discuss any other allergies you have with your doctor.
Provide your physician with a medical history before treatment, especially with regard to:
- Seizure disorders
- Brain injury or tumors
- Nervous system disorders
- Kidney disease
- Liver disease
- Myasthenia gravis
- Tendonitis or bursitis
- Heart problems
Cipro may cause QT prolongation, which rarely causes serious or fatal rapid or abnormal heartbeat, dizziness, or fainting. If this occurs, seek immediate medical attention.
Inform your physician if you experience symptoms of high or low blood sugar during treatment of Cipro. Your physician should monitor your blood sugar levels carefully, especially in diabetic patients.
When taking this medication, exercise caution when driving, operating machinery, or performing other potentially dangerous tasks, as Cipro may cause dizziness. Limit alcohol consumption.
Avoid excessive exposure to the sun, as well as tanning booths. While outdoors, wear protective clothing and use sunscreen.
If bacterial prostatitis is acute, your physician may require hospitalization for IV infusions.
Are There Side Effects Associated with IV Infusions for Prostatitis?
Side effects of Levaquin may include:
- Nausea
- Vomiting
- Diarrhea
- Headache
- Constipation
- Trouble sleeping
- Dizziness
- Stomach pain
- Rash
- Gas
- Itching
- Tendinitis
- Tendon rupture
- Pseudomembranous colitis
- Sensitivity to sunlight
Side effects of Cipro may include:
- Nausea
- Diarrhea
- Dizziness
- Lightheadedness
- Headache
- Difficulty sleeping
- Sensitivity to sunlight
If you experience any of the above side effects, inform your physician promptly.
If you experience any of the following side effects with Cipro, seek medical attention immediately:
- Pain, numbness, tingling, burning, or weakness in any body part
- Changes in touch, pain, body temperature, body position, or vibration
- Abnormal bruising or bleeding
- Symptoms of a new infection
- Changes in the amount or color of urine
- Symptoms of liver problems
- Severe or enduring headache
- Changes in vision
- Tremors
- Seizures
- Severe dizziness
- Fainting
- Rapid or abnormal heartbeat
- Anxiety, depression, confusion, or suicidal thoughts
- Yeast infection or oral thrush
- Rash
- Itching or swelling, especially of the face, tongue, or throat
- Severe dizziness
- Difficulty breathing
Do IV Infusions Have Special Storage Instructions?
Diluted Levaquin injection is stable for 72 hours if stored at or below 25°C (77°F). It is stable for 14 days if refrigerated at 5°C (41°F) in plastic containers. Frozen diluted solutions in glass or plastic containers are stable for six months if stored at -20°C (-4°F).
Thaw frozen solutions at room temperature or in a refrigerator. Do not place in warm water or microwave to speed up the thawing process. Do not refreeze a solution if it has been thawed already.
Cipro should be stored in vials between 41° and 86°F. Flexible containers should be stored between 41° and 77°F.
Protect Cipro from light, heat, and freezing.
Diluted Cipro injection is stable for up to 14 days in a refrigerator (36° to 46°F) or at room temperature below 86°F.
What Do I Do in the Case of an Accidental Overdose?
In case of a suspected overdose, contact an emergency room or poison control center immediately. For a local control center in the United States, call 1-800-222-1222. Canada residents: call a poison control center within your province.
What Else Should I Know About IV Infusions for Prostatitis?
Sulbactam/cefoperazone (SBT/CPZ) may also be used intravenously for acute bacterial prostatitis.