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Drug Interaction With Quinolone Antibiotics in Intensive Care Unit Patients

Drug Interaction With Quinolone Antibiotics in Intensive Care Unit Patients Abstract To the Editor. — It is not uncommon for the patients in an intensive care unit to become colonized with resistant organisms after a course of antibiotics. These organisms are frequently resistant to most antibiotics, and ciprofloxacin often becomes one of the few options for oral treatment. The majority of the patients in the intensive care unit, however, also receive prophylactic antacid therapy to prevent stress ulcers. Despite the profound negative effect of antacids or sucralfate on the absorption of ciprofloxacin,1,2 an effort to avoid this significant drug-drug interaction to ensure adequate drug levels does not always seem to occur when the antibiotic or antacid treatment is initiated. We reviewed retrospectively the medication orders for our intensive care unit patients to determine the incidence of this combination. During a 3-month period (November 1989 to January 1990), ciprofloxacin was prescribed in 54 intensive care unit patients. In 41 of these References 1. Nix DE, Watson WA, Handy L, et al. The effect of sucralfate pretreatment on the pharmacokinetics of ciprofloxacin . Pharmacotherapy. 1989;9:377-380. 2. Hoffken G, Borner K, Glatzel PD, et al. Reduced enteral absorption of ciprofloxacin in the presence of antacids . Eur J Clin Microbiol. 1985;4:345.Crossref 3. Wingender W, Beerman D, Forster D, et al. Interactions of ciprofloxacin with food intake and drugs . In: New HC, Weuta H, eds. First International Ciprofloxacin Workshop, Leverkusen, West Germany, 1985 . Amsterdam, the Netherlands: Excerpta Medica; 1986:136-140. 4. Parpia SH, Nix DE, Hejmanowski LG, et al. Sucralfate reduces the gastrointestinal absorption of norfloxacin . Antimicrob Agents Chemother. 1989;33:99-102.Crossref 5. Nix DE, Wilton JH, Ronald B, et al. Inhibition of norfloxacin absorption by antacids . Antimicrob Agents Chemother. 1990;34:432-435.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Drug Interaction With Quinolone Antibiotics in Intensive Care Unit Patients

Drug Interaction With Quinolone Antibiotics in Intensive Care Unit Patients

Abstract

Abstract To the Editor. — It is not uncommon for the patients in an intensive care unit to become colonized with resistant organisms after a course of antibiotics. These organisms are frequently resistant to most antibiotics, and ciprofloxacin often becomes one of the few options for oral treatment. The majority of the patients in the intensive care unit, however, also receive prophylactic antacid therapy to prevent stress ulcers. Despite the profound negative effect of antacids or...
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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1991.00400030145037
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor. — It is not uncommon for the patients in an intensive care unit to become colonized with resistant organisms after a course of antibiotics. These organisms are frequently resistant to most antibiotics, and ciprofloxacin often becomes one of the few options for oral treatment. The majority of the patients in the intensive care unit, however, also receive prophylactic antacid therapy to prevent stress ulcers. Despite the profound negative effect of antacids or sucralfate on the absorption of ciprofloxacin,1,2 an effort to avoid this significant drug-drug interaction to ensure adequate drug levels does not always seem to occur when the antibiotic or antacid treatment is initiated. We reviewed retrospectively the medication orders for our intensive care unit patients to determine the incidence of this combination. During a 3-month period (November 1989 to January 1990), ciprofloxacin was prescribed in 54 intensive care unit patients. In 41 of these References 1. Nix DE, Watson WA, Handy L, et al. The effect of sucralfate pretreatment on the pharmacokinetics of ciprofloxacin . Pharmacotherapy. 1989;9:377-380. 2. Hoffken G, Borner K, Glatzel PD, et al. Reduced enteral absorption of ciprofloxacin in the presence of antacids . Eur J Clin Microbiol. 1985;4:345.Crossref 3. Wingender W, Beerman D, Forster D, et al. Interactions of ciprofloxacin with food intake and drugs . In: New HC, Weuta H, eds. First International Ciprofloxacin Workshop, Leverkusen, West Germany, 1985 . Amsterdam, the Netherlands: Excerpta Medica; 1986:136-140. 4. Parpia SH, Nix DE, Hejmanowski LG, et al. Sucralfate reduces the gastrointestinal absorption of norfloxacin . Antimicrob Agents Chemother. 1989;33:99-102.Crossref 5. Nix DE, Wilton JH, Ronald B, et al. Inhibition of norfloxacin absorption by antacids . Antimicrob Agents Chemother. 1990;34:432-435.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Mar 1, 1991

References