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Beta-Lactam Antibiotics

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Drug Interactions in Infectious Diseases

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Abstract

This chapter describes the drug–drug interactions of the beta-lactam antibiotics: penicillins, cephalosporins, carbapenems, and monobactams. The beta-lactam antibiotics are a large class of diverse compounds used clinically in oral, parenteral, and inhaled dosage formulations. The beta-lactam antibiotic agents have become the most widely used therapeutic class of antimicrobials because of their broad antibacterial spectrum and excellent safety profile. Reports of drug–drug interactions with the beta-lactam antimicrobials are a relatively rare phenomenon, and when they do occur they are generally of minor significance.

In this chapter each beta-lactam drug interaction has been categorized as major, moderate or minor and is presented in Table 7.1. Interactions classified as major are considered well documented and have the potential to be life threatening or dangerous. Moderate interactions are those for which more documentation is needed and/or potential harm to the patient is less. Minor interactions are either poorly documented, present minimal potential harm to the patient, or occur with a low incidence.

The drug interactions of most concern with the beta-lactam antibiotics are those with oral contraceptive products, methotrexate and valproic acid. In the case oral contraceptives, even though a small percentage of women may potentially experience decreased effectiveness of these birth control products while taking beta-lactam antibiotic, alternative birth control methods should be considered while taking these antibiotics. Weak organic acids such as penicillins and cephalosporins can compete with methotrexate for renal tubular secretion which may increase the risk of adverse effects of methotrexate. Lastly, decreased plasma concentrations to subtherapeutic ranges have been reported in patients taking the carbapenems and valproic acid concomitantly.

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Authors and Affiliations

  1. College of Pharmacy (M/C 886), University of Illinois at Chicago, Chicago, IL, 60612, USA

    Larry H. Danziger

  2. Department of Veterans Affairs, Pharmacy Benefit Management Strategic Healthcare Group, Hines, IL, USA

    Melinda Neuhauser

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  1. Larry H. Danziger
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  2. Melinda Neuhauser
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Correspondence to Larry H. Danziger .

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Editors and Affiliations

  1. , Infectious Diseases, GlaxoSmithKline, Research Triangle Park, 27709, North Carolina, USA

    Stephen C. Piscitelli

  2. College of Pharmacy, Dept. Pharmacy Practice, University of Illinois, Chicago, Chicago, 60612-7230, Illinois, USA

    Keith A. Rodvold

  3. , Pharmaceutical Sciences, Albany College of Pharmacy, Albany, 12208, New York, USA

    Manjunath P. Pai

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Danziger, L.H., Neuhauser, M. (2011). Beta-Lactam Antibiotics. In: Piscitelli, S., Rodvold, K., Pai, M. (eds) Drug Interactions in Infectious Diseases. Infectious Disease. Humana Press. https://doi.org/10.1007/978-1-61779-213-7_7

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  • DOI: https://doi.org/10.1007/978-1-61779-213-7_7

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