Fluoroquinolones are a widely-prescribed, broad-spectrum class of antibiotics with several oral formulations notable for their high bioavailability. For certain infections, fluoroquinolones are the first line or only treatment choice. When administered orally, fluoroquinolones require proper administration to ensure adequate systemic absorption and, thereby, protect patients from treatment failure. Oral drug preparations that contain multivalent cations are well known to chelate with fluoroquinolones in the gastrointestinal tract; co-administration may lead to clinically significant decreases in oral fluoroquinolone bioavailability and an overall increase in fluoroquinolone-resistant bacteria. Based on a search and evaluation of the literature, this focused review describes oral fluoroquinolone-multivalent cation drug-drug interactions and their magnitude and offers several clinical management strategies for these potentially clinically significant interactions.
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http://dx.doi.org/10.3390/antibiotics8030108 | DOI Listing |
Antibiotics (Basel)
December 2024
Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, 00149 Rome, Italy.
: Tuberculosis (TB) is preventable and curable, but multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) pose significant challenges worldwide due to the limited treatment options, lengths of therapies, and high rates of treatment failure. The management of MDR-TB has been revolutionized by all oral anti-TB drug regimens that are likely to improve adherence and treatment outcomes. These regimes include bedaquiline (B), pretomanid (P), and linezolid (L) (BPaL), and moxifloxacin if resistance to fluoroquinolones is not detected (BPaLM).
View Article and Find Full Text PDFAnn Am Thorac Soc
January 2025
The University of Tokyo, Department of Clinical Epidemiology and Health Economics, Bunkyo-ku, Tokyo, Japan.
Rationale: Although the guidelines generally omit routine antibiotic prophylaxis for diagnostic bronchoscopy, this recommendation is primarily based on studies with relatively small sample sizes conducted at single institutions. Moreover, the applicability of recent technical and procedural advancements to these guidelines remains uncertain.
Objectives: To evaluate whether oral prophylactic antibiotic administration for diagnostic bronchoscopy reduces post-bronchoscopy infections among non-infectious diseases in the current setting.
Drugs R D
January 2025
Research Division, Federal Institute of Drugs and Medical Devices (BfArM), Kurt-Georg-Kiesinger-Allee 3, 53175, Bonn, Germany.
Introduction: In November 2018, the European Medicines Agency (EMA) restricted the use of fluoroquinolones (used by mouth, injections or inhalation) in the context of a referral due to long-lasting and potentially irreversible adverse drug reactions (ADRs). Fluoroquinolones should no longer be used to treat mild or moderate bacterial infections unless other antibacterials cannot be used.
Objectives: The first aim of our study was to analyze whether in the period before compared with after the referral the characteristics of spontaneous ADR reports related to fluoroquinolones differed and whether specific ADRs were more frequently reported for fluoroquinolones compared with cotrimoxazole.
Antimicrob Steward Healthc Epidemiol
July 2024
Cardinal Health Innovative Delivery Solutions, Stafford, TX, USA.
Objective: The aim of this study was to determine if oral beta-lactam therapy is non-inferior to alternative therapy at discharge following inpatient treatment with an IV cephalosporin for acute pyelonephritis.
Design: Institutional Review Board (IRB)-approved, multicenter, retrospective, non-inferiority cohort (15% non-inferiority margin).
Setting: Six hospitals within two healthcare systems.
Infect Agent Cancer
January 2025
Genetics and Cytology Department, National Research Centre, Dokki, 12622, Giza, Egypt.
Background: Cancer is a significant global health issue due to its high incidence and mortality rates. In recent years, the relationship between the human microbiota and cancer has garnered attention across various medical fields. This includes research into the microbial communities that influence cancer development, tumor-associated microorganisms, and the interactions between the microbiome and tumor, collectively referred to as the oncobiome.
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