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Can I substitute ciprofloxacin with ofloxacin for pharyngitis?

Dr Chandra M Gulhati
Editor, MIMS,
New Delhi

Q: Ciprofloxacin gives me severe gastric irritation and distention. Being a quinolone, will substituting it with ofloxacin for pharyngitis produce similar gastric irritation? I am able to tolerate norfloxacin with absolutely no side effects. I do not find any listing for gatifloxacin in your generic drug list. Since I am in my 50s, I suspect prostatitis symptoms too. Hence can I kill 2 birds (URI and prostatitis) with one shot using ofloxacin?

A:The first point is that most cases of pharyngitis are either allergic (due to dust) or due to viral infections. In such cases there is no point in taking any antibacterial. It is known that up to 66 per cent of antibiotic use is irrational and potentially dangerous as per WHO surveys. Assuming that a throat swab does show bacterial growth, then appropriate antibiotic can be taken to which grown germs are sensitive which may or may not be a quinolone (norfloxacin, ciprofloxacin, ofloxacin, lomefloxacin, gatifloxacin, pefloxacin) but an antibiotic such as amoxycillin, ampicillin etc. Even though quinolones have common properties, it is possible that one or more side effects that occur with one member of the quinolones in a particular patient may not manifest with another quinolone. It is also possible that your problem is due to prostatic hypertrophy and not prostatitis. It is better to get it checked since the treatment will differ.