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Circumventing Drug Interactions

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Drug Interactions in Infectious Diseases

Part of the book series: Infectious Disease ((ID))

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Abstract

There are myriad opportunities for drug interactions involving antimicrobial agents. The potential for drug interactions encountered in clinical practice continues to grow as the number of different antimicrobial classes expands, the number of specific agents within these drug classes increases, and antimicrobial drug regimens become more complex (e.g., treatment of mycobacterial infection and human immunodeficiency virus [HIV] disease). In addition, antimicrobials are commonly used in certain patient populations (e.g., critically ill, geriatric, and HIV-infected patients) where many drugs of various classes are being used and the potential for drug interactions therefore increases as a function of the number and types of drugs present. Many interactions are of minimal clinical importance and often ignored. However, other interactions are associated with substantial risk of adverse pharmacokinetic or pharmacodynamic interactions, resulting in decreased therapeutic efficacy, increased incidence of drug toxicities, and potential for increased antimicrobial resistance. Thus the ability to prevent or minimize adverse drug interactions is of vital importance in optimizing the appropriate and effective use of antimicrobials and enhancing patient outcome.

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References

  1. Fantry LE, Tramont EC. Treponema pallidum. In: Yu V, Merigan T, Barriere SL (eds.). Antimicrobial Chemotherapy and Vaccines. Baltimore, MD: Williams Wilkins, 1998, pp. 462–471.

    Google Scholar 

  2. Piscitelli SC, Flexner C, Minor JR, Polis MA, Masur H. Drug interactions in patients infected with human immunodeficiency virus. Clin Infect Dis 1996; 23: 685–693.

    Article  PubMed  CAS  Google Scholar 

  3. Tseng AL, Foisy MM. Management of drug interactions in patients with HIV. Ann Pharmacother 1997; 31: 1040–1058.

    PubMed  CAS  Google Scholar 

  4. Lee BL, Safrin S. Interactions and toxicities of drugs used in patients with AIDS. Clin Infect Dis 1992; 14: 773–779.

    Article  PubMed  CAS  Google Scholar 

  5. Albengres E, Le Louet H, Tillement JP. Systemic antifungal agents. Drug interactions of clinical significance. Drug Safety 1998; 18 (2): 83–97.

    Article  PubMed  CAS  Google Scholar 

  6. Hilts AE, Fish DN. Dosing of antiretroviral agents in patients with organ dysfunction. Am J Health-Syst Pharm 1998; 55: 2528–2533.

    PubMed  CAS  Google Scholar 

  7. Periti P, Mazzei T, Mini E, Novelli A. Pharmacokinetic drug interactions of macrolides. Clin Pharmacokinet 1992; 23: 106–131.

    Article  PubMed  CAS  Google Scholar 

  8. Rodvold KA, Piscitelli SC. New oral macrolide and fluoroquinolone antibiotics: an overview of pharmacokinetics, interactions, and safety. Clin Infect Dis 1993; 17 (suppl 1): S192–199.

    Article  PubMed  CAS  Google Scholar 

  9. Okimoto N, Niki Y, Soejima R. Effect of levofloxacin on serum concentration of theophylline. Chemotherapy 1992; 40 (suppl 3): 68–74.

    CAS  Google Scholar 

  10. Gisclon LG, Curtin CR, Fowler CL, et al. Absence of a pharmacokinetic interaction between intravenous theophylline and orally administered levofloxacin [abstr A-39]. American Society for Microbiology: Programs and abstracts of the 35th Interscience Conference on Antimicrobial Agents and Chemotherapy. San Francisco, CA, September 17–20, 1995.

    Google Scholar 

  11. Manita S, Toriumi C, Kusajima H, Momo K. The influence of gatifloxacin (AM-1155) on pharmacokinetics and metabolism of theophylline in rats and humans [abstr A-16a]. American Society for Microbiology: Programs and abstracts of the 38th Interscience Conference on Antimicrobial Agents and Chemotherapy. San Diego, CA, September 24–27, 1998.

    Google Scholar 

  12. Liao S, Palmer M, Fowler C, Nayak RK. Absence of an effect of levofloxacin on warfarin pharmacokinetics and anticoagulation in male volunteers. J Clin Pharmacol 1996; 36: 1072–1077.

    Article  PubMed  CAS  Google Scholar 

  13. Mueller FO, Hundt HKL, Muir AR, et al. Study to investigate the influence of 400 mg BAY 12–8039 given once daily to healthy volunteers on PK and PD of warfarin (W) [abstr A-131. American Society for Microbiology: Programs and abstracts of the 38th Interscience Conference on Antimicrobial Agents and Chemotherapy. San Diego, CA, September 24–27, 1998.

    Google Scholar 

  14. Blondeau JM. A review of the comparative in-vitro activity of 12 antimicrobial agents, with a focus on five new “respiratory quinolones.” J Antimicrob Chemother 1999; 43 (suppl B): 1–12.

    CAS  Google Scholar 

  15. Causey D. Concomitant ganciclovir and zidovudine treatment for cytomegalovirus retinitis in patients with HIV infection: an approach to treatment. J Acq Immune Defic Syndr 1991; 4 (suppl 1): S16 - S21.

    Google Scholar 

  16. Hochster H, Dieterich D, Bozzette S, et al. Toxicity of combined ganciclovir and zidovudine for cytomegalovirus disease associated with AIDS: an AIDS clinical trials group study. Ann Intern Med 1990; 113: 111–117.

    Article  PubMed  CAS  Google Scholar 

  17. Burger DM, Meenhorst PL, Koks CHW, Beijnen JH. Drug interactions with zidovudine. AIDS 1993; 7: 445–460.

    Article  PubMed  CAS  Google Scholar 

  18. Lomaestro BM, Baillie GR. Effect of staggered dose of calcium on the bioavailability of ciprofloxacin. Antimicrob Agents Chemother 1991; 35: 1004–1007.

    Article  PubMed  CAS  Google Scholar 

  19. Flor S, Guay DRP, Opsahl JA, et al. Effects of magnesium-aluminum hydroxide and calcium carbonate antacids on bioavailability of ofloxacin. Antimicrob Agents Chemother 1990; 34: 2436–2438.

    Article  PubMed  CAS  Google Scholar 

  20. Knupp CA, Barbhaiya RH. A multiple-dose pharmacokinetic interaction study between didanosine (Videx®) and ciprofloxacin (Cipro®) in male subjects seropositive for HIV but asymptomatic. Biopharm Drug Dispos 1997; 18: 65–77.

    Article  PubMed  CAS  Google Scholar 

  21. Nix DE, Watson WA, Lener ME, et al. Effects of aluminum and magnesium antacids and ranitidine on the absorption of ciprofloxacin. Clin Pharmacol Ther 1989; 46: 700–705.

    Article  PubMed  CAS  Google Scholar 

  22. Grasela TH Jr, Schentag JJ, Sedman AT, et al Inhibition of enoxacin absorption by antacids or ranitidine. Antimicrob Agents Chemother 1989; 33: 615–617.

    Article  PubMed  CAS  Google Scholar 

  23. Van Slooten AD, Nix DE, Wilton JH, Love JH, Spivey JM, Goldstein HR. Combined use of ciprofloxacin and sucralfate. DICP Ann Pharmacother 1991; 25: 578–582.

    Google Scholar 

  24. Lee L-J, Hafkin B, Lee I-D, Hoh J, Dix R. Effects of food and sucralfate on a single oral dose of 500 mg of levofloxacin in healthy subjects. Antimicrob Agents Chemother 1997; 41: 2196–2200.

    PubMed  CAS  Google Scholar 

  25. Sahai J, Gallicano K, Oliveras L, Khaliq S, Hawley-Foss N, Garber G. Cations in the didanosine tablet reduce ciprofloxacin bioavailability. Clin Pharmacol Ther 1993; 53: 292–297.

    Article  PubMed  CAS  Google Scholar 

  26. Piscitelli SC, Goss TF, Wilton JH, D’Andrea DT, Goldstein H, Schentag JJ. Effects of ranitidine and sucralfate on ketoconazole bioavailability. Antimicrob Agents Chemother 1991; 35: 1765–1771.

    Article  PubMed  CAS  Google Scholar 

  27. Blum RA, D’Andrea DT, Florentino BM, et al. Increased gastric pH and the bioavailability of fluconazole and ketoconazole. Ann Intern Med 1991; 114: 755–757.

    Article  PubMed  CAS  Google Scholar 

  28. Crixivan (indinavir sulfate) capsules product monograph. Nutley, NJ: Roche Laboratories, 1995.

    Google Scholar 

  29. Preston SL, Postelnick M, Purdy BD, Petrolati J, Aasi H, Stein DS. Drug interactions in HIV-positive patients initiated on protease inhibitor therapy [letter]. AIDS 1998; 12 (2): 228–230.

    PubMed  CAS  Google Scholar 

  30. Erice A, Balfour HH Jr. Resistance of human immunodeficiency virus type 1 to antiretroviral agents: a review. Clin Infect Dis 1994; 18: 149–156.

    Article  PubMed  CAS  Google Scholar 

  31. Singh N, Squier C, Sivek C, et al. Determinants of compliance with antiretroviral therapy in patients with human immunodeficiency virus: prospective assessment with implications for enhancing compliance. AIDS Care 1996; 8: 261–269.

    Article  PubMed  CAS  Google Scholar 

  32. Williams A. Antiretroviral therapy: factors associated with adherence. J Assoc Nurses AIDS Care 1997; 8 (suppl): 18–23.

    Article  PubMed  Google Scholar 

  33. Chessney M, et al. Evaluation of factors associated with medication adherence and clinical response [abstr]. 12th World AIDS Conference. Geneva, Switzerland, June 28-July 3, 1998.

    Google Scholar 

  34. Samet EH, Libman H, Steger KA, et al. Compliance with zidovudine therapy in patients infected with human immunodeficiency virus, type 1: a cross-sectional study in a municipal hospital clinic. Am J Med 1992; 92: 495–502.

    Article  PubMed  CAS  Google Scholar 

  35. Craig WA. Pharmacokinetic/pharmacodynamic parameters: rationale for antibacterial dosing of mice and men. Clin Infect Dis 1998; 26: 1–12.

    Article  PubMed  CAS  Google Scholar 

  36. Maderas-Kelly KJ, Ostergaard BE, Hovde LB, Rotschafer JC. Twenty-four-hour area under the concentration-time curve/MIC ratio as a generic predictor or fluoroquinolone antimicrobial effect by using three strains of Pseudomonas aeruginosa and an in vitro pharmacodynamic model. Antimicrob Agents Chemother 1996; 40: 627–632.

    Google Scholar 

  37. Preston SL, Drusano GL, Berman AL, et al. Pharmacodynamics of levofloxacin. A new paradigm for early clinical trials. JAMA 1998; 279: 125–129.

    Article  PubMed  CAS  Google Scholar 

  38. Forrest A, Nix DE, Ballow CH, Goss TF, Birmingham MC, Schentag JJ. Pharmacodynamics of intravenous ciprofloxacin in severely ill patients. Antimicrob Agents Chemother 1993; 37: 1073–1081.

    Article  PubMed  CAS  Google Scholar 

  39. D’ Aquila RT, Johnson VA, Wells SL, et al. Zidovudine resistance and HIV-1 disease progression during antiretroviral therapy. Ann Intern Med 1995; 122: 401–408.

    Article  Google Scholar 

  40. Centers for Disease Control and Prevention. Report of the NIH panel to define principles of therapy of HIV infection and guidelines for the use of antiretroviral agents in HIV-infected adults and adolescents. MMWR 1998; 47 (no. RR-5): 8–13.

    Google Scholar 

  41. Acosta EP, Henry K, Baken L, Page LM, Fletcher CV. Indinavir concentrations and antiviral effect. Pharmacother 1999; 19: 708–712.

    Article  CAS  Google Scholar 

  42. American Thoracic Society. Guidelines for the initial management of adults with community-acquired pneumonia: diagnosis, assessment of severity, and initial antimicrobial therapy. Am J Respir Dis 1993; 148: 1418–1426.

    Article  Google Scholar 

  43. Bartlett JG, Breiman RF, Mandell LA, File TM Jr. Community-acquired pneumonia in adults: guidelines for management. Clin Infect Dis 1998; 26: 811–838.

    Article  PubMed  CAS  Google Scholar 

  44. Lumholtz B, Siersbaeck-Nielsen K, Skovsted L, Kampmann J, Hansen J. Sulfamethizole indiced inhibition of diphenylhydantoin, tolbutamide, and warfarin metabolism. Clin Pharmacol Ther 1975; 17: 731–734.

    PubMed  CAS  Google Scholar 

  45. Raasch R. Interactions of oral antibiotics and common chronic medications. Geriatrics 1987; 42: 69–74.

    PubMed  CAS  Google Scholar 

  46. Perdue BE, Standiford HC. Tetracyclines. In: Yu VL, Merigan TC Jr, Barriere SL (eds). Antimicrobial Therapy and Vaccines. Baltimore, MD: Williams Wilkins, 1999, pp. 981–994.

    Google Scholar 

  47. Von Rosentiel N-A, Adam D. Macrolide antibacterials. Drug interactions of clinical significance. Drug Safety 1995; 13: 105–122.

    Article  Google Scholar 

  48. Jacobus RB, Brouwers J. Drug interactions with quinolone antibiotics. Drug Safety 1992; 7: 268–281.

    Article  Google Scholar 

  49. Marchbanks CR. Drug-drug interactions with fluoroquinolones. Pharmacotherapy 1993; 13 (pt 2): 23S - 28S.

    PubMed  CAS  Google Scholar 

  50. Okimoto N, Niki Y, Soejima R. Effect of levofloxacin on serum concentration of theophylline. Chemotherapy. 1992; 40 (suppl 3): 68–74.

    CAS  Google Scholar 

  51. Gisclon LG, Curtin CR, Fowler CL, et al. Absence of a pharmacokinetic interaction between intravenous theophylline and orally administered levofloxacin [abstr A-39]. In: Program and abstracts of the 35th Interscience Conference on Antimicrobial Agents and Chemotherapy. San Francisco, CA, September 17–20, 1995.

    Google Scholar 

  52. Balfour JAB, Wiseman LR. Moxifloxacin. Drugs. 1999; 57: 363–373.

    Article  CAS  Google Scholar 

  53. Manita S, Toriumi C, Kusajima H, et al. The influence of gatifloxacin (AM-1155) on pharmacokinetics and metabolism of theophylline in rats and humans [abstr A-16a]. In: Program and abstracts of the 38th Interscience Conference on Antimicrobial Agents and Chemotherapy. San Diego, CA, September 24–27, 1998.

    Google Scholar 

  54. Sanchez Navarro A, Martinez Cabarga M, Dominguez-Gil Hurle A. Comparative study of the influence of Cat+ on absorption parameters of ciprofloxacin and ofloxacin. J Antimicrob Chemother 1994; 34: 119–125.

    Article  PubMed  CAS  Google Scholar 

  55. Shiba K, Sakai O, Shimada J, Okazaki O, Aoki H, Hakusui H. Effects of antacids, ferrous sulfate, and ranitidine on absorption of DR-3355 in humans. Antimicrob Agents Chemother 1992; 36: 2270–2274.

    Article  PubMed  CAS  Google Scholar 

  56. Wharton JM, Coleman DL, Wofsy CB, et al. Trimethoprim-sulfamethoxazole or pentamidine for Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome. Ann Intern Med 1986; 105: 37–44.

    Article  PubMed  CAS  Google Scholar 

  57. Wofsy WB. Use of trimethoprim-sulfamethoxazole in the treatment of Pneumocystis carinii pneumonitis in patients with acquired immunodeficiency syndrome. Rev Infect Dis 1987; 9 (suppl 2): S184 - S194.

    Article  PubMed  Google Scholar 

  58. Hardy WD. Combined ganciclovir and recombinant human granulocyte-macrophage colony-stimulating factor in the treatment of cytomegalovirus retinitis in AIDS patients. J Aqc Immune Defic Syndr 1991; 4 (suppl 1): S22 - S28.

    Google Scholar 

  59. Freitas VR, Fraser-Smith EB, Matthews TR. Efficacy of ganciclovir in combination with other antimicrobial agents against cytomegalovirus in vitro and in vivo. Antiviral Res 1993; 20: 1–12.

    Article  PubMed  CAS  Google Scholar 

  60. Grossberg HS, Bonnem EM, Buhles WC Jr. GM-CSF with ganciclovir for the treatment of CMV retinitis in AIDS [letter]. N Engl J Med 1989; 321: 1560.

    Google Scholar 

  61. Palestine AG, Polis MA, de Smet MD, et al. A randomized controlled trial of foscarnet in the treatment of cytomegalovirus retinitis in patients with AIDS. Ann Intern Med 1991; 115: 665–673.

    Article  PubMed  CAS  Google Scholar 

  62. Deray G, Katlama C, Dohin E. Prevention of foscarnet nephrotoxicity. Ann Intern Med 1990; 113: 332.

    Article  PubMed  CAS  Google Scholar 

  63. Wachsman M, Petty BG, Cundy KC, et al. Pharmacokinetics, safety and bioavailability of HPMPC (cidofovir) in human immunodeficiency virus-infected subjects. Antiviral Res 1996; 29: 153–161.

    Article  PubMed  CAS  Google Scholar 

  64. Lalezari JP, Kuppermann BD. Clinical experience with cidofovir in the treatment of cytomegalovirus retinitis. J Acq Immune Defic Syndr Hum Retrovirol 1997; 14: S27 - S31.

    Article  CAS  Google Scholar 

  65. Frost DW, Lasseter KC, Noe Ai, Shamblen EC, Lettieri J. Effect of aluminum hydroxide and calcium carbonate antacids on the bioavailability of ciprofloxacin. Antimicrob Agents Chemother 1992; 36: 830–832.

    Article  CAS  Google Scholar 

  66. Hoffken G, Lode H, Wiley R, et al. Pharmacokinetics and bioavailability of ciprofloxacin and ofloxacin: effect of food and antacid intake. Rev Infect Dis 1988; 10 (suppl 1): S138 - S139.

    Article  Google Scholar 

  67. Peloquin CA, Bulpitt AE, Jaresko GS, Jelliffe RW, Nix DE. Effect of food and antacids on the pharmacokinetics of ethambutol and pyrazinamide [abstr A-3]. American Society for Microbiology: Programs and abstracts of the 37th Interscience Conference on Antimicrobial Agents and Chemotherapy. Toronto, Ont., September 28-October 1, 1997.

    Google Scholar 

  68. Mattila MJ, Linnoila MST, Koskinen R. Effect of aluminium hydroxide and glycopyrrhonium on the absorption of ethambutol and alcohol in man. Br J Clin Pharmacol 1978; 5: 161–166.

    Article  PubMed  CAS  Google Scholar 

  69. Moore KHP, Yuen GJ, Raasch RH, et al. Pharmacokinetics of lamivudine administered alone and with trimethoprim-sulfamethoxazole. Clin Pharmacol Ther 1996; 59: 550–558.

    Article  PubMed  CAS  Google Scholar 

  70. Abbott Laboratories. Norvir product monograph. North Chicago, IL, 1996.

    Google Scholar 

  71. Benedek IH, Fiske WD, White SJ, Stevenson D, Joseph JL, Kornhauser DM. Pharmacokinetic interaction between multiple doses of efavirenz and rifabutin in healthy volunteers [abstr]. Clin Infect Dis 1998; 27: 1008.

    Google Scholar 

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Authors
  1. Douglas N. Fish
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Editors and Affiliations

  1. Clinical Pharmacokinetics Research Laboratory, Clinical Center Pharmacy Department, National Institutes of Health, Bethesda, MD, USA

    Stephen C. Piscitelli Pharm.D. (Coordinator) (Coordinator)

  2. Pharmacy College of Pharmacy and Medicine, University of Illinois at Chicago, Chicago, IL, USA

    Keith A. Rodvold Pharm.D. (Professor of Pharmacy Practice and Associate Professor of Medicine) (Professor of Pharmacy Practice and Associate Professor of Medicine)

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Fish, D.N. (2001). Circumventing Drug Interactions. In: Piscitelli, S.C., Rodvold, K.A. (eds) Drug Interactions in Infectious Diseases. Infectious Disease. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-025-4_12

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  • DOI: https://doi.org/10.1007/978-1-59259-025-4_12

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-4757-5031-7

  • Online ISBN: 978-1-59259-025-4

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