Interactions Between Antibiotics and Other Drugs - Common Clinical Problem

A special issue of Antibiotics (ISSN 2079-6382).

Deadline for manuscript submissions: closed (31 March 2021) | Viewed by 10478

Special Issue Editors

Department of Pharmaceutical Chemistry, Poznan University of Medical Sciences, 60-780 Poznan, Poland
Interests: drug analysis; drug stability; pharmaceutical chemistry
Special Issues, Collections and Topics in MDPI journals
Department of Pharmaceutical Chemistry, Poznan University of Medical Sciences, 60-780 Poznan, Poland
Interests: drug interactions; parenteral nutrition; hospital pharmacy; nanotechnology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The issue of drug interactions is crucial in daily clinical practice for physicians, nurses, and pharmacists. This problem is especially important in the case of antibiotics, where the interplay between co-administered drugs can change the pharmacological activity of the antibiotic and may affect the treatment of the infection. The safety of drug administration is a vital aspect of clinical practice, especially in light of reports showing that about half of all intravenous preparations and infusions are administered incorrectly. The use of incompatible preparations causes approximately 20% of all medical errors and accounts for 89% of errors in drug administration.

This Special Issue in Antibiotics is dedicated to interactions between antibiotics and parenteral drugs and aims to draw together experts in the fields of pharmaceutical sciences, microbiology, chemistry, and clinical medicine. Submissions (original papers and reviews) contributing to the understanding of drug–drug interactions and presenting implications for clinical practice are invited for this Special Issue.

Prof. Dr. Anna Jelińska
Dr. Maciej Stawny
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • antibiotics interaction
  • medical errors
  • drug compatibility
  • drug stability
  • drug safety

Published Papers (3 papers)

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Research

14 pages, 1450 KiB  
Article
Effect of Clindamycin on Intestinal Microbiome and Miltefosine Pharmacology in Hamsters Infected with Leishmania infantum
by Ana Isabel Olías-Molero, Pedro Botías, Montserrat Cuquerella, Jesús García-Cantalejo, Emilia Barcia, Susana Torrado, Juan José Torrado and José María Alunda
Antibiotics 2023, 12(2), 362; https://doi.org/10.3390/antibiotics12020362 - 09 Feb 2023
Viewed by 1488
Abstract
Visceral leishmaniasis (VL), a vector-borne parasitic disease caused by Leishmania donovani and L. infantum (Kinetoplastida), affects humans and dogs, being fatal unless treated. Miltefosine (MIL) is the only oral medication for VL and is considered a first choice drug when resistance to antimonials [...] Read more.
Visceral leishmaniasis (VL), a vector-borne parasitic disease caused by Leishmania donovani and L. infantum (Kinetoplastida), affects humans and dogs, being fatal unless treated. Miltefosine (MIL) is the only oral medication for VL and is considered a first choice drug when resistance to antimonials is present. Comorbidity and comedication are common in many affected patients but the relationship between microbiome composition, drugs administered and their pharmacology is still unknown. To explore the effect of clindamycin on the intestinal microbiome and the availability and distribution of MIL in target organs, Syrian hamsters (120–140 g) were inoculated with L. infantum (108 promastigotes/animal). Infection was maintained for 16 weeks, and the animals were treated with MIL (7 days, 5 mg/kg/day), clindamycin (1 mg/kg, single dose) + MIL (7 days, 5 mg/kg/day) or kept untreated. Infection was monitored by ELISA and fecal samples (16 wpi, 18 wpi, end point) were analyzed to determine the 16S metagenomic composition (OTUs) of the microbiome. MIL levels were determined by LC-MS/MS in plasma (24 h after the last treatment; end point) and target organs (spleen, liver) (end point). MIL did not significantly affect the composition of intestinal microbiome, but clindamycin provoked a transient albeit significant modification of the relative abundance of 45% of the genera, including Ruminococcaceae UCG-014, Ruminococcus 2; Bacteroides and (Eubacterium) ruminantium group, besides its effect on less abundant phyla and families. Intestinal dysbiosis in the antibiotic-treated animals was associated with significantly lower levels of MIL in plasma, though not in target organs at the end of the experiment. No clear relationship between microbiome composition (OTUs) and pharmacological parameters was found. Full article
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16 pages, 523 KiB  
Article
Stability and Compatibility Aspects of Drugs: The Case of Selected Cephalosporins
by Szymon Tomczak, Aleksandra Gostyńska, Malwina Nadolna, Karolina Reisner, Marta Orlando, Anna Jelińska and Maciej Stawny
Antibiotics 2021, 10(5), 549; https://doi.org/10.3390/antibiotics10050549 - 09 May 2021
Cited by 6 | Viewed by 4452
Abstract
Intravenous drug incompatibilities are a common cause of medical errors, contributing to ineffective therapy and even life-threatening events. The co-administration of drugs must always be supported by studies confirming compatibility and thus guarantee the therapy’s safety. Particular attention should be paid to the [...] Read more.
Intravenous drug incompatibilities are a common cause of medical errors, contributing to ineffective therapy and even life-threatening events. The co-administration of drugs must always be supported by studies confirming compatibility and thus guarantee the therapy’s safety. Particular attention should be paid to the possible incompatibilities or degradation of intravenous cephalosporins in different infusion regimens since the administration of drugs with inadequate quality may cause treatment failure. Therefore, an appropriate stability test should be performed. The study aimed to present various aspects of the stability and compatibility of five cephalosporins: cefepime (CFE), cefuroxime (CFU), ceftriaxone (CFX), ceftazidime (CFZ), and cefazoline (CFL). The degradation studies in parenteral infusion fluids and PN admixtures were conducted for CFE and CFU. The interactions between CFX or CFZ and PN admixtures, as well as the compatibility of CFL with five commercial parenteral nutrition (PN) admixtures, were investigated. The content of CFX and CFZ in PN admixture after 24 h was >90%. CFL administered simultaneously with PN admixture by the same infusion set using Y-site was compatible only with Nutriflex Lipid Special. CFE and CFU were stable in all tested infusion fluids for a minimum of 48 h and decomposed in PN admixtures during storage. Full article
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11 pages, 576 KiB  
Article
Toward Safe Pharmacotherapy: The Interplay between Meropenem and Parenteral Nutrition Admixtures
by Aleksandra Gostyńska, Ludwika Piwowarczyk, Malwina Nadolna, Anna Jelińska, Katarzyna Dettlaff, Magdalena Ogrodowczyk, Maria Popielarz-Brzezińska and Maciej Stawny
Antibiotics 2021, 10(2), 217; https://doi.org/10.3390/antibiotics10020217 - 22 Feb 2021
Cited by 9 | Viewed by 2970
Abstract
Simultaneous administration of parenteral nutrition (PN) admixtures with intravenous antibiotics is a common clinical problem. Coadministration of drugs incompatible with PN admixture may affect its stability, especially in the context of lipid droplet size, which is a crucial parameter for patient safety. In [...] Read more.
Simultaneous administration of parenteral nutrition (PN) admixtures with intravenous antibiotics is a common clinical problem. Coadministration of drugs incompatible with PN admixture may affect its stability, especially in the context of lipid droplet size, which is a crucial parameter for patient safety. In the present study, we investigate the in vitro compatibility of meropenem (Meropenem 1000, MPM) with five commercial PN admixtures used worldwide: Kabiven, Olimel N9E, Nutriflex Lipid Special, Nutriflex Omega Special, and SmofKabiven. The appropriate volumetric ratios, reflecting their clinical practice ratios, were used to prepare the MPM–PN admixture samples. Physicochemical properties of MPM–PN admixtures samples were determined upon preparation and after four hours of storage. The pH changes for all MPM–PN admixtures samples did not exceed the assumed level of acceptability and ranged from 6.41 to 7.42. After four hours of storage, the osmolarity changes were ±3%, except MPM–Olimel N9E samples, for which differences from 7% to 11% were observed. The adopted level of acceptability of changes in zeta potential after four hours of storage (±3 mV) was met for MPM–Kabiven, MPM–Nutriflex Lipid Special, and MPM–Nutriflex Omega Special. The mean droplet diameter for all samples was below 500 nm. However, only in the case of Nutriflex Lipid Special and Nutriflex Omega Special, the addition of MPM did not cause the formation of the second fraction of lipid droplets. The coadministration of MPM via Y-site with Kabiven, Olimel N9E, and Smofkabiven should be avoided due to osmolarity fluctuations (MPM–Olimel), significant differences in zeta potential (MPM–Olimel, MPM–Smofkabiven), and the presence of the second fraction of lipid droplets >1000 nm (MPM–Kabiven, MPM–Olimel, and MPM–Smofkabiven). The assumed acceptance criteria for MPM compatibility of MPM with PN admixtures were met only for Nutriflex Lipid Special and Nutriflex Omega Special in 1:1, 2:1, and 4:1 volume ratios. Full article
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