Neomycin Phenoxymethylpenicillin

NEOMYCIN PENICILLIN V 1 levels of phenoxymethylpenicillin and possible therapeutic failure 1 absorption of phenoxymethylpenicillin due to malabsorption syndrome caused by neomycin Patients should be monitored for efficacy of phenoxymethylpenicillin... 

The use of piperacillin is reported to be a risk factor for aminoglycoside-associated nephrotoxicity. A reduction in serum aminoglycoside levels can occur if aminoglycosides and penicillins are given together to patients with severe renal impairment. No pharmacokinetic interaction of importance appears to occur with intravenous aminoglycoside and penicillins in those with normal renal function or between aminoglycosides and carbapenems. The serum levels of oral phenoxymethylpenicillin can be halved by oral neomycin. 

In the case of phenoxymethylpenicillin, the levels are prohahly lowered because oral neomycin can cause a reversible malabsorption syndrome (histologically similar to nontropical sprue). 

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