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Unasyn (ampicillin / sulbactam) Disease Interactions

There are 5 disease interactions with Unasyn (ampicillin / sulbactam):

Major

Beta-Lactams (Parenteral) (Includes Unasyn) ↔ Renal Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Most beta-lactam antibiotics are eliminated by the kidney as unchanged drug and, in some cases, also as metabolites. The serum concentrations of beta-lactam antibiotics and their metabolites may be increased and the half-lives prolonged in patients with impaired renal function. Neurotoxic reactions, including encephalopathy, asterixis, myoclonus, seizures and coma, have been reported in such patients treated parenterally with these agents. Dosage adjustments may be necessary and modifications should be based on the degree of renal impairment as well as severity of infection in accordance with the individual product package labeling. Renal function tests should be performed periodically during prolonged and/or high-dose therapy, since nephrotoxicity and alterations in renal function have occasionally been associated with the use of these drugs.

References

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  46. Alshohaib S, Satti MS, Abunijem Z "Acute interstitial nephritis due to cefotaxime." Nephron 73 (1996): 725
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  55. Pitkin D, Dubb J, Actor P, et al "Kinetics and renal handling of cefonicid." Clin Pharmacol Ther 30 (1981): 587-93
  56. Frimodt-Moller N, Maigaard S, Toothaker RD, et al "Mezlocillin pharmacokinetics after single intravenous doses to patients with various degrees of renal function." Antimicrob Agents Chemother 17 (1980): 599-607
  57. Czerwinski AW, Pederson JA, Barry JP "Cefazolin plasma concentrations and urinary excretion in patients with renal impairment." J Clin Pharmacol 14 (1974): 560-6
  58. Fillastre J-P, Fourtillan J-B, Leroy A, et al "Pharmacokinetics of cefonicid in uraemic patients." J Antimicrob Chemother 18 (1986): 203-11
  59. Fillastre JP, Leroy A, Baudoin C, et al "Pharmacokinetics of aztreonam in patients with chronic renal failure." Clin Pharmacokinet 10 (1985): 91-100
  60. Hardin TC, Butler SC, Ross S, Wakeford JH, Jorgensen JH "Comparison of ampicillin-sulbactam and ticarcillin-clavulanic acid in patients with chronic renal failure - effects of differential pharmacokinetics on serum bactericidal activity." Pharmacotherapy 14 (1994): 147-52
  61. Andriole VT "Pharmacokinetics of cephalosporins in patients with normal or reduced renal function." J Infect Dis 137 (1978): s88-97
  62. Martinez-Rodriguez JE, Barriga FJ, Santamaria J, et al. "Nonconvulsive status epilepticus associated with cephalosporins in patients with renal failure." Am J Med 111 (2001): 115-9
  63. Benner EJ "Renal damage associated with prolonged administration of ampicillin, cephaloridine, and cephalothin." Antimicrob Agents Chemother 9 (1969): 417-20
  64. Nielsen OS, Toothaker RD, Bundtzen RW, et al "Cefotaxime pharmacokinetics following a single intravenous dose to patients with varying renal function." Infection 8 (1980): s305-9
  65. Welling PG, Craig WA, Bundtzen RW, et al "Pharmacokinetics of piperacillin in subjects with various degrees of renal function." Antimicrob Agents Chemother 23 (1983): 881-7
  66. Garcia MJ, Dominguez-Gil A, Tabernero JM, Tomero JA "Pharmacokinetics of cefoxitin in patients with normal or impaired renal function." Eur J Clin Pharmacol 16 (1979): 119-24
  67. "Product Information. Ancef (cefazolin)." SmithKline Beecham, Philadelphia, PA.
  68. Trang JM, Monson TP, Ackerman BH, et al "Effect of age and renal function on cefonicid pharmacokinetics." Antimicrob Agents Chemother 33 (1989): 142-6
  69. Bergan T, Orjavik O, Brodwall EK "Pharmacokinetics of cefapirin in patients with normal and impaired renal functions." Arzneimittelforschung 31 (1981): 1773-6
  70. Ings RM, Reeves DS, White LP, et al "The human pharmacokinetics of cefotaxime and its metabolites and the role of renal tubular secretion on their elimination." J Pharmacokinet Biopharm 13 (1985): 121-42
  71. Barriere SL, Gambertoglio JG, Alexander DR, et al "Pharmacokinetic disposition of cefonicid in patients with renal failure and receiving hemodialysis." Rev Infect Dis 6 (1984): s809-15
  72. Craig CP, Rifkin SI "Pharmacokinetics and hemodialyzability of cefazolin in uremic patients." Clin Pharmacol Ther 19 (1976): 825-9
  73. "Product Information. Zefazone (cefmetazole)." Pharmacia and Upjohn, Kalamazoo, MI.
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  75. Pickering MJ, Spooner GR, Quesada A, de Cade JR "Declining renal function associated with administration of cephalothin." South Med J 63 (1970): 426-8
  76. Foord RD "Cephaloridine, cephalothin and the kidney." J Antimicrob Chemother 1 (1975): 119-33
  77. Barrons RW, Murray KM, Richey RM "Populations at risk for penicillin-induced seizures." Ann Pharmacother 26 (1992): 26-9
  78. Wu MJ, Narsette TA, Hussey JL, Weinstein AB, Wen SF "Cephalothin neurotoxicity in renal failure." Ann Intern Med 89 (1978): 429
  79. Matzke GR, Abraham PA, Halstenson CE, Keane WF "Cefotaxime and desacetylcefotaxime kinetics in renal impairment." Clin Pharmacol Ther 38 (1985): 31-6
  80. Ehrnebo M, Nilsson SO, Boreus LO "Pharmacokinetics of ampicillin and its prodrugs bacampicillin and pivampicillin in man." J Pharmacokinet Biopharm 7 (1979): 429-51
  81. Engle JE, Drago J, Carlin B, Schoolwerth AC "Letter: Reversible acute renal failure after cephalothin." Ann Intern Med 83 (1975): 232-3
  82. "Product Information. Claforan (cefotaxime)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  83. Ohkawa M, Okasho A, Motoi I, et al "Elimination kinetics of cefotaxime and desacetylcefotaxime in patients with renal insufficiency and during hemodialysis." Chemotherapy 29 (1983): 4-12
  84. Smyth RD, Pfeffer M, Glick A, et al "Clinical pharmacokinetics and safety of high doses of ceforanide (BL-S786R) and cefazolin." Antimicrob Agents Chemother 16 (1979): 615-21
  85. Wright N, Wise R, Hegarty T "Cefotetan elimination in patients with varying degrees of renal dysfunction." J Antimicrob Chemother 1 (1983): 213-6
  86. Yamasaku F, Tsuchida R, Usuda Y "A study of the kinetics of cephalosporins in renal impairment." Postgrad Med J Suppl (1970): 57-9
  87. Pascual J, Liano F, Ortuno J "Cefotaxime-induced encephalopathy in an uremic patient." Nephron 54 (1990): 92
  88. Oe PL, Simonian S, Verhoef J "Pharmacokinetics of the new penicillins." Chemotherapy 19 (1973): 279-88
  89. Thompson MI, Russo ME, Matsen JM, Atkin-Thor E "Piperacillin pharmacokinetics in subjects with chronic renal failure." Antimicrob Agents Chemother 19 (1981): 450-3
  90. Ortiz A, Martin-Llonch N, Garron MP, et al "Cefazolin-induced encephalopathy in uremic patients." Rev Infect Dis 13 (1991): 772-3
  91. "Product Information. Pipracil (piperacillin)." Lederle Laboratories, Wayne, NJ.
  92. "Product Information. Tazicef (ceftazidime)." SmithKline Beecham, Philadelphia, PA.
  93. Hansen MM, Kaaber K "Nephrotoxicity in combined cephalothin and gentamicin therapy." Acta Med Scand 201 (1977): 463-7
  94. Kirby WM, de Maine JB, Serrill WS "Pharmacokinetics of the cephalosporins in healthy volunteers and uremic patients." Postgrad Med J 47 Suppl (1971): 41-6
  95. Douglas MA, Quandt CM, Stanley DA "Ceftazidime-induced encephalopathy in a patient with renal impairment." Arch Neurol 45 (1988): 936-7
  96. Appel GB, Neu HC, Parry MF, et al "Pharmacokinetics of cefamandole in the presence of renal failure and in patients undergoing hemodialysis." Antimicrob Agents Chemother 10 (1976): 623-5
  97. Simpson IJ "Nephrotoxicity and acute renal failure associated with cephalothin and cephaloridine." N Z Med J 74 (1971): 312-5
  98. Fanning WL, Gump D, Jick H "Gentamicin- and cephalothin-associated rises in blood urea nitrogen." Antimicrob Agents Chemother 10 (1976): 80-2
  99. Csanyi P, Rado JP, Hormay M "Acute renal failure due to cephamandole." Br Med J 296 (1988): 455
  100. "Product Information. Ceftin (cefuroxime)." Glaxo Wellcome, Research Triangle Park, NC.
  101. "Product Information. Omnipen (ampicillin)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  102. Palla R, Panichi V, Bionda A, et al "Acute renal failure after mezlocilline." Clin Nephrol 25 (1986): 315-6
  103. Jungbluth GL, Cooper DL, Doyle GD, Chudzik GM, Jusko WJ "Pharmacokinetics of ticarcillin and clavulanic acid (timentin) in relation to renal function." Antimicrob Agents Chemother 30 (1986): 896-900
  104. Barbhaiya RH, Knupp CA, Forgue ST, Matzke GR, Halstenson CE, Opsahl JA, Pittman KA "Disposition of the cephalosporin cefepime in normal and renally impaired subjects." Drug Metab Dispos 19 (1991): 68-73
  105. Johnson CA, Halstenson CE, Kelloway JS, et al "Single-dose pharmacokinetics of piperacillin and tazobactam in patients with renal disease." Clin Pharmacol Ther 51 (1992): 32-41
  106. Ohkawa M, Hirano S, Tokunaga S, et al "Pharmacokinetics of cefotetan in normal subjects and patients with impaired renal function." Antimicrob Agents Chemother 23 (1983): 31-5
  107. Mellin H-E, Welling PG, Madsen PO "Pharmacokinetics of cefamandole in patients with normal and impaired renal function." Antimicrob Agents Chemother 11 (1977): 262-6
  108. al Shohaib S, Satti MS, Abunijem Z "Acute interstitial nephritis due to cefotaxime." Nephron 73 (1996): 725
  109. "Product Information. Ticar (ticarcillin)." SmithKline Beecham, Philadelphia, PA.
  110. Parry MF, Neu HC "Pharmacokinetics of ticarcillin in patients with abnormal renal function." J Infect Dis 133 (1976): 46-9
  111. Mihindu JC, Scheld WM, Bolton ND, Spyker DA, Swabb EA, Bolton K "Pharmacokinetics of aztreonam in patients with various degrees of renal dysfunction." Antimicrob Agents Chemother 24 (1983): 252-61
  112. Nguyen VD, Nagelberg H, Agarwal BN "Acute interstitial nephritis associated with cefotetan therapy." Am J Kidney Dis 16 (1990): 259-61
  113. Ings RM, Fillastre J-P, Godin M, et al "The pharmacokinetics of cefotaxime and its metabolites in subjects with normal and impaired renal function." Rev Infect Dis 4 (1982): s379-91
  114. Welling PG, Craig WA, Amidon GL, Kunin CM "Pharmacokinetics of cefazolin in normal and uremic subjects." Clin Pharmacol Ther 15 (1973): 344-53
  115. Ackerman BH, Ross J, Tofte RW, Rotschafer JC "Effect of decreased renal function on the pharmacokinetics of ceftazidime." Antimicrob Agents Chemother 25 (1984): 785-6
  116. van Dalen R, Vree TB, Baars AM, Termond E "Dosage adjustment for ceftazidime in patients with impaired renal function." Eur J Clin Pharmacol 30 (1986): 597-605
  117. Trollfors B, Ahlmen J, Alestig K "Renal function during cefoperazone treatment." J Antimicrob Chemother 9 (1982): 485-7
  118. Toll LL, Lee M, Sharifi R "Cefoxitin-induced interstitial nephritis." South Med J 80 (1987): 274-5
  119. Nilsson-Ehle I, Nilsson-Ehle P "Pharmacokinetics of cephalothin: accumulation of its deacetylated metabolite in uremic patients." J Infect Dis 139 (1979): 712-6
  120. Reitberg DP, Marble DA, Schultz RW, Whall TJ, Schentag JJ "Pharmacokinetics of cefoperazone (2.0 g) and sulbactam (1.0 g) coadministered to subjects with normal renal function, patients with decreased renal function, and patients with end-stage renal disease on hemodialysis." Antimicrob Agents Chemother 32 (1988): 503-9
  121. Barbhaiya RH, Knupp CA, Forgue ST, Matzke GR, Guay DR, Pittman KA "Pharmacokinetics of cefepime in subjects with renal insufficiency." Clin Pharmacol Ther 48 (1990): 268-76
  122. Bryan CS, Stone WJ ""Comparably massive" penicillin G therapy in renal failure." Ann Intern Med 82 (1975): 189-95
  123. Plaut ME, O'Connell CJ, Pabico RC, Davidson D "Penicillin handling in normal and azotemic patients." J Lab Clin Med 74 (1969): 12-8
  124. Bloomer HA, Barton LJ, Maddock RK "Penicillin-induced encephalopathy in uremic patients." JAMA 200 (1967): 121-3
  125. Phelps RT, Conte JE "Multiple-dose pharmacokinetics of cefonicid in patients with impaired renal function." Antimicrob Agents Chemother 29 (1986): 913-7
  126. "Product Information. Cefadyl (cephapirin)." Apothecon Inc, Plainsboro, NJ.
  127. Leroy J, Leguy F, Borsa F, et al "Pharmacokinetics of ceftazidime in normal and uremic subjects." Antimicrob Agents Chemother 25 (1984): 638-42
  128. Ohkawa M, Okasho A, Sugata T, Kuroda K "Elimination kinetics of ceftizoxime in humans with and without renal insufficiency." Antimicrob Agents Chemother 22 (1982): 308-11
  129. New PS, Wells CE "Cerebral toxicity associated with massive intravenous penicillin therapy." Neurology 15 (1965): 1053-8
  130. Wise R, Wright N "The pharmacokinetics of cefotaxime and ceftriaxone in renal and hepatic dysfunction." Infection 13 (1985): s145-50
  131. "Product Information. Cefizox (ceftizoxime)." Fujisawa, Deerfield, IL.
  132. Walstad RA, Dahl K, Hellum KB, et al "The pharmacokinetics of ceftazidime in patients with impaired renal function and concurrent frusemide therapy." Eur J Clin Pharmacol 35 (1988): 273-9
  133. Blair AD, Maxwell BM, Forland SC, et al "Cefonicid kinetics in subjects with normal and impaired renal function." Clin Pharmacol Ther 35 (1984): 798-803
  134. Doluisio JT "Clinical pharmacokinetics of cefotaxime in patients with normal and reduced renal function." Rev Infect Dis 4 Suppl (1982): s333-45
  135. Mackie K, Pavlin EG "Recurrent paralysis following piperacillin administration." Anesthesiology 72 (1990): 561-3
  136. Hillsley RE, Massey EW "Truncal asterixis associated with ceftazidime, a third-generation cephalosporin." Neurology 41 (1991): 2008
  137. Slaker RA, Danielson B "Neurotoxicity associated with ceftazidime therapy in geriatric patients with renal dysfunction." Pharmacotherapy 11 (1991): 351-2
  138. Bulger RJ, Lindholm DD, Murray JS, Kirby WM "Effects of uremia on methicillin and oxacillin blood levels." JAMA 187 (1964): 319-22
  139. Jackson GD, Berkovic SF "Ceftazidime encephalopathy: absence status and toxic hallucinations." J Neurol Neurosurg Psychiatry 55 (1992): 333-4
  140. Kowalsky SF, Echols RM, Venezia AR, Andrews EA "Pharmacokinetics of ceftizoxime in subjects with various degrees of renal function." Antimicrob Agents Chemother 24 (1983): 151-5
  141. Gibaldi M, Perrier D "Drug distribution and renal failure." J Clin Pharmacol 12 (1972): 201-4
  142. Chow M, Quintiliani R, Cunha BA, et al "Pharmacokinetics of high-dose oral cephalosporins." J Clin Pharmacol 19 (1979): 185-94
  143. Czerwinski AW, Pederson JA "Pharmacokinetics of cefamandole in patients with renal impairment." Antimicrob Agents Chemother 15 (1979): 161-4
  144. Brogard JM, Pinget M, Brandt C, Lavillaureix J "Pharmacokinetics of cefazolin in patients with renal failure: special reference to hemodialysis." J Clin Pharmacol 17 (1977): 225-30
  145. "Product Information. Monocid (cefonicid)." SmithKline Beecham, Philadelphia, PA.
  146. Andriole VT "Pharmacokinetics of cephalosporins in patients with normal or reduced renal function." J Infect Dis 137 (1978): s88-99
  147. Barrientos A, Bello I, Gutierrez-Millet V "Letter; Renal failure and cephalothin." Ann Intern Med 84 (1976): 612
  148. Konishi K, Suzuki H, Hayashi M, Saruta T "Pharmacokinetics of cefuroxime axetil in patients with normal and impaired renal function." J Antimicrob Chemother 31 (1993): 413-20
  149. Reddy J, Bailey RR "Cefoxitin-associated renal failure." N Z Med J 93 (1981): 337-9
  150. "Product Information. Pfizerpen (penicillin)." Roerig Division, New York, NY.
  151. Kabins SA, Cohen S "Cephalothin serum levels in the azotemic patient." Antimicrob Agents Chemother 10 (1964): 207-14
  152. Arvidsson A, Borga O, Alvan G "Renal excretion of cephapirin and cephaloridine: evidence for saturable tubular reabsorption." Clin Pharmacol Ther 25 (1979): 870-6
  153. "Product Information. Cefotan (cefotetan)." Stuart Pharmaceuticals, Wilmington, DE.
View all 153 references
Moderate

Aminopenicillins (Includes Unasyn) ↔ Mononucleosis

Moderate Potential Hazard, High plausibility

Applies to: Mononucleosis

Patients with mononucleosis treated with an aminopenicillin antibiotic, particularly ampicillin, quite frequently develop a pruritic erythematous maculopapular skin rash that generally occurs 5 to 10 days after therapy is initiated. The rash is usually self-limiting and resolves within days of discontinuing the offending agent. An altered drug metabolism or an immune-mediated process unrelated to drug hypersensitivity has been proposed as the underlying mechanism. Clinicians should recognize that a skin eruption under this circumstance does not necessarily indicate a life-long allergy to these agents or other penicillin derivatives. Therapy with aminopenicillin antibiotics may not be appropriate in patients with mononucleosis.

References

  1. "Product Information. Polycillin (ampicillin)." Apothecon Inc, Plainsboro, NJ.
  2. Chan HL "Fixed drug eruption to bacampicillin (ampicillin)." Arch Dermatol 120 (1984): 542
  3. Adcock BB, Rodman DP "Ampicillin-specific rashes." Arch Fam Med 5 (1996): 301-4
  4. "Product Information. Spectrobid (bacampicillin)." Roerig Division, New York, NY.
  5. Marra CA, Shalansky KF "Ampicillin-induced macropapular versus urticarial rash." Ann Pharmacother 30 (1996): 401-2
  6. "Product Information. Amoxil (amoxicillin)." SmithKline Beecham, Philadelphia, PA.
  7. Arias J, Fernandezrivas M, Panadero P "Selective fixed drug eruption to amoxycillin." Clin Exp Dermatol 20 (1995): 339-40
View all 7 references
Moderate

Ampicillin (Includes Unasyn) ↔ Sodium

Moderate Potential Hazard, High plausibility

Applies to: Congestive Heart Failure, Fluid Retention, Hypertension, Hypernatremia

Parenteral ampicillin sodium contains approximately 67 to 71 mg (2.9 to 3.1 mEq) of sodium per each gram of ampicillin activity. The combination, ampicillin-sulbactam, contains approximately 115 mg (5 mEq) of sodium per 1.5 gram of total drug. The sodium content should be considered when these products are used in patients with conditions that may require sodium restriction, such as congestive heart failure, hypertension, and fluid retention.

References

  1. "Product Information. Unasyn (ampicillin-sulbactam)." Roerig Division, New York, NY.
  2. "Product Information. Omnipen (ampicillin)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
Moderate

Antibiotics (Includes Unasyn) ↔ Colitis

Moderate Potential Hazard, Moderate plausibility

Applies to: Colitis/Enteritis (Noninfectious)

Pseudomembranous colitis has been reported with most antibacterial agents and may range in severity from mild to life-threatening, with an onset of up to two months following cessation of therapy. Antibiotic therapy can alter the normal flora of the colon and permit overgrowth of Clostridium difficile, whose toxin is believed to be a primary cause of antibiotic- associated colitis. The colitis is usually characterized by severe, persistent diarrhea and severe abdominal cramps, and may be associated with the passage of blood and mucus. The most common culprits are clindamycin, lincomycin, the aminopenicillins (amoxicillin, ampicillin), and the cephalosporins. Therapy with broad-spectrum antibiotics and other agents with significant antibacterial activity should be administered cautiously in patients with a history of gastrointestinal diseases, particularly colitis. There is some evidence that pseudomembranous colitis, if it occurs, may run a more severe course in these patients and that it may be associated with flares in their underlying disease activity. The offending antibiotic(s) should be discontinued if significant diarrhea occurs during therapy. Stool cultures for Clostridium difficile and stool assay for C. difficile toxin may be helpful diagnostically. A large bowel endoscopy may be considered to establish a definitive diagnosis in cases of severe diarrhea.

References

  1. Moriarty HJ, Scobie BA "Pseudomembranous colitis in a patient on rifampicin and ethambutol." N Z Med J 04/23/80 (1980): 294-5
  2. Thomas E, Mehta JB "Pseudomembranous colitis due to oxacillin therapy." South Med J 77 (1984): 532-3
  3. Saadah HA "Carbenicillin and pseudomembranous enterocolitis." Ann Intern Med 93 (1980): 645
  4. Bauwens JE, McFarland LV, Melcher SA "Recurrent clostridium difficile disease following ciprofloxacin use." Ann Pharmacother 31 (1997): 1090
  5. Daly JJ, Chowdary KV "Pseudomembranous colitis secondary to metronidazole." Dig Dis Sci 28 (1983): 573-4
  6. Lyon JA "Imipenem/cilastatin: the first carbapenem antibiotic." Drug Intell Clin Pharm 19 (1985): 894-8
  7. Trexler MF, Fraser TG, Jones MP "Fulminant pseudomembranous colitis caused by clindamycin phosphate vaginal cream." Am J Gastroenterol 92 (1997): 2112-3
  8. Davies J, Beck E "Recurrent colitis following antibiotic-associated pseudomembranous colitis." Postgrad Med J 57 (1981): 599-601
  9. O'Meara TF, Simmons RA "Carbenicillin and pseudomembranous enterocolitis." Ann Intern Med 92 (1980): 440-1
  10. Dan M, Samra Z "Clostridium difficile colitis associated with ofloxacin therapy." Am J Med 87 (1989): 479
  11. Meadowcroft AM, Diaz PR, Latham GS "Clostridium difficile toxin-induced colitis after use of clindmycin phosphate vaginal cream." Ann Pharmacother 32 (1998): 309-11
  12. Milstone EB, McDonald AJ, Scholhamer CF Jr "Pseudomembranous colitis after topical application of clindamycin." Arch Dermatol 117 (1981): 154-5
  13. Harmon T, Burkhart G, Applebaum H "Perforated pseudomembranous colitis in the breast-fed infant." J Pediatr Surg 27 (1992): 744-6
  14. Ehrenpreis ED, Lievens MW, Craig RM "Clostridium difficile-associated diarrhea after norfloxacin." J Clin Gastroenterol 12 (1990): 188-9
  15. Cone JB, Wetzel W "Toxic megacolon secondary to pseudomembranous colitis." Dis Colon Rectum 25 (1982): 478-82
  16. Burt RA "A review of the drug events reported by 12,917 patients treated with cephalexin." Postgrad Med J 59 (1983): 47-50,51-3
  17. Cannon SR, Dyson PH, Sanderson PJ "Pseudomembranous colitis associated with antibiotic prophylaxis in orthopaedic surgery." J Bone Joint Surg Br 70-B (1988): 600-2
  18. Miller DL, Sedlack JD, Holt RW "Perforation complicating rifampin-associated pseudomembranous enteritis." Arch Surg 124 (1989): 1082
  19. Miller SN, Ringler RP "Vancomycin-induced pseudomembranous colitis." J Clin Gastroenterol 9 (1987): 114-5
  20. Wang C, Calandra GB, Aziz MA, Brown KR "Efficacy and safety of imipenem/cilastatin: a review of worldwide clinical experience." Rev Infect Dis 7 (1985): s528-36
  21. Calandra GB, Brown KR, Grad LC, et al "Review of adverse experiences and tolerability in the first 2,516 patients treated with imipenem/cilastatin." Am J Med 78 (1985): 73-8
  22. Osler T, Lott D, Bordley J, et al "Cefazolin-induced pseudomembranous colitis resulting in perforation of the sigmoid colon." Dis Colon Rectum 29 (1986): 140-3
  23. Parry MF, Rha CK "Pseudomembranous colitis caused by topical clindamycin phosphate." Arch Dermatol 122 (1986): 583-4
  24. Clissold SP, Todd PA, Campoli-Richards DM "Imipenem/cilastatin: a review of its antibacterial activity, pharmacokinetic properties and therapeutic efficacy." Drugs 33 (1987): 185-241
  25. Pokorney BH, Nichols TW, Jr "Pseudomembranous colitis. A complication of sulfasalazine therapy in a patient with Crohn's colitis." Am J Gastroenterol 76 (1981): 374-6
  26. Sankarankutty M, McGeorge D, Galasko CS "Pseudomembranous colitis following cephradine prophylaxis." Postgrad Med J 58 (1982): 726-8
  27. Hutcheon DF, Milligan FD, Yardley JH, Hendrix TR "Cephalosporin-associated pseudomembranous colitis." Am J Dig Dis 23 (1978): 321-6
  28. Bingley PJ, Harding GM "Clostridium difficile colitis following treatment with metronidazole and vancomycin." Postgrad Med J 63 (1987): 993-4
  29. Gordin F, Gibert C, Schmidt ME "Clostridium difficile colitis associated with trimethoprim-sulfamethoxazole given as prophylaxis for pneumocystis carinii pneumonia." Am J Med 96 (1994): 94-5
  30. Sugarman B "Trimethoprim-sulfamethoxazole, pseudomembranous colitis, and spinal cord injury." South Med J 78 (1985): 711-3
  31. Ring FA, Hershfield NB, Machin GA, Scott RB "Sulfasalazine-induced colitis complicating idiopathic ulcerative colitis." Can Med Assoc J 131 (1984): 43-5
  32. Bernstein L "Adverse reaction to trimethoprim-sulfamethoxazole, with particular reference to long-term therapy." Can Med Assoc J 112 (1975): s96-8
  33. Friedman RJ, Mayer IE, Galambos JT, Hersh T "Oxacillin-induced pseudomembranous colitis." Am J Gastroenterol 73 (1980): 445-7
  34. Golledge CL, Riley TV "Clostridium difficile-associated diarrhoea after doxycycline malaria prophylaxis." Lancet 345 (1995): 1377-8
  35. Midtvedt T, Carlstedt-Duke B, Hoverstad T, et al "Influence of peroral antibiotics upon the biotransformatory activity of the intestinal microflora in healthy subjects." Eur J Clin Invest 16 (1986): 11-7
  36. Altamirano A, Bondani A "Adverse reactions to furazolidone and other drugs. A comparative review." Scand J Gastroenterol Suppl 169 (1989): 70-80
  37. "Multum Information Services, Inc. Expert Review Panel"
  38. Leigh DA, Simmons K, Williams S "Gastrointestinal side effects following clindamycin and lincomycin treatment: a follow up study." J Antimicrob Chemother 6 (1980): 639-45
  39. Edlund C, Lidbeck A, Kager L, Nord CE "Effect of enoxacin on colonic microflora of healthy volunteers." Eur J Clin Microbiol 6 (1987): 298-300
  40. Hecht JR, Olinger EJ "Clostridium difficile colitis secondary to intravenous vancomycin." Dig Dis Sci 34 (1989): 148-9
  41. Boriello SP, Jones RH, Phillips I "Rifampicin-associated pseudomembranous colitis." Br Med J 281 (1980): 1180-1
  42. Van Ness MM, Cattau EL Jr "Fulminant colitis complicating antibiotic-associated pseudomembranous colitis: case report and review of the clinical manifestations and treatment." Am J Gastroenterol 82 (1987): 374-7
  43. Brause BD, Romankiewicz JA, Gotz V, Franklin JE Jr, Roberts RB "Comparative study of diarrhea associated with clindamycin and ampicillin therapy." Am J Gastroenterol 73 (1980): 244-8
  44. Klinger D, Radford P, Collin J "Pneumoperitoneum without faecal peritonitis in a patient with pseudomembranous colitis." Br Med J 288 (1984): 1271-2
  45. Hinton NA "The effect of oral tetracycline HCl and doxycycline on the intestinal flora." Curr Ther Res Clin Exp 12 (1970): 341-52
  46. Edlund C, Brismar B, Nord CE "Effect of lomefloxacin on the normal oral and intestinal microflora." Eur J Clin Microbiol Infect Dis 1 (1990): 35-9
  47. Saginur R, Hawley CR, Bartlett JG "Colitis associated with metronidazole therapy." J Infect Dis 141 (1980): 772-4
View all 47 references
Moderate

Penicillins (Includes Unasyn) ↔ Hemodialysis

Moderate Potential Hazard, High plausibility

Applies to: hemodialysis

Penicillin antibiotics (except for agents in the penicillinase-resistant class) are removed by hemodialysis. Doses should either be scheduled for administration after dialysis or supplemental doses be given after dialysis.

References

  1. Francke EL, Appel GB, Neu HC "Kinetics of intravenous amoxicillin in patients on long-term dialysis." Clin Pharmacol Ther 26 (1979): 31-5
  2. Blum RA, Kohli RK, Harrison NJ, Schentag JJ "Pharmacokinetics of ampicillin (2.0 grams) and sulbactam (1.0 gram) coadministered to subjects with normal and abnormal renal function and with end-stage renal disease on hemodialysis." Antimicrob Agents Chemother 33 (1989): 1470-6
  3. Davies BE, Boon R, Horton R, Reubi FC, Descoeudres CE "Pharmacokinetics of amoxycillin and clavulanic acid in haemodialysis patients following intravenous administration of augmentin." Br J Clin Pharmacol 26 (1988): 385-90
  4. "Product Information. Mezlin (mezlocillin)." Bayer, West Haven, CT.
  5. Brogard JM, Comte F, Spach MO, Lavillaureix J "Pharmacokinetics of mezlocillin in patients with kidney impairment: special reference to hemodialysis and dosage adjustments in relation to renal function." Chemotherapy 28 (1982): 318-26
  6. Reitberg DP, Marble DA, Schultz RW, Whall TJ, Schentag JJ "Pharmacokinetics of cefoperazone (2.0 g) and sulbactam (1.0 g) coadministered to subjects with normal renal function, patients with decreased renal function, and patients with end-stage renal disease on hemodialysis." Antimicrob Agents Chemother 32 (1988): 503-9
  7. "Product Information. Polycillin (ampicillin)." Apothecon Inc, Plainsboro, NJ.
  8. Rho JP, Jones A, Wood M, et al "Single-dose pharmacokinetics of intravenous ampicillin plus sulbactam in healthy elderly and young adult subjects." J Antimicrob Chemother 24 (1989): 573-80
  9. "Product Information. Geocillin (carbenicillin)." Roerig Division, New York, NY.
  10. "Product Information. Spectrobid (bacampicillin)." Roerig Division, New York, NY.
  11. "Product Information. Pfizerpen (penicillin)." Roerig Division, New York, NY.
  12. Thorsteinsson SB, Steingrimsson O, Asmundsson P, Bergan T "Pharmacokinetics of mezlocillin during haemodialysis." Scand J Infect Dis 29 (1981): 59-63
  13. "Product Information. Ticar (ticarcillin)." SmithKline Beecham, Philadelphia, PA.
  14. Heim KL "The effect of hemodialysis on piperacillin pharmacokinetics." Drug Intell Clin Pharm 19 (1985): 455
  15. Kampf D, Schurig R, Weihermuller K, Forster D "Effects of impaired renal function hemodialysis and peritoneal dialysis on the pharmacokinetics of mezlocillin." Antimicrob Agents Chemother 18 (1980): 81-7
  16. Francke E, Mehta S, Neu HC, Appel GB "Kinetics of intravenous mezlocillin in chronic hemodialysis patients." Clin Pharmacol Ther 26 (1979): 228-31
  17. Janicke DM, Mangione A, Schultz RW, Jusko WJ "Mezlocillin disposition in chronic hemodialysis patients." Antimicrob Agents Chemother 20 (1981): 590-4
  18. Wise R, Reeves DS, Parker AS "Administration of ticarcillin, a new antipseudomonal antibiotic, in patients undergoing dialysis." Antimicrob Agents Chemother 5 (1974): 119-20
  19. Oe PL, Simonian S, Verhoef J "Pharmacokinetics of the new penicillins." Chemotherapy 19 (1973): 279-88
  20. Giron JA, Meyers BR, Hirschman SZ, Srulevitch E "Pharmacokinetics of piperacillin in patients with moderate renal failure and in patients undergoing hemodialysis." Antimicrob Agents Chemother 19 (1981): 279-83
  21. Slaughter RL, Kohli R, Brass C "Effects of hemodialysis on the pharmacokinetics of amoxicillin/clavulanic acid combination." Ther Drug Monit 6 (1984): 424-7
  22. "Product Information. Pipracil (piperacillin)." Lederle Laboratories, Wayne, NJ.
View all 22 references

Unasyn (ampicillin / sulbactam) drug Interactions

There are 80 drug interactions with Unasyn (ampicillin / sulbactam)

Unasyn (ampicillin / sulbactam) alcohol/food Interactions

There are 2 alcohol/food interactions with Unasyn (ampicillin / sulbactam)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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