Drug Interactions between fecal microbiota, live and moxifloxacin / triamcinolone

MONITOR CLOSELY: Concomitant administration of corticosteroids may potentiate the risk of tendinitis and tendon rupture associated with fluoroquinolone treatment. The mechanism is unknown. Tendinitis and tendon rupture have most frequently involved the Achilles tendon, although cases involving the rotator cuff (the shoulder), the hand, the biceps, and the thumb have also been reported. Some have required surgical repair or resulted in prolonged disability. Tendon rupture can occur during or up to several months after completion of fluoroquinolone therapy.

MANAGEMENT: Caution is recommended if fluoroquinolones are prescribed in combination with corticosteroids, particularly in patients with other concomitant risk factors (e.g., age over 60 years; recipient of kidney, heart, and/or lung transplant). Patients should be advised to stop taking the fluoroquinolone, avoid exercise and use of the affected area, and promptly contact their physician if they experience pain, swelling, or inflammation of a tendon. In general, fluoroquinolones should only be used to treat conditions that are proven or strongly suspected to be caused by bacteria and only if the benefits outweigh the risks.

ADJUST DOSING INTERVAL: Antibiotics may interfere with the therapeutic effects of fecal microbiota, which contains live bacteria. The mechanism may be related to the antibiotic inactivating the bacteria or reducing bacterial replication. In clinical studies an antibiotic washout period between 24 to 72 hours was required prior to the rectal administration of fecal microbiota.

MANAGEMENT: Although data are limited, it may be prudent to have an antibiotic washout period between 24 to 72 hours prior to administration of the rectal formulation of fecal microbiota. In addition, the manufacturer recommends avoiding oral antibiotics for up to 8 weeks after administration of the rectal formulation of fecal microbiota.