natgillin/translations-raw huggingface dataset:
For the indications falling within this category 1, the PRAC considered that their benefit overweighs the risks, in particular the identified risk of occurrence of long-lasting, disabling and potentially irreversible adverse drug reactions.
Za indikacije, ki spadajo v kategorijo 1, je odbor PRAC menil, da njihova korist prevlada nad tveganji, zlasti ugotovljenim tveganjem za pojav dolgotrajnih, onesposobljajočih in možnih nepopravljivih neželenih učinkov zdravila.
As for the cases of pharyngitis of bacterial aetiology, the most common pathogen causing bacterial acute pharyngitis is Streptococcus pyogenes.
Kar zadeva bakterijsko etiologijo za primere faringitisa, je najpogostejši povzročitelj bakterijskega akutnega faringitisa bakterija Streptococcus pyogenes.
Therefore, the risks outweigh the benefits in this indication and the indication should be deleted.
Ker so tveganja večja od koristi pri tej indikaciji, je treba indikacijo izbrisati.
The use of (fluoro)quinolones is not warranted in mild to moderate episodes with alternative treatment options.
Uporaba (fluoro)kinolonov ni upravičena pri blagih do zmernih epizodah z drugimi, nadomestnimi možnostmi zdravljenja.
In case of bacterial otitis externa, the main common causative pathogens are Pseudomonas aeruginosa and Staphylococcus aureus, often occurring as a polymicrobial infection (Dibb 1991; Clark et al. 1997).
V primeru bakterijskih okužb zunanjega ušesa sta pogosta povzročitelja Pseudomonas aeruginosa in Staphylococcus aureus, ki se pogosto pojavljata kot del polimikrobne okužbe (Dibb 1991; Clark et al. 1997).
However, for pefloxacin PRAC considered that some of the indications mentioned above in Table 1 should be restricted as below:
Hkrati je za pefloksacin menil, da je treba nekatere indikacije, navedene v preglednici 1, omejiti na naslednji način:
In category 1 indications, it is considered that the newly identified safety concern (long-lasting, disabling and potentially irreversible adverse drug reactions) has a limited impact on the benefit-risk balance of all quinolones/ fluoroquinolones containing products.
Za indikacije kategorije 1 se šteje, da ima novo ugotovljeni zadržek glede varnosti (dolgotrajni, onesposobljajoči in možni nepopravljivi neželeni učinek) omejen vpliv na razmerje med tveganji in koristmi pri vseh zdravilih, ki vsebujejo kinolone/fluorokinolone.
• Prevention of traveller's diarrhoea Preoperative preparations for chronic cholesteatomatous otitis and chronic otitis spreading to bone Septicaemia Selective decontamination of gastrointestinal tract in patients with compromised immune system Prevention of exacerbations in women with recurring urinary tract
• Preprečevanje potovalne driske Predoperativne priprave pri kroničnem holestatskem otitisu in kroničnem otitisu, ki se širi na kost Septikemija Selektivna dekontaminacija prebavil pri imunsko oslabljenih bolnikih Preprečevanje poslabšanja pri ženskah s ponavljajočimi se okužbami sečil
Regarding the indication “Selective decontamination of gastrointestinal tract in patients with compromised immune system” the benefit of using (fluoro)quinolones is extremely limited.
Pri indikaciji „selektivna dekontaminacija prebavil pri imunsko oslabljenih bolnikih“ je korist uporabe (fluoro)kinolonov zelo omejena.
AOM is regarded as a multifactorial and polymicrobial disease, which usually occurs as a complication of viral upper respiratory tract infection (Marom et al 2012).
Akutno vnetje srednjega ušesa velja za multifaktorialno in polimikrobno okužbo, ki se po navadi pojavlja kot zaplet virusne okužbe zgornjih dihal (Marom et al., 2012).
For the purpose of this review, the indications are grouped under heading/cover terms, taking into account all available data, in particular the impact of the long-lasting, disabling and potentially irreversible adverse drug reactions on the benefit-risk balance of these indications:
Za namen tega pregleda so indikacije združene pod naslovi/krovnimi izrazi, ki upoštevajo vse razpoložljive podatke, zlasti vpliv dolgotrajnih, onesposobljajočih in možnih nepopravljivih neželenih učinkov zdravila na razmerje med tveganji in koristmi zadevnih indikacij.
Having considered the above, the PRAC considered that the benefit-risk balance of (fluoro)quinolones in preoperative preparations for chronic cholesteatomatous otitis and chronic otitis spreading to bone is negative.
Ob upoštevanju zgoraj navedenega je odbor PRAC menil, da je razmerje med tveganji in koristmi uporabe (fluoro)kinolonov za predoperativne priprave pri kroničnem holestatskem otitisu in kroničnem otitisu, ki se širi na kost, negativno.
Mainly CRS is caused by the following pathogens: Streptococcus pneumoniae, Haemophilus influenza, Staphylococcus spp., Streptococcus pyogenes, Moraxella catarrhalis, Klebsiella pneumoniae, anaerobes, and Chlamydia spp.
Streptococcus pneumoniae, Haemophilus influenza, Staphylococcus spp., Streptococcus pyogenes, Moraxella catarrhalis, Klebsiella pneumoniae, anaerobi in Chlamydia spp.
This is in view of the severity of the diseases targeted, their possible serious complications including prevention of manifestations of irreversible anatomical or functional lesions, the favourable tissue distribution of (fluoro)quinolones and specificity of the pathogen covered by the microbiological spectrum of (fluoro)quinolones.
To velja z upoštevanjem resnosti ciljnih bolezni, možnih resnih zapletov, vključno s preprečevanjem pojavov nepopravljivih anatomskih ali funkcionalnih okvar, ugodne razporeditve (fluoro)kinolonov v tkivih in posebnosti patogenov, ki jih zajema mikrobiološki spekter (fluoro)kinolonov.
The benefit risk balance of four substances (pipemidic acid, nalidixic acid, flumequine and cinoxacin) is considered negative.
Razmerje med tveganji in koristmi pri teh štirih snoveh (pipemidna kislina, nalidiksna kislina, flumekvin in cinoksacin) se šteje za negativno.
Pharyngitis-Tonsillitis
Faringitis-tonzilitis
Chronic pulmonary infections due to Pseudomonas aeruginosa in adult patients with cystic fibrosis
Kronične okužbe pljuč zaradi bakterije Pseudomonas aeruginosa pri odraslih bolnikih s cistično fibrozo
Assessment of the post-marketing spontaneous and literature data together with the evaluation of available non-clinical and clinical information related to the possible underlying mechanisms of longlasting, disabling and potentially permanent ADRs provided enough evidence to support causal relationship between the (fluoro)quinolones and potentially disabling ADRs.
Vrednotenje spontanih podatkov in podatkov iz literature iz dejavnosti v obdobju trženja skupaj z oceno razpoložljivih nekliničnih in kliničnih informacij, povezanih z morebitnimi osnovnimi mehanizmi dolgotrajnih, onesposobljajočih in možnih trajnih neželenih učinkov, je zagotovilo dovolj dokazov za podporo vzročni zvezi med (fluoro)kinoloni in možnimi onesposobljajočimi neželenimi učinki.
In addition to the amendments to the indications mentioned above, the PRAC recommended other changes to the product information including further warnings and precautions of use relating to the long-lasting, disabling and potentially irreversible adverse drug reactions.
Poleg sprememb zgoraj omenjenih indikacij je odbor PRAC priporočil tudi druge spremembe informacij o zdravilu, vključno z dodatnimi opozorili in previdnostnimi ukrepi v zvezi z dolgotrajnimi, onesposobljajočimi in možnimi nepopravljivimi neželenimi učinki zdravil.
For the indications falling under category 2, the risk benefit balance is considered impacted by the abovementioned safety concern in view of the benefits of (fluoro)quinolones in the concerned diseases, as well as the limited severity of some of these conditions and thus the use in these indications needs to be restricted.
Za indikacije, ki spadajo v kategorijo 2, se šteje, da na razmerje med tveganji in koristmi vplivata zgoraj omenjeni zadržek glede varnosti z vidika koristi (fluoro)kinolonov pri zadevnih boleznih ter omejena resnost nekaterih bolezni, zato je treba omejiti uporabo pri teh indikacijah.
• As a consequence, the PRAC recommended the suspension of the following quinolones medicinal products, nalidixic acid, pipemidic acid, cinoxacin and flumequine, as they do not retain any indication with a positive benefit-risk.
• Posledično je odbor PRAC priporočil začasni umik naslednjih kinolonskih zdravil: nalidiksne kisline, pipemidne kisline, cinoksacina in flumekvina, ker nimajo več nobenih indikacij s pozitivnim razmerjem med tveganji in koristmi.
Therefore, the benefit-risk balance in the indication of uncomplicated cystitis is considered changed and (fluoro)quinolones should only be used in patients who have no alternative treatment options.
Zato se šteje, da je razmerje med tveganji in koristmi pri indikaciji nezapletenega cistitisa spremenjeno in da se smejo (fluoro)kinoloni uporabljati le pri bolnikih, ki nimajo drugih možnosti zdravljenja.
In patients with cystic fibrosis, the predominant pathogen causing broncho-pulmonary infections is Pseudomonas aeruginosa.
Pri bolnikih s cistično fibrozo je prevladujoči povzročitelj bronhialnih in pljučnih okužb bakterija Pseudomonas aeruginosa.
Complicated skin and skin structure infections / Complicated skin and soft tissue infections Gastro-intestinal infections
Zapletene okužbe kože in podkožja/zapletene okužbe kože in mehkih tkiv Okužbe prebavil
Indication heading Pharyngitis-Tonsillitis
Naslov indikacije Faringitis-tonzilitis
The benefitrisk balance of (fluoro)quinolone use in pharyngitis and/or tonsillitis of bacterial origin is therefore considered negative.
Razmerje med tveganji in koristmi uporabe (fluoro)kinolonov pri bakterijskem faringitisu in/ali tonzilitisu se zato šteje za negativno.
The current role of pefloxacin for the treatment of this indication is considered as not established.
Šteje se, da trenutna vloga pefloksacina pri zdravljenju te indikacije ni dokazana.
This pharmacovigilance referral procedure focuses on the review of the impact of long-lasting, disabling and potentially irreversible known adverse drug reactions (ADRs) on the benefit-risk balance of quinolones and fluoroquinolones containing products for systemic and inhalation use and the need for adequate risk minimisation measures.
Farmakovigilančni napotitveni postopek se osredotoča na pregled vpliva znanih dolgotrajnih, onesposobljajočih in možnih nepopravljivih neželenih učinkov zdravila na razmerje med tveganji in koristmi zdravil za sistemsko in inhalacijsko uporabo, ki vsebujejo kinolone in fluorokinolone, ter potrebo po ustreznih ukrepih za zmanjšanje tveganja.
It is considered that uncomplicated cystitis constitutes a non-severe, non-life-threatening indication for which the potential risk outweighs the benefit when using (fluoro)quinolones as first line treatment.
Šteje se, da nezapleteni cistitis predstavlja manj hudo, smrtno nenevarno indikacijo, za katero morebitno tveganje uporabe (fluoro)kinolonov kot zdravila prve izbire prevlada nad koristmi.
• The PRAC concluded that for patients with a serious infection that is susceptible to these antibiotics fluoroquinolones remain an important treatment option despite the very rare risk of long-lasting, disabling and potentially irreversible adverse reactions.
• Odbor PRAC je sklenil, da so pri bolnikih z resno okužbo, ki je dovzetna za te antibiotike, fluorokinoloni še vedno pomembna možnost zdravljenja kljub zelo redkemu tveganju dolgotrajnih, onesposobljajočih in možnih nepopravljivih neželenih učinkov.
Table 2 - Category 2 indications
Preglednica 2 - indikacije kategorije 2
The indications falling within the category 3 are considered to have a benefit-risk balance negative, taking into account the abovementioned safety concern and in view of the limited benefits of (fluoro)quinolones in the concerned diseases.
Za indikacije, ki spadajo v kategorijo 3, se šteje, da je razmerje med tveganji in koristmi negativno, pri čemer se upošteva zgoraj navedeni zadržek glede varnosti in glede na omejene koristi (fluoro)kinolonov pri zadevni bolezni.
Considering potential insufficient coverage of pathogens responsible for meningitis by pefloxacin and risks associated with inappropriate treatment of meningitis, the overall benefit-risk balance of this indication is considered negative and therefore should be deleted.
Glede na morebitno nezadostno pokrivanje povzročiteljev meningitisa s pefloksacinom in tveganja, povezana z neustreznim zdravljenjem meningitisa, se celotna ocena razmerja med tveganji in koristmi pri tej indikaciji šteje za negativno in jo je zato treba izbrisati.
In view of the above, the PRAC concluded that the benefit-risk balance of the following fluoroquinolone medicinal products, pefloxacin, lomefloxacin, ciprofloxacin, levofloxacin, ofloxacin, moxifloxacin, norfloxacin, prulifloxacin, rufloxacin remains favourable subject to the agreed amendments to the product information and other risk minimisation measures.
je glede na zgoraj navedeno odbor PRAC ugotovil, da razmerje med tveganji in koristmi uporabe naslednjih zdravil s fluorokinoloni: pefloksacin, lomefloksacin, ciprofloksacin, levofloksacin, ofloksacin, moksifloksacin, norfloksacin, prulifloksacin, rufloksacin, ostane ugodno, če se upoštevajo dogovorjene spremembe informacij o zdravilu in drugi ukrepi za zmanjšanje tveganja.
Chronic sinusitis
Kronični sinuzitis
Problems related to the use of (fluoro)quinolones in surgical prophylaxis must always be considered, including the development and dissemination of resistant pathogens and the occurrence of adverse drug reactions due to (fluoro)quinolones, including the risk of potentially disabling ADRs.
Vedno je treba upoštevati težave, povezane z uporabo (fluoro)kinolonov v kirurški profilaksi, vključno z razvojem in razširjanjem odpornih povzročiteljev ter pojavom neželenih reakcij zdravil zaradi (fluoro)kinolonov, vključno z nevarnostjo možnih onesposobljajočih neželenih učinkov.
Therefore in view of the risk related to the use of (fluoro)quinolones, including the risk of long-lasting, disabling and potentially permanent serious ADRs, (fluoro)quinolones should be used only when it is considered inappropriate to use antibacterial agents that are commonly recommended for the initial treatment of ABS infections.
Zato je treba zaradi tveganja, povezanega z uporabo (fluoro)kinolonov, vključno s tveganjem za dolgotrajne, onesposobljajoče in možne trajne resne neželene učinke, (fluoro)kinolone uporabljati le, če se šteje, da ni primerno uporabljati protibakterijskih zdravil, ki so pogosto priporočena za začetno zdravljenje ABS.
Based on the lack of scientific evidence on efficacy and the recommendation of the IDWP, the benefit/risk balance of (fluoro)quinolone use in “Selective decontamination of gastrointestinal tract in patients with compromised immune system” is considered negative.
Zaradi pomanjkanja znanstvenih dokazov o učinkovitosti in priporočila IDWP se razmerje med tveganji in koristmi uporabe (fluoro)kinolonov pri „selektivni dekontaminaciji prebavil pri imunsko oslabljenih bolnikih“ šteje za negativno.
Considering insufficient coverage of the pathogens involved in these infections, PRAC conclude that the use of pefloxacin should be restricted to the patients in whom it is considered inappropriate to use other antibacterial agents for the treatment of these infections (last line option).
Glede na nezadostno pokritost povzročiteljev, ki so vpleteni v te okužbe, je odbor PRAC zaključil, da je treba uporabo pefloksacina omejiti na bolnike, pri katerih se šteje, da je za zdravljenje teh okužb neprimerno uporabljati druga protibakterijska zdravila (zdravilo zadnje izbire).
Regarding the high success rate in placebo treated patients and the mild severity of sinusitis in majority of the cases, the benefit of antibiotics should be carefully weight against the occurrence of adverse drug reactions and the potential risk of selection of resistance.
Glede na visoko stopnjo uspešnosti ozdravljenja pri bolnikih, ki so prejemali placebo, in ker je sinuzitis večinoma blag, je treba korist antibiotikov skrbno pretehtati glede na pojavnost neželenih učinkov zdravila in morebitno tveganje pojava odpornosti.
Apart from that, same resistance patterns to pefloxacin are shared with other quinolones making pefloxacin not suitable for the use in peri-procedural prophylaxis.
Poleg tega se enaki vzorci odpornosti proti pefloksacinu pojavljajo tudi pri drugih kinolonih, kar pomeni, da pefloksacin ni uporaben za profilakso pred posegom.
• Acute uncomplicated infection of lower urinary tract (simple cystitis) Acute exacerbation of COPD including chronic bronchitis
• Akutna nezapletena okužba spodnjih sečil (nezapleteni cistitis) Akutno poslabšanje KOPB, vključno s kroničnim bronhitisom
• The PRAC also concluded that in case of mild and/or self-limiting infections, the benefit of quinolones and fluoroquinolones treatment does not outweigh the overall risk related to the use of these medicinal products including serious risk of long-lasting, disabling and potentially irreversible adverse drug reactions.
• Odbor PRAC je prav tako sklenil, da v primeru blagih okužb in/ali okužb, ki izzvenijo same od sebe, koristi zdravljenja s kinoloni in fluorokinoloni ne odtehtajo celotnega tveganja, povezanega z uporabo teh zdravil, vključno z resnim tveganjem za dolgotrajne, onesposobljajoče in možne nepopravljive neželene učinke.
Table 3 - Category 3 indications
Preglednica 3 - indikacije kategorije 3
• Acute sinusitis
• Akutni sinuzitis
Moreover, increasing resistance to (fluoro)quinolones and a possibility of disabling ADRs in this mostly non-severe condition needs to be considered.
Poleg tega je treba razmisliti o naraščajoči odpornosti proti (fluoro)kinolonom in možnosti onesposobljajočih neželenih učinkov pri tej manj hudi okužbi.
Prevention of infection in surgical procedures
Preprečevanje okužb po kirurških posegih
• Also, the PRAC recommended changes to the product information including the indication and further warnings and precautions of use relating to the long-lasting, disabling and potentially irreversible adverse drug reactions.
• Poleg tega je odbor PRAC priporočil spremembe informacij o zdravilu, vključno z indikacijami ter dodatnimi opozorili in previdnostnimi ukrepi v zvezi z dolgotrajnimi, onesposobljajočimi in možnimi nepopravljivimi neželenimi učinki zdravil.
The PRAC also concluded that the benefit-risk balance of the following quinolone medicinal products, nalidixic acid, pipemidic acid, cinoxacin and flumequine is no longer favourable and should be suspended.
Odbor PRAC je tudi sklenil, da razmerje med tveganji in koristmi naslednjih kinolonskih zdravil: nalidiksna kislina, pipemidna kislina, cinoksacin in flumekvin, ni več ugodno, zato jih je treba začasno umakniti.
Typical microorganisms that can cause infective endocarditis include Viridans streptococci, Streptococcus bovis, HACEK group, Staphylococcus aureus or enterococci.
Med mikroorganizme, ki običajno povzročijo infektivni endokarditis, spadajo streptokoki Viridans, Streptococcus bovis, skupina HACEK,
The Committee, as a consequence, recommends the variation to the terms of the marketing authorisations for pefloxacin, lomefloxacin, ciprofloxacin, levofloxacin, ofloxacin, moxifloxacin, norfloxacin, prulifloxacin, rufloxacin.
Zato je priporočil spremembo pogojev dovoljenj za promet s pefloksacinom, lomefloksacinom, ciprofloksacinom, levofloksacinom, ofloksacinom, moksifloksacinom, norfloksacinom, prulifloksacinom, rufloksacinom.
• Exacerbations of broncho-pulmonary infections in cystic fibrosis
• Poslabšanje bronhialnih in pljučnih okužb pri cistični fibrozi
Taking into consideration the efficacy data, the risk of developing resistance and the risk profile of (fluoro)quinolones together with the new risk of long-lasting, disabling and potentially irreversible ADRs it is concluded that benefit-risk balance is unchanged only in severe episodes of AECB and COPD or where other therapeutic options are not effective or tolerable.
Ob upoštevanju podatkov o učinkovitosti, tveganja razvoja odpornosti in profila tveganja (fluoro)kinolonov skupaj z novim tveganjem za dolgotrajne, onesposobljajoče in možne nepopravljive neželene učinke je odbor zaključil, da je razmerje med tveganji in koristmi nespremenjeno samo pri hudih epizodah akutnega poslabšanja kroničnega bronhitisa in KOPB, ali če druge terapevtske možnosti niso učinkovite ali sprejemljive.
Considering potential insufficient coverage of pathogens responsible for endocarditis by pefloxacin and risks associated with inappropriate treatment of endocarditis, the benefit-risk balance of this indication is considered negative.
Glede na morebitno nezadostno pokritost povzročiteljev endokarditisa s pefloksacinom in tveganja, povezana z neustreznim zdravljenjem endokarditisa, se razmerje med tveganji in koristmi pri tej indikaciji šteje za negativno.
Considering the poor pneumococcal susceptibility of pefloxacine and the potential risks, PRAC concluded that the use of pefloxacin in the treatment of acute exacerbations of chronic sinusitis should be restricted to the patients in whom it is considered inappropriate to use other antibacterial agents for the treatment of these infections (last line option).
Ob upoštevanju slabe občutljivosti pnevmokokov na pefloksacin in morebitnih tveganj je odbor PRAC zaključil, da je treba uporabo pefloksacina pri zdravljenju akutnih poslabšanj kroničnega sinuzitisa omejiti na bolnike, pri katerih se šteje, da je za zdravljenje okužbe neprimerno uporabljati druga protibakterijska zdravila (zdravilo zadnje izbire).
No updated data (e.g. in relation to the current prevalence of resistance in Enterobacterales and other Gram-negative bacteria) are available regarding the antimicrobial activity of pefloxacin, as no clinical breakpoints were defined by EUCAST.
V zvezi s protimikrobnim delovanjem pefloksacina ni na voljo nobenih posodobljenih podatkov (npr. glede na trenutno razširjenost odpornosti pri enterobakterijah in drugih gramnegativnih bakterijah), saj odbor EUCAST ni določil kliničnih mejnih vrednosti.
The PRAC also recommended the suspension of the following quinolones medicinal products, nalidixic acid, pipemidic acid, cinoxacin and flumequine.
Prav tako je priporočil začasni umik dovoljenja za promet z naslednjimi kinolonskimi zdravili: nalidiksna kislina, pipemidna kislina, cinoksacin in flumekvin.
• Prophylaxis after surgeries or interventions in the urogenital system o prophylaxis after surgeries or interventions in the urogenital system o Prophylaxis of recurrent urinary infections following trans-urethral surgery or transrectal prostatic biopsy
• Profilaksa po kirurških operacijah ali posegih v sečilih in spolovilih o Profilaksa po kirurških operacijah ali posegih v sečilih in spolovilih o Profilaksa ponavljajočih se okužb sečil po transuretralnem kirurškem posegu ali
• The PRAC concluded that some of the serious adverse drug reactions associated with the use of quinolones and fluoroquinolones could very rarely be long-lasting, disabling and potentially irreversible and that these risks are a class effect.
• Odbor PRAC je ugotovil, da so nekateri resni neželeni učinki zdravila, povezani z uporabo kinolonov in fluorokinolonov, v zelo redkih primerih lahko dolgotrajni, onesposobljajoči in možno nepopravljivi ter da so ta tveganja povezana z razredom zdravil.
Considering the high resistance pattern to pefloxacin, possible development of cross resistance to other quinolones, and the newly recognised risk of long-lasting and potentially disabling adverse effects, the risks of using pefloxacin outweigh its benefits.
Glede na vzorec pogoste odpornosti proti pefloksacinu, možnost razvoja navzkrižne odpornosti proti drugim kinolonom in novo ugotovljeno tveganje za dolgotrajne in možne onesposobljajoče neželene učinke so tveganja uporabe pefloksacina večja od koristi.
To lift the suspension the MAH should submit the appropriate scientific evidence to demonstrate a positive benefit-risk of the medicinal product.
Imetnik dovoljenja za promet z zdravilom mora za odpravo začasnega umika predložiti ustrezne znanstvene dokaze, ki bodo pokazali pozitivno razmerje med tveganji in koristmi uporabe zdravila.
Indication heading Complicated urinary tract infections/pyelonephritis
Naslov indikacije Zapletene okužbe sečil/pielonefritis