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Keflin (cephalothin) Disease Interactions

There are 4 disease interactions with Keflin (cephalothin):

Major

Beta-Lactams (Parenteral) (Includes Keflin) ↔ 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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View all 153 references
Moderate

Antibiotics (Includes Keflin) ↔ 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

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  8. 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
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  10. 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
  11. Saadah HA "Carbenicillin and pseudomembranous enterocolitis." Ann Intern Med 93 (1980): 645
  12. 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
  13. Miller SN, Ringler RP "Vancomycin-induced pseudomembranous colitis." J Clin Gastroenterol 9 (1987): 114-5
  14. 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
  15. Miller DL, Sedlack JD, Holt RW "Perforation complicating rifampin-associated pseudomembranous enteritis." Arch Surg 124 (1989): 1082
  16. Trexler MF, Fraser TG, Jones MP "Fulminant pseudomembranous colitis caused by clindamycin phosphate vaginal cream." Am J Gastroenterol 92 (1997): 2112-3
  17. Daly JJ, Chowdary KV "Pseudomembranous colitis secondary to metronidazole." Dig Dis Sci 28 (1983): 573-4
  18. Lyon JA "Imipenem/cilastatin: the first carbapenem antibiotic." Drug Intell Clin Pharm 19 (1985): 894-8
  19. Hutcheon DF, Milligan FD, Yardley JH, Hendrix TR "Cephalosporin-associated pseudomembranous colitis." Am J Dig Dis 23 (1978): 321-6
  20. Bingley PJ, Harding GM "Clostridium difficile colitis following treatment with metronidazole and vancomycin." Postgrad Med J 63 (1987): 993-4
  21. 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
  22. O'Meara TF, Simmons RA "Carbenicillin and pseudomembranous enterocolitis." Ann Intern Med 92 (1980): 440-1
  23. Meadowcroft AM, Diaz PR, Latham GS "Clostridium difficile toxin-induced colitis after use of clindmycin phosphate vaginal cream." Ann Pharmacother 32 (1998): 309-11
  24. Sankarankutty M, McGeorge D, Galasko CS "Pseudomembranous colitis following cephradine prophylaxis." Postgrad Med J 58 (1982): 726-8
  25. Bernstein L "Adverse reaction to trimethoprim-sulfamethoxazole, with particular reference to long-term therapy." Can Med Assoc J 112 (1975): s96-8
  26. 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
  27. 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
  28. Altamirano A, Bondani A "Adverse reactions to furazolidone and other drugs. A comparative review." Scand J Gastroenterol Suppl 169 (1989): 70-80
  29. Ehrenpreis ED, Lievens MW, Craig RM "Clostridium difficile-associated diarrhea after norfloxacin." J Clin Gastroenterol 12 (1990): 188-9
  30. Boriello SP, Jones RH, Phillips I "Rifampicin-associated pseudomembranous colitis." Br Med J 281 (1980): 1180-1
  31. Klinger D, Radford P, Collin J "Pneumoperitoneum without faecal peritonitis in a patient with pseudomembranous colitis." Br Med J 288 (1984): 1271-2
  32. Ring FA, Hershfield NB, Machin GA, Scott RB "Sulfasalazine-induced colitis complicating idiopathic ulcerative colitis." Can Med Assoc J 131 (1984): 43-5
  33. Friedman RJ, Mayer IE, Galambos JT, Hersh T "Oxacillin-induced pseudomembranous colitis." Am J Gastroenterol 73 (1980): 445-7
  34. "Multum Information Services, Inc. Expert Review Panel"
  35. 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
  36. 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
  37. 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
  38. 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
  39. Parry MF, Rha CK "Pseudomembranous colitis caused by topical clindamycin phosphate." Arch Dermatol 122 (1986): 583-4
  40. 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
  41. Hecht JR, Olinger EJ "Clostridium difficile colitis secondary to intravenous vancomycin." Dig Dis Sci 34 (1989): 148-9
  42. 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
  43. Hinton NA "The effect of oral tetracycline HCl and doxycycline on the intestinal flora." Curr Ther Res Clin Exp 12 (1970): 341-52
  44. Saginur R, Hawley CR, Bartlett JG "Colitis associated with metronidazole therapy." J Infect Dis 141 (1980): 772-4
  45. Sugarman B "Trimethoprim-sulfamethoxazole, pseudomembranous colitis, and spinal cord injury." South Med J 78 (1985): 711-3
  46. Golledge CL, Riley TV "Clostridium difficile-associated diarrhoea after doxycycline malaria prophylaxis." Lancet 345 (1995): 1377-8
  47. 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
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Moderate

Cephalosporins (Includes Keflin) ↔ Dialysis

Moderate Potential Hazard, High plausibility

Applies to: hemodialysis

Most cephalosporin antibiotics are removed by hemodialysis. Doses should either be scheduled for administration after dialysis or supplemental doses be given after dialysis. Cefonicid, cefixime, and ceftriaxone are not significantly removed by hemodialysis.

References

  1. "Product Information. Vantin (cefpodoxime)." Pharmacia and Upjohn, Kalamazoo, MI.
  2. 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
  3. Chodos J, Francke EL, Saltzman M, Neu HC "Pharmacokinetics of intravenous cefotaxime in patients undergoing chronic hemodialysis." Ther Drug Monit 3 (1981): 71-4
  4. "Product Information. Claforan (cefotaxime)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  5. "Product Information. Ceftin (cefuroxime)." Glaxo Wellcome, Research Triangle Park, NC.
  6. "Product Information. Velosef (cephradine)." Apothecon Inc, Plainsboro, NJ.
  7. Garcia RL, Santivanez V, Battilana CA "Single-dose pharmacokinetics of ceftriaxone in patients with end-stage renal disease and hemodialysis." Chemotherapy 34 (1988): 261-6
  8. Shyu WC, Pittman KA, Wilber RB, et al "Pharmacokinetics of cefprozil in healthy subjects and patients with renal impairment." J Clin Pharmacol 31 (1991): 362-71
  9. Reisberg BE, Mandelbaum JM "Cephalexin: absorption and excretion as related to renal function and hemodialysis." Infect Immun 3 (1971): 540-3
  10. Nikolaidis P, Tourkantonis A "Effect of hemodialysis on ceftazidime pharmacokinetics." Clin Nephrol 24 (1985): 142-6
  11. "Product Information. Tazicef (ceftazidime)." SmithKline Beecham, Philadelphia, PA.
  12. Spyker DA, Richmond JD, Scheld WM, Bolton WK "Pharmacokinetics of multiple-dose cefoperazone in hemodialysis patients." Am J Nephrol 5 (1985): 355-60
  13. 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
  14. Ti TY, Fortin L, Kreeft JH, East DS, Ogilvie RI, Somerville PJ "Kinetic disposition of intravenous ceftriaxone in normal subjects and patients with renal failure on hemodialysis or peritoneal dialysis." Antimicrob Agents Chemother 25 (1984): 83-7
  15. Matzke GR, Frye RF, Joy MS, Palevsky PM "Determinants of ceftriaxone clearance by continuous venovenous hemofiltration and hemodialysis." Pharmacotherapy 20 (2000): 635-43
  16. Hoffler D, Koeppe P, Corcilius M, Przyklink A "Cefpodoxime proxetil in patients with endstage renal failure on hemodialysis." Infection 18 (1990): 157-62
  17. "Product Information. Cedax (ceftibuten)." Schering-Plough, Liberty Corner, NJ.
  18. Allaouchiche B, Breilh D, Jaumain H, Gaillard B, Renard S, Saux MC "Pharmacokinetics of cefepime during continuous venovenous hemodiafiltration." Antimicrob Agents Chemother 41 (1997): 2424-7
  19. "Product Information. Mandol (cefamandole)." Lilly, Eli and Company, Indianapolis, IN.
  20. Aziz NS, Gambertoglio JG, Lin ET, Grausz H, Benet LZ "Pharmacokinetics of cephalothin and its metabolite in uremic patients undergoing hemodialysis using an HPLC assay." Jernal Perubatan UKM (Medical Journal, National Univ. of Malaysia) 2 (2) (1980): 82-9
  21. Weiss LG, Cars O, Danielson BG, et al "Pharmacokinetics of intravenous cefuroxime during intermittent and continuous arteriovenous hemofiltration." Clin Nephrol 30 (1988): 282-6
  22. Spyker DA, Gober LL, Scheld WM, et al "Pharmacokinetics of cefaclor in renal failure: effects of multiple doses and hemodialysis." Antimicrob Agents Chemother 21 (1982): 278-81
  23. Bunke CM, Aronoff GR, Luft FC "Pharmacokinetics of common antibiotics used in continuous ambulatory peritoneal dialysis." Am J Kidney Dis 3 (1983): 114-7
  24. "Product Information. Duricef (cefadroxil)." Bristol-Myers Squibb, Princeton, NJ.
  25. "Product Information. Omnicef (cefdinir)." Parke-Davis, Morris Plains, NJ.
  26. "Product Information. Lorabid (loracarbef)." Lilly, Eli and Company, Indianapolis, IN.
  27. 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
  28. Gartenberg G, Meyers BR, Hirschman SZ, Srulevitch E "Pharmacokinetics of cefaclor in patients with stable renal impairment, and patients undergoing haemodialysis." J Antimicrob Chemother 5 (1979): 465-70
  29. Browning MJ, Holt HA, White LO, et al "Pharmacokinetics of cefotetan in patients with end-stage renal failure on maintenance dialysis." J Antimicrob Chemother 18 (1986): 103-6
  30. Hasegawa H, Imada A, Horiuchi A, et al "Pharmacokinetics of cefotaxime in patients undergoing haemodialysis and continuous ambulatory peritoneal dialysis." J Antimicrob Chemother 14 Suppl (1984): 135-42
  31. Madhavan T, Yaremchuk K, Levin N, et al "Effects of renal failure and dialysis on cefazolin pharmacokinetics." Antimicrob Agents Chemother 8 (1975): 63-6
  32. Kroh UF, Lennartz H, Edwards DJ, Stoeckel K "Pharmacokinetics of ceftriaxone in patients undergoing continuous veno-venous hemofiltration." J Clin Pharmacol 36 (1996): 1114-9
  33. "Product Information. Ancef (cefazolin)." SmithKline Beecham, Philadelphia, PA.
  34. "Product Information. Cefobid (cefoperazone)." Roerig Division, New York, NY.
  35. Johnson CA, Ateshkadi A, Zimmerman SW, Hughes GS, Craig WA, Carey PM, Borin MT "Pharmacokinetics and ex vivo susceptibility of cefpodoxime proxetil in patients receiving continuous ambulatory peritoneal dialysis." Antimicrob Agents Chemother 37 (1993): 2650-5
  36. "Product Information. Maxipime (cefepime)." Bristol-Myers Squibb, Princeton, NJ.
  37. "Product Information. Suprax (cefixime)." Lupin Pharmaceuticals Inc, Baltimore, MD.
  38. "Product Information. Keflin (cephalothin)." Lilly, Eli and Company, Indianapolis, IN.
  39. Garcia MJ, Dominguez-Gil A, Tabernero JM, Roman AB "Pharmacokinetics of cefoxitin in patients undergoing hemodialysis." Int J Clin Pharmacol Biopharm 17 (1979): 366-70
  40. "Product Information. Mefoxin (cefoxitin)." Merck & Co, Inc, West Point, PA.
  41. Campillo JA, Lanao JM, Dominguez-Gil A, et al "Pharmacokinetics of cefamandole in patients undergoing hemodialysis." Int J Clin Pharmacol Biopharm 17 (1979): 416-20
  42. McCloskey RV, Terry EE, McCracken AW, Sweeney MJ, Forland MF "Effect of hemodialysis and renal failure on serum and urine concentrations of cephapirin sodium." Antimicrob Agents Chemother 1 (1972): 90-3
  43. "Product Information. Spectracef (cefditoren)." TAP Pharmaceuticals Inc, Deerfield, IL.
  44. Davis GM, Forland SC, Cutler RE "Serum and dialysate concentrations of cephalexin following repeated dosing in CAPD patients." Am J Kidney Dis 6 (1985): 177-80
  45. "Product Information. Rocephin (ceftriaxone)." Roche Laboratories, Nutley, NJ.
  46. Gabutti L, Taminelli-Beltraminelli L, Marone C "Clearance of ceftriaxone during haemodialysis using cuprophane, haemophane and polysulfone dialysers." Eur J Clin Pharmacol 53 (1997): 123-6
  47. Berman SJ, Boughton WH, Sugihara JG, et al "Pharmacokinetics of cefaclor in patients with end stage renal disease and during hemodialysis." Antimicrob Agents Chemother 14 (1978): 281-3
  48. Ahern MJ, Finkelstein FO, Andriole VT "Pharmacokinetics of cefamandole in patients undergoing hemodialysis and peritoneal dialysis." Antimicrob Agents Chemother 10 (1976): 457-61
  49. Garcia MJ, Dominguez-Gil A, Tabernero JM, Molina MD "Pharmacokinetics of cefoxitin during haemofiltration." Eur J Clin Pharmacol 25 (1983): 395-8
  50. "Product Information. Ceclor (cefaclor)." Lilly, Eli and Company, Indianapolis, IN.
  51. Gambertoglio JG, Aziz NS, Lin ET, et al "Cefamandole kinetics in uremic patients undergoing hemodialysis." Clin Pharmacol Ther 26 (1979): 592-9
  52. "Product Information. Cefadyl (cephapirin)." Apothecon Inc, Plainsboro, NJ.
  53. Bunke CM, Aronoff GR, Brier ME, et al "Cefazolin and cephalexin kinetics in continuous ambulatory peritoneal dialysis." Clin Pharmacol Ther 33 (1983): 66-72
  54. Craig CP, Rifkin SI "Pharmacokinetics and hemodialyzability of cefazolin in uremic patients." Clin Pharmacol Ther 19 (1976): 825-9
  55. "Product Information. Keflex (cephalexin)." Dista Products Company, Indianapolis, IN.
  56. Gabutti L, TaminelliBeltraminelli L, Marone C "Clearance of ceftriaxone during haemodialysis using cuprophane, haemophane and polysulfone dialysers." Eur J Clin Pharmacol 53 (1997): 123-6
  57. Ohkawa M, Nakashima T, Shoda R, et al "Pharmacokinetics of ceftazidime in patients with renal insufficiency and in those undergoing hemodialysis." Chemotherapy 31 (1985): 410-6
  58. 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
  59. "Product Information. Cefizox (ceftizoxime)." Fujisawa, Deerfield, IL.
  60. "Product Information. Cefzil (cefprozil)." Bristol-Myers Squibb, Princeton, NJ.
  61. Bailey RR, Gower PE, Dash CH "The effect of impairment of renal function and haemodialysis on serum and urine levels of cephalexin." Postgrad Med J 46 (1970): 60-4
  62. "Product Information. Monocid (cefonicid)." SmithKline Beecham, Philadelphia, PA.
  63. Cohen D, Appel GB, Scully B, Neu HC "Pharmacokinetics of ceftriaxone in patients with renal failure and in those undergoing hemodialysis." Antimicrob Agents Chemother 24 (1983): 529-32
  64. "Product Information. Cefotan (cefotetan)." Stuart Pharmaceuticals, Wilmington, DE.
View all 64 references
Moderate

Cephalothin (Includes Keflin) ↔ Sodium

Moderate Potential Hazard, High plausibility

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

Parenteral cephalothin sodium contains approximately 63 mg (2.8 mEq) of sodium per each gram of cephalothin activity. The sodium content should be considered in patients with conditions that may require sodium restriction, such as congestive heart failure, hypertension, and fluid retention.

References

  1. "Product Information. Keflin (cephalothin)." Lilly, Eli and Company, Indianapolis, IN.

Keflin (cephalothin) drug Interactions

There are 40 drug interactions with Keflin (cephalothin)

Keflin (cephalothin) alcohol/food Interactions

There is 1 alcohol/food interaction with Keflin (cephalothin)

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.

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