Safety of parenteral third-generation cephalosporins
Article Abstract:
Third-generation cephalosporins have a broad spectrum of activity, and are effective in the treatment of serious infections and infections that involve several species of bacteria. Cephalosporins may be administered parenterally (by a non-oral route), and are generally quite safe, but complications can occur. Perhaps the most important complications result from the anticoagulation properties associated with cephalosporins which can cause gastrointestinal bleeding. Such coagulopathy and bleeding is most common with moxolactam. Regular coagulation tests are appropriate whenever a patient at high risk for bleeding is treated with cephalosporins. Another side effect of cephalosporins in some patients is a severe reaction to alcohol, which is similar the effects of Antabuse. The alcohol present in a medication such as cough syrup may be sufficient to elicit this effect. Diarrhea is a common complication of most antibiotic therapy, including cephalosporin therapy. An unusual side effect, unique to ceftriaxone, is pseudolithiasis, which is the formation of sludge-like material in the gall bladder that is not firm enough to be called a stone. Pseudolithiasis can produce symptoms of nausea, anorexia, epigastric distress, and colic, but the condition resolves when the antibiotic is discontinued. Ceftazidime has been reported to cause seizures in some patients, although this is uncommon. This effect may be related to the ease with which most of the third-generation cephalosporins pass from the blood into the brain. Headaches and mild neurological symptoms have been widely reported. Although there are some similarities in the chemical structure of penicillin and cephalosporins, allergic reactions to cephalosporins are rare. Nevertheless, it is prudent to consider patients allergic to penicillin as being at higher risk for the development of allergy to cephalosporins as well. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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Ceftriaxone-induced granulopenia related to a peculiar mechanism of granulopoiesis inhibition
Article Abstract:
Beta-lactam antibiotics such as ceftriaxone are sometimes responsible for severe neutropenia, a white blood cell deficiency. This deficiency may be caused by a reaction between ceftriaxone and peripheral white blood cells residing in the serum, or to a reaction between the drug and the bone marrow that produces white blood cells. Recent laboratory studies have shown a correlation between the capacity of ceftriaxone to inhibit the growth of white blood cells in the bone marrow and the dosages of the drug administered clinically. The case of a patient who was administered ceftriaxone and developed a white blood cell deficiency is described. After ceftriaxone was discontinued, the white blood cell count returned to normal. Subsequently, two bone marrow aspirates were taken from the patient on days 18 and 58 after the onset of neutropenia. These were cultured with two of the patient's serum samples, one with a low white blood cell count and one taken after recovery. Neither of the serum specimens contained ceftriaxone. Nevertheless, the low white blood count serum inhibited the formation of white blood cells on the 18-day bone marrow aspirate. The normal serum did not affect either bone marrow aspirate. The authors suggest that this may indicate that ceftriaxone produces a transient modification in the bone marrow and a change in the serum that reacts with this modification. These effects seem to inhibit the formation of white blood cells.
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1989
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Overview of fluoroquinolone safety
Article Abstract:
The safety of the fluoroquinolones, a new type of antibiotic, was analyzed in 29 different studies. The safety of this group of antibiotics was compared with the safety of other types of antimicrobials. Twenty-two studies showed no significant difference in the toxicity of the drugs. Five studies showed that the fluoroquinolones were safer than other drugs and two studies showed that the fluoroquinolones were more toxic. The adverse side effects reported with fluoroquinolones were experienced mild problems of the digestive system and, less frequently, more serious problems of the central nervous system. Interactions between the fluoroquinolones and other drugs were investigated, and it was shown that the fluoroquinolones interacted with antacids. Some fluoroquinolones (enoxacin, ciprofloxacin and ofloxacin) also interacted with the bronchodilator theophylline. Adverse effects of the fluoroquinolones shown in animal studies included: damage to the cartilage of joints; damage to DNA; the formation of crystals in the urine; and damage to the developing fetus. No clinical evidence exists in humans for these effects. The fluoroquinolones appear to be reasonably safe and effective antimicrobial agents. However, because the drugs are relatively new, clinical experience is limited. Further use will conclusively determine their safety. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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