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PIRONEF

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Karim BenHarbi

General medicine8 years of experience

Dr. Karim Ben Harbi is a licensed general practitioner based in Italy. He provides online consultations for adults and children, combining international clinical experience with evidence-based medicine. His care approach is focused on accurate diagnosis, preventive care, and personalised health guidance.

Dr. Ben Harbi received his medical degree from Sapienza University in Rome. His training included hands-on experience in diverse settings — tropical medicine, rural healthcare, and urban outpatient practice. He also conducted clinical research in microbiology, exploring the role of the gut microbiome in chronic gastrointestinal issues.

You can consult Dr. Ben Harbi for:

  • General health concerns, prevention, and primary care.
  • Hypertension, type 1 and type 2 diabetes, metabolic issues.
  • Cold, cough, flu, respiratory infections, sore throat, fever.
  • Chronic digestive issues: bloating, gastritis, IBS, microbiome imbalance.
  • Skin rashes, mild allergic reactions, basic dermatological complaints.
  • Medication guidance, treatment adjustments, prescription review.
  • Paediatric concerns — fever, infections, general well-being.
  • Lifestyle optimisation: stress, sleep, weight, and diet counselling.

Dr. Ben Harbi offers reliable, accessible medical support through online consultations, helping patients make informed decisions about their health with a clear, structured, and compassionate approach.

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Svetlana Kolomeeva

Cardiology17 years of experience

Dr. Svetlana Kolomeeva is a general practitioner and internal medicine doctor providing online consultations for adults. She helps patients manage acute symptoms, chronic conditions, and preventive care. Her clinical focus includes cardiovascular health, hypertension control, and managing symptoms like fatigue, weakness, sleep issues, and overall low energy.

Patients commonly seek her help for:

  • High blood pressure, headaches, dizziness, swelling, palpitations.
  • Diagnosis and management of hypertension, arrhythmias, and tachycardia.
  • Metabolic syndrome, excess weight, high cholesterol.
  • Chronic fatigue, insomnia, poor concentration, anxiety.
  • Respiratory symptoms: colds, flu, sore throat, cough, fever.
  • Digestive issues: heartburn, bloating, constipation, IBS symptoms.
  • Chronic conditions: diabetes, thyroid disorders.
  • Interpretation of lab tests and medical reports, therapy adjustment.
  • Second opinion and decision-making support.
  • Cardiovascular disease prevention and metabolic risk reduction.
  • Long-term follow-up and dynamic health monitoring.

Dr Kolomeeva combines clinical expertise with personalised care. She clearly explains diagnoses, guides patients through symptoms and treatment options, and provides actionable plans. Her consultations are designed not only to address current complaints but also to stabilise chronic conditions and prevent future complications. She supports patients through every stage of care – from first symptoms to ongoing health management.

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This page is for general information. Consult a doctor for personal advice. Call emergency services if symptoms are severe.
About the medicine

How to use PIRONEF

INSTRUCTIONS for medical use of the medicinal product FLOXIMED (FLOXIMED)

Composition

active substance: ciprofloxacin; 1 ml of solution contains ciprofloxacin (in the form of hydrochloride) 3 mg; excipients: sodium acetate, trihydrate; mannitol (E 421); disodium edetate; benzalkonium chloride; glacial acetic acid; purified water.

Pharmaceutical form

Eye and ear drops, solution.

Main physical and chemical properties

Transparent solution from colorless to greenish-yellow.

Pharmacotherapeutic group

Agents for use in ophthalmology and otology. Antimicrobial agents. ATC code S03A A07.

Pharmacological properties

Pharmacodynamics
Mechanism of action

The medicinal product contains ciprofloxacin from the class of quinolones. The bactericidal action of quinolones, which mainly affects the synthesis of bacterial DNA, is expressed by inhibiting DNA gyrase.

Ciprofloxacin has high activity in vitro against most gram-negative microorganisms, including Pseudomonas aeruginosa. It is also effective against aerobic gram-positive microorganisms, such as staphylococci and streptococci.

Susceptibility to microorganisms
Use in ophthalmology

Both in vitro and in clinical use in eye infections, it has been proven that ciprofloxacin is active against most strains of the following organisms.

Aerobic gram-positive microorganisms: Staphylococcus aureus (including methicillin-sensitive and methicillin-resistant strains); Staphylococcus epidermidis; Staphylococcus spp., other coagulase-negative species Staphylococcus spp., including S. haemolyticus and S. hominis; Corynebacterium spp.; Streptococcus pneumoniae; Streptococcus group Viridans.
Aerobic gram-negative microorganisms: Acinetobacter spp.; Haemophilus influenzae; Pseudomonas aeruginosa; Moraxella spp. (including M. catarrhalis).
Use in otology

Ciprofloxacin has high activity in vitro against most aerobic gram-negative microorganisms, including Pseudomonas aeruginosa. It is also effective against aerobic gram-positive microorganisms, such as staphylococci and streptococci.

Bacterial speciesIsolates N =MIC min (μg / ml)MIC50 (μg / ml)MIC90 (μg / ml)MIC max (μg / ml)
Pseudomonas aeruginosa10890.030.130.2516
Staphylococcus aureus2210.130.501.0128
Staphylococcus epidermidis2570.060.250.50128
Staphylococcus caprae750.130.500.502.0
Enterococcus faecalis530.501.02.04.0
Enterobacter cloacae450.0040.0160.0320.25
Limit values of microbial growth inhibition zones
Use in ophthalmology

Ciprofloxacin has been shown to be active in vitro against most strains of the following microorganisms; however, the clinical significance of these data in ophthalmic infections is unknown.

Aerobic gram-positive microorganisms: Bacillus species.
Aerobic gram-negative microorganisms: Acinetobacter calcoaceticus; Enterobacter aerogenes; Escherichia coli; Haemophilus parainfluenzae; Klebsiella pneumoniae; Neisseria gonorrhoeae; Proteus mirabilis; Proteus vulgaris; Serratia marcescens.
Others: Peptococcus spp.; Peptostreptococcus spp.; Propionibacterium acnes; Clostridium perfringens.
Insensitive species

Some strains of Burkholderia cepacia and Stenotrophomonas maltophilia are resistant to ciprofloxacin, as well as some anaerobic bacteria, especially Bacteroides fragilis.

Preclinical safety data

Ciprofloxacin and other quinolones cause the development of arthropathy in young animals of most species studied after oral administration.

Clinical characteristics

Indications

Corneal ulcers and superficial eye infections (eyes) and their appendages, caused by bacterial strains sensitive to ciprofloxacin.

Acute otitis externa, as well as acute otitis media with drainage through a tympanostomy tube, caused by bacterial strains sensitive to ciprofloxacin.

Contraindications

Increased sensitivity to ciprofloxacin, other quinolones, and/or excipients of the medicinal product.

Interaction with other medicinal products and other types of interactions

No interaction studies were conducted.

Special warnings and precautions for use
General

The medicinal product is intended for local use (in the conjunctival sac or in the external auditory canal).

For eye drops

Clinical experience with ciprofloxacin eye drops in children under 1 year of age, especially newborns, is quite limited.

For ear drops

The efficacy and safety of ciprofloxacin ear drops in children under 1 year of age have not been evaluated.

Use during pregnancy or breastfeeding

Pregnancy

There are no adequate data on the local use of ciprofloxacin in pregnant women.

Breastfeeding

When administered orally, ciprofloxacin was found in breast milk.

Ability to affect reaction rate when driving vehicles or operating machinery

Ciprofloxacin for local use does not have or has a negligible effect on the ability to drive vehicles or operate machinery.

Method of administration and dosage

Use in ophthalmology
Dosage

Adolescents and adults, including elderly patients.

Corneal ulcers. The medicinal product should be used at the following intervals, including at night:

· on the 1st day, instill 2 drops into the conjunctival sac(s) of the affected eye(s) every 15 minutes for the first 6 hours, then 2 drops every 30 minutes during the first day;

· on the 2nd day, instill 2 drops into the conjunctival sac(s) of the affected eye(s) every hour;

· from the 3rd to the 14th day, instill 2 drops into the conjunctival sac(s) of the affected eye(s) every 4 hours.

Method of administration

To prevent contamination of the dropper tip and solution, care should be taken not to touch the eyelids, adjacent areas, or other surfaces with the edge of the dropper bottle.

Use in otology
Dosage

Adults, including elderly patients.

The medicinal product is used in a dose of 4 drops into the ear canal 2 times a day.

Method of administration

The external auditory canal should be carefully cleaned.

Overdose

Symptoms. Given the characteristics of this medicinal product, intended for local use, no toxic effect is expected when used in ophthalmology/otology in the recommended doses, as well as in the event of accidental ingestion of the contents of 1 bottle.

Adverse reactions

Adverse effects observed after application of ciprofloxacin to the eye
Infections and invasionsRarely — barley, rhinitis
Immune system disordersRarely — increased sensitivity
Nervous system disordersOften — dysgeusia; Rarely — headache; Rarely — dizziness
Eye disordersOften — deposits on the cornea, feeling of discomfort in the eye, hyperemia of the eye; Rarely — keratopathy, infiltrates of the cornea, discoloration of the cornea, photophobia, decreased visual acuity, swelling of the eyelids, blurred vision, eye pain, dryness of the eye, swelling of the eyes, itching of the eye, feeling of a foreign body in the eye, increased lacrimation, discharge from the eye, formation of scales on the edges of the eyelids, peeling of the eyelids, swelling of the conjunctiva, erythema of the eyelids; Rarely — eye toxicity, punctate keratitis, keratitis, conjunctivitis, dysfunction of the cornea, epithelial defect of the cornea, diplopia, hypesthesia of the eye, asthenopia, irritation of the eye, inflammation of the eye, hyperemia of the conjunctiva
Ear and labyrinth disordersRarely — ear pain
Respiratory, thoracic, and mediastinal disordersRarely — hypersecretion of the paranasal sinuses
Gastrointestinal disordersRarely — nausea; Rarely — diarrhea, abdominal pain
Skin and subcutaneous tissue disordersRarely — dermatitis
Musculoskeletal and connective tissue disordersFrequency unknown — tendon damage
General disordersRarely — intolerance to the medicinal product
Laboratory studiesRarely — deviation from normal laboratory test results
Adverse reactions observed after application of ciprofloxacin to the ear
Nervous system disordersRarely — crying, headache
Ear and labyrinth disordersRarely — ear pain, ear fullness, otorrhea, itching in the ear; Frequency unknown — tinnitus
Skin and subcutaneous tissue disordersRarely — dermatitis
General disordersRarely — hyperthermia

Shelf life

3 years.

Storage conditions

Store at a temperature not exceeding 25 °C in the original packaging and out of reach of children.

Packaging

5 ml of solution in a dropper bottle; 1 dropper bottle in a cardboard box.

Release category

By prescription.

Manufacturer

S.C. Rompharm Company S.R.L., Romania / K.O. Rompharm Comp ani S.R.L., Romania.

Location of the manufacturer and address of the place of business

Otopeni city, Eroilor str. № 1A, 075100, Ilfov county / м. Отопень, вул. Ероілор № 1А, 075100, округ Ілфов.

Applicant

WORLD MEDICINE, LLC, Ukraine / ТОВ «УОРЛД МЕДИЦИН», Україна.

Online doctors for PIRONEF

Discuss dosage, side effects, interactions, contraindications, and prescription renewal for PIRONEF – subject to medical assessment and local rules.

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Doctor

Roman Raevskii

Oncology6 years of experience

Dr. Roman Raevskii is an oncologist and general practitioner. He provides online consultations focused on cancer-related care, early diagnosis, and personalised treatment – combining clinical expertise with a patient-centred approach.

Dr. Raevskii provides medical care in the following areas:

  • Diagnosis and management of common conditions: hypertension, diabetes, respiratory and digestive disorders.
  • Oncological consultations: early cancer detection, risk evaluation, and treatment navigation.
  • Supportive care for oncology patients — pain control, symptom relief, and side effect management.
  • Preventive medicine and health screenings.
  • Development of tailored treatment plans based on clinical guidelines.

With a patient-centred approach, Dr. Raevskii helps individuals manage both chronic illnesses and complex oncological cases. His consultations are guided by current medical standards and adapted to each patient’s needs.

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Mar Tabeshadze

Endocrinology10 years of experience

Dr. Mar Tabeshadze is a licensed endocrinologist and general practitioner in Spain. She provides online consultations for adults, offering medical support for a wide range of endocrine conditions and related health concerns.

  • Diagnostic consultations for suspected endocrine disorders
  • Management of thyroid conditions, including in pregnant women
  • Early detection and treatment of type 1 and type 2 diabetes, with personalised therapy plans
  • Obesity treatment: identifying underlying causes of weight gain, combining medication and non-pharmacological strategies, and long-term support
  • Diagnosis and treatment of endocrine-related skin, hair, and nail issues
  • Ongoing care for patients with osteoporosis, pituitary, and adrenal gland disorders
Dr. Tabeshadze takes a patient-centred approach based on evidence-based medicine. Her goal is to help patients achieve hormonal balance, manage chronic conditions effectively, and improve overall well-being through targeted, personalised care.
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Doctor

Nataliia Bessolitsyna

Rheumatology25 years of experience

Dr. Nataliia Bessolitsyna is a rheumatologist with extensive clinical experience. She provides online consultations focused on the diagnosis, treatment, and long-term management of joint diseases and systemic autoimmune disorders, following international clinical guidelines and evidence-based medicine.

You can consult Dr. Bessolitsyna about:

  • Joint pain — acute, chronic, or recurring pain.
  • Inflammatory arthritis: rheumatoid arthritis, psoriatic arthritis, polyarthritis, gouty arthritis.
  • Degenerative joint conditions: osteoarthritis, knee and hip arthritis (gonarthrosis, coxarthrosis), nodal polyosteoarthritis.
  • Periarthritis and spondyloarthritis.
  • Spinal inflammation: ankylosing spondylitis (Bechterew’s disease).
  • Systemic autoimmune diseases: lupus, scleroderma, systemic vasculitis.
  • Osteoporosis and bone fragility.

Dr. Bessolitsyna offers a personalised and structured approach — helping patients identify causes of joint pain, interpret test results, and follow tailored treatment plans. Her consultations focus on early diagnosis, symptom control, complication prevention, and improving long-term quality of life.

With remote access to specialist care, patients can receive expert rheumatology support wherever they are.

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Doctor

Alexandra Alexandrova

General medicine8 years of experience

Dr Alexandra Alexandrova is a licensed general medicine doctor in Spain, specialising in trichology, nutrition, and aesthetic medicine. She offers online consultations for adults, combining a therapeutic approach with personalised care for hair, scalp, and overall health.

Areas of expertise:

  • Hair loss in women and men, postpartum hair loss, androgenetic and telogen effluvium.
  • Scalp conditions: seborrheic dermatitis, psoriasis, scalp irritation, dandruff.
  • Chronic conditions: hypertension, diabetes, metabolic disorders.
  • Online trichology consultation: customised treatment plans, nutritional support, hair growth stimulation.
  • Hair loss prevention: hormonal imbalance, stress factors, haircare strategies.
  • Routine health check-ups, prevention of cardiovascular and metabolic diseases.
  • Personalised nutritional advice to improve hair strength, skin health, and hormonal balance.
  • Aesthetic medicine: non-invasive strategies to enhance skin quality, tone, and metabolic wellness.

Dr Alexandrova follows an evidence-based and holistic approach: online consultations with a therapist and trichologist on Oladoctor provide professional support for hair, scalp, and overall health — all from the comfort of your home.

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