Adverse drug reactions antibacterials

The pharmacoeconomic impact of adverse effects of antimicrobial drugs is enormous. Antibacterial drug reactions account for about 25% of adverse drug reactions. The adverse effects profile of an antimicrobial agent can... 

In contrast, one report describes 2 patients stabilised on warfarin who had marked rises in their INRs (to 6.2 and 7.3), and another patient recently started on warfarin who had a more modest rise (to 4.2) within 1 to 5 days of starting moxifloxacin. All these patients had recently been receiving other antibacterials, which complicates interpretation. For the period October 2000 to January 2004, Health Canada h received 12 reports of suspected coagulation disorders associated with moxifloxacin and warfarin, 11 of which were considered serious. Similarly, in February 2006, the Australia Adverse Drug Reactions Advisory Committee stated they had received one report of a suspected interaction between warfarin and moxifloxacin. In this patient the DSTR rose from around 2 to greater than 10, four days after starting moxifloxacin. ... 

The pharmacoeconomic impact of adverse effects of antimicrobial drugs is enormous. Antibacterial drug reactions... 

Dapsone (Avlosulfon) is a member of a class of chemical agents known as the sulfones. Dapsone is especially effective against M. leprae and is used with rifampin as the primary method of treating leprosy. Dapsone appears to exert its antibacterial effects in a manner similar to that of the sulfonamide drugs that is, dapsone impairs folic acid synthesis by competing with PABA in bacterial cells. Primary adverse effects associated with dapsone include peripheral motor weakness, hypersensitivity reactions (skin rashes, itching), fever, and blood dyscrasias, such as hemolytic anemia. 

Even in patients with normal renal function, adverse reactions have occurred in up to 25%, contributing to death in 5% (10). At therapeutically equivalent doses, suggestions of differences in nephrotoxicity or neurotoxicity between polymjTtin B and colistin are not convincing. In view of their potential for adverse effects, the poljmjodns have now been largely replaced by other antibacterial drugs. 

The manufacturers report that basiliximab has been used with analgesics, antibacterials, antifiingals, antivirals, diuretics, beta blockers and calcium-channel blockers without any increase in adverse reactions. None of the drugs was individually named. ... 

New cephalosporins that are (or probably soon will become) available for parenteral use are cefamandole, cefuroxime and cefoxitin. These antibiotics seem to possess a broader spectrum of antibacterial activity, partly because of their greater resistance to various lactamases. Reports on the adverse reactions to these new drugs are still awaited. 

Other such enzyme deficiencies have been revealed through an individual s adverse reaction to drugs. More than 90% of Orientals are genetically rapid N-acetylators of isoniazid (6.12), whereas only 40% of black or white citizens of the United States showed this trait (Kalow, 1962). Rapid acetylators produce acetylhydrazine, which can cause liver damage. The same inheritance controls the acetylation (deactivation) of the sulphonamide antibacterials. The rise of intraocular pressure when glucocorticoids are placed in the eye is another pharmacogenetic effect. Low and high responses are shown by 66% and 5%, respectively, of a sample white population. 

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