Deciphering the Intricate Interplay in the Framework of Antibiotic-Drug Interactions: A Narrative Review.

Drug interactions are a significant and integral part of the concept of medication-related adverse events, whether referring to potential interactions or those currently observed in real-world conditions. The high global consumption of antibiotics and their pharmacokinetic and pharmacodynamic mechanisms make antibiotic-drug interactions a key element that requires continuous study due to their clinical relevance. In the present work, the current state of knowledge on antibiotic-drug interactions, which are less studied than other drug-drug interactions despite their frequent use in acute settings, has been consolidated and updated. The focus was on the interactions of the commonly used antibiotics in clinical practice, on the characteristics of the geriatric population susceptible to interactions, and on the impact of online drug interaction checkers. Additionally, strategies for optimizing the management of these interactions, including spacing out administrations, monitoring, or avoiding certain combinations, are suggested. Sustained research and careful monitoring are critical for improving antibiotic safety and efficacy, especially in susceptible populations, to enhance precision in managing antibiotic-drug interactions.

Antibiotic-Drug Interactions in the Intensive Care Unit: A Literature Review.

Interactions between drugs are a common problem in Intensive Care Unit patients, as they mainly have a critical condition that often demands the administration of multiple drugs simultaneously. Antibiotics are among the most frequently used medications, as infectious diseases are often observed in ICU patients. In this review, the most important antibiotic-drug interactions, based on the pharmacokinetic and pharmacodynamic mechanisms, were gathered together and described. In particular, some of the most important interactions with main groups of antibacterial drugs were observed in patients simultaneously prescribed oral anticoagulants, NSAIDs, loop diuretics, and valproic acid. As a result, the activity of drugs can be increased or decreased, as dosage modification might be necessary. It should be noted that these crucial interactions can help predict and avoid negative consequences, leading to better patient recovery. Moreover, since there are other factors, such as fluid therapy or albumins, which may also modify the effectiveness of antibacterial therapy, it is important for anaesthesiologists to be aware of them.

[Safety in the selection of oral antibiotic treatment in community infections, beyond COVID-19]. / Seguridad en la selección del tratamiento antibiótico oral en las infecciones comunitarias, más allá de la COVID-19.

Oral antibiotics are among the most frequently used medications in the community. Its adverse effects are generally considered to be infrequent and mild, and include allergies, toxicities and drug interactions. Antibiotics are able to harm patients by various mechanisms, not always well known. Knowledge of the clinically relevant antibiotic-associated adverse effects can allow a judicious use based on the principle first do no harm, primun non nocere. In this review we explore the main adverse effects of oral antibiotics with specific focus on ß-lactams, macrolides, and fluoroquinolones.