Aminoglycosides Aminoglycoside antibacterials Cephalosporins

There is an in vitro interaction between aminoglycoside antibiotics and carbenicUhn or ticarciUin, leading to a significant loss of aminoglycoside antibacterial activity if these antibiotics are mixed in the same infusion bottle (184). The extent of inactivation depends on the penicUhn concentration, the contact time, and the temperature. Azlocillin and mezlocUhn inactivate aminoglycosides in a similar manner to that described for carbenicUhn (185,186). Aminoglycosides should not be mixed with penicillins or cephalosporins in the same infusion bottle. 

It is extremely important that fluoroquinolones have a specific mechanism of action, different from antibiotics and other groups of antibacterials (cephalosporins, aminoglycosides, etc.), which allows one to apply fluoroquinolones for treatment of infectious diseases caused by strains resistant to many other classes of antibacterials drugs. 

The quinolone antibiotics feature as the one main gronp of antibacterial agents that is totally synthetic, and not derived from or based upon natural products, as are penicillins, cephalosporins, macrolides, tetracyclines, and aminoglycosides. The first of these compounds to be employed clinically was nalidixic acid more recent drugs in current use include ciprofloxacin, norfloxacin, and ofloxacin... 

Benzylpenicillin is incompatible with rubber products and metal ions. Stability is affected by alcohols, surfactants, oxidizing and reducing agents, macrogols and other hydroxy compounds, glycerol, glycols, some paraffins and ointment bases, preservatives such as chlorocresol or thiomersal, blood and blood products, and antibacterials such as amphotericin, cephalosporins, and vancomycin. Injections of benzylpenicillins and aminoglycosides should be administered separately. 

However, by far the most important strategy involves the production of enzymes that destroy or deactivate the antibiotics. Bacterial enzymes that inactivate chloramphenicol (e.g., chloramphenicol acetyl transferase) and the aminoglycosides (usually enzymes that acetylate or phosphorylate the aminoglycosides) are quite common, but it is the penicillinases or, as they are now called, the beta-lactamases, that have had the most impact on antibacterial chemotherapy. The beta-lactam antibiotics, including the penicillins, cephalosporins and the newer variants called penems, carbapen-ems, cephamycins and monobactams, all possess the four-membered ring... 

Classes of Useful Antibacterial Antibiotics Penicillin Cephalosporin -C Steroid Aminoglycoside Polymyxin Chloramphenicol Cycloserine Tetracycline Macrolide Ansa macrolide Lincomycin Cycloserine Novobiocin... 

The nephrotoxicity of various combinations of antibiotics was assessed in 171 cancer patients (139 treated with a combination of aminoglycoside with penicillin or cephalosporin 32 treated with amphotericin B or vancomycin with other antibacterials). The highest nephrotoxicity (based on changes in urea and electrolytes) was found in patients treated with amphotericin B with an aminoglycoside and a cephalosporin. ... 

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