Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-28T00:42:46.254Z Has data issue: false hasContentIssue false

Coadministration of Oral Levofloxacin With Agents That Impair Absorption: Impact on Antibiotic Resistance

Published online by Cambridge University Press:  02 January 2015

Keira A. Cohen
Affiliation:
Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
Ebbing Lautenbach
Affiliation:
Divisions of Infectious Diseases, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania Departments of Medicine and of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania Center for Education and Research on Therapeutics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
Mark G. Weiner
Affiliation:
General Internal Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
Marie Synnestvedt
Affiliation:
Office of Human Research, School of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
Leanne B. Gasink*
Affiliation:
Divisions of Infectious Diseases, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania Center for Education and Research on Therapeutics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
*
Ground Floor Penn Tower, Suite 101, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 ([email protected])

Abstract

Coadministration of oral divalent or trivalent cation-containing compounds with oral fluoroquinolones may impair fluoroquinolone absorption. Among 3,134 patients who received a course of oral levofloxacin, coadministration was significantly associated with subsequent identification of a levofloxacin-resistant isolate. Strategies to curb the emergence of fluoroquinolone resistance should include avoiding the coadministration of divalent or trivalent cation-containing compounds and fluoroquinolone.

Type
Concise Communication
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Linder, JA, Huang, ES, Steinman, MA, Gonzales, R, Stafford, RS. Fluoroquinolone prescribing in the United States: 1995 to 2002. Am J Med 2005;118:259268.Google Scholar
2.Lautenbach, E, Strom, BL, Nachamkin, I, et al.Longitudinal trends in fluoroquinolone resistance among Enterobacteriaceae isolates from inpatients and outpatients, 1989–2000: differences in the emergence and epidemiology of resistance across organisms. Clin Infect Dis 2004;38:655662.Google Scholar
3.Neuhauser, MM, Weinstein, RA, Rydman, R, Danziger, LH, Karam, G, Quinn, JP. Antibiotic resistance among gram-negative bacilli in US intensive care units: implications for fluoroquinolone use. JAMA 2003;289:885888.Google Scholar
4.Guay, D. Quinolones. In: Piscitelli, S, Rodvold, K, eds. Drug Interactions in Infectious Diseases. Totowa, NJ: Humana Press; 2001:121150.Google Scholar
5.Quain, RD, Barton, TD, Fishman, NO, Weiner, MG, Lautenbach, E. Coadministration of oral levofloxacin with agents that impair its absorption: potential impact on emergence of resistance. Int J Antimicrob Agents 2005;26:327330.CrossRefGoogle ScholarPubMed
6.Barton, TD, Fishman, NO, Weiner, MG, LaRosa, LA, Lautenbach, E. High rate of coadministration of di- or tri-valent cation-containing compounds with oral fluoroquinolones: risk factors and potential implications. Infect Control Hosp Epidemiol 2005;26:9399.CrossRefGoogle ScholarPubMed
7.Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing:16th informational supplement. Wayne, PA: CLSI, 2006:M100S16.Google Scholar
8.Zervos, MJ, Hershberger, E, Nicolau, DP, et al.Relationship between fluoroquinolone use and changes in susceptibility to fluoroquinolones of selected pathogens in 10 United States teaching hospitals, 1991–2000. Clin Infect Dis 2003;37:16431648.Google Scholar
9.Michea-Hamzehpour, M, Auckenthaler, R, Regamey, P, Pechere, JC. Resistance occurring after fluoroquinolone therapy of experimental Pseudomonas aeruginosa peritonitis. Antimicrob Agents Chemother 1987;31:18031808.CrossRefGoogle ScholarPubMed