Abstract
The current drug-nutrient interaction (DNI) data on antimicrobials available in the literature are a byproduct of both drug-food interaction and drug-antacid interaction data. Much less is available on the influence of antimicrobials on nutritional status. Drug-food interactions are often described as changes in a drug’s bioavailability secondary to the effect of food on the gastrointestinal (GI) tract. These effects include changes in transit time through the GI tract, changes in drug absorption from the GI tract—either as a result of direct reduction of drug absorption through chelation or enhancement of transporters that keep the drug in the GI tract, and changes in drug metabolism due to variances in intrinsic gut metabolism as well as drug delivery to the liver (first-pass metabolism) (1–3). Drug-antacid interaction data may be extrapolated to apply to DNIs or drug-food interactions because antacids represent a standardized, quantifiable delivery method of nutrients (i.e., minerals) to the body. The mechanisms of drug-mineral interactions include chelation, adsorption, alteration in gastric pH, and decreased absorption via otherwise unspecified mechanisms, but may also impact drug elimination by altering urinary pH (4–7). From this information, it becomes apparent that in DNIs—and specifically, antimicrobial-nutrient interactions—nutrients have a greater impact on the disposition and effect of antimicrobials than the reverse.
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Wallace, A.W. (2004). Antimicrobial-Nutrient Interactions. In: Boullata, J.I., Armenti, V.T. (eds) Handbook of Drug-Nutrient Interactions. Nutrition and Health. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-781-9_25
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DOI: https://doi.org/10.1007/978-1-59259-781-9_25
Publisher Name: Humana Press, Totowa, NJ
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