title: Coadministration of oral levofloxacin with agents that impair absorption: impact on antibiotic resistance.
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.
authors.affiliation: Divisions of Infectious Diseases, Departments of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.
authors.forename: Keira A
authors.initials: KA
authors.lastname: Cohen
authors.forename: Ebbing
authors.initials: E
authors.lastname: Lautenbach
authors.forename: Mark G
authors.initials: MG
authors.lastname: Weiner
authors.forename: Marie
authors.initials: M
authors.lastname: Synnestvedt
authors.forename: Leanne B
authors.initials: LB
authors.lastname: Gasink
mesh_terms: D000042:Absorption; D000284:Administration, Oral; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology; D002412:Cations / Q000008:administration & dosage; D002413:Cations, Divalent / Q000008:administration & dosage; D004347:Drug Interactions; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000302:isolation & purification; D006095:Gram-Positive Cocci / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D064704:Levofloxacin; D008826:Microbial Sensitivity Tests; D015242:Ofloxacin / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents; D002412:Cations; D002413:Cations, Divalent; D064704:Levofloxacin; D015242:Ofloxacin