Treatment failures secondary to drug interactions with divalent cations and fluoroquinolone.
We observed four cases of therapeutic failures while patients were simultaneously taking medications that contained divalent cations and oral fluoroquinolones. Patients improved after conversion to the intravenous formulation of the same antibiotics, proper spacing of the divalent cation, or conversion to a different antibiotic class. Patients prescribed oral fluoroquinolones should receive instructions on proper separations of these antibiotics with divalent cations. Health care professionals should be cognizant of these interactions and educated on their potential deleterious effect.
Department of Clinical Sciences and Administration, University of Houston College of Pharmacy, 1441 Moursund Street, Houston, TX 77030, USA.
Katie J
KJ
Suda
Kevin W
KW
Garey
Larry H
LH
Danziger
D000284:Administration, Oral; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D002413:Cations, Divalent / Q000008:administration & dosage / Q000009:adverse effects*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D005260:Female; D024841:Fluoroquinolones / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006331:Heart Diseases / Q000188:drug therapy; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D017211:Treatment Failure
D000900:Anti-Bacterial Agents; D002413:Cations, Divalent; D024841:Fluoroquinolones