Absorption of two antibacterial drugs, cephalexin and co-trimoxazole, in malabsorption syndromes

Parsons, R. L.; Paddock, Gillian M.

doi:10.1093/jac/1.suppl_3.59

Cited by 19 publications

(7 citation statements)

References 4 publications

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“…Griffith and Black (12) found levels of cephalexin in serum to be twice as high in the monohydrate form as in the anhydrate form. Cholestyramine, an anionic-exchange resin, reduces bioavailability of cephalexin (32). No influence on gastrointestinal absorption was exerted by N-butylscopolamine, an anticholinergic drug (21).…”

Section: Discussionmentioning

confidence: 99%

Influence of ranitidine, pirenzepine, and aluminum magnesium hydroxide on the bioavailability of various antibiotics, including amoxicillin, cephalexin, doxycycline, and amoxicillin-clavulanic acid

Deppermann

Lode

Höffken

et al. 1989

Antimicrob Agents Chemother

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Two randomized double-blind crossover studies and one randomized crossover study were performed to document possible drug-drug interactions between antacids (aluminum magnesium hydroxide, 10 ml per dose for 10 doses), antimuscarinic drugs (pirenzepine, 50 mg per dose for 4 doses), and H2-blockers (ranitidine, 150 mg per dose for 3 doses) and amoxicillin (1,000 mg), cephalexin (1,000 mg), doxycycline (200 mg), and amoxicillin-clavulanic acid (625 mg). Ten healthy volunteers participated in each study. Concentrations in serum and urine were measured by bioassay, and pharmacokinetic parameters were calculated by the usual open one-or two-compartment models (statistics were determined by the Wilcoxon test). The antacid, pirenzepine, and ranitidine had no influence on the bioavailability of amoxicillin, cephalexin, and amoxicillinclavulanic acid. Only small differences could be observed in the pharmacokinetic parameters, but they are not of therapeutic importance. However, the antacid caused a significant (P < 0.01) reduction in the gastrointestinal absorption of doxycycline (area under the concentration-time curve, 38.6 + 22.7 mg * h/liter, fasting; 6.0 + 3.2 mg. h/liter, with antacid), resulting in subtherapeutic levels of doxycycline.

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Section: Discussionmentioning

confidence: 99%

Influence of ranitidine, pirenzepine, and aluminum magnesium hydroxide on the bioavailability of various antibiotics, including amoxicillin, cephalexin, doxycycline, and amoxicillin-clavulanic acid

Deppermann

Lode

Höffken

et al. 1989

Antimicrob Agents Chemother

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“…Faster dissolution rate Hurwitz (1971) Sulphadiazine sodium Antacids Decreased (in rats) Delayed stomach emptying Hurwitz (1971) Sulphamethoxazole Cholestyramine Reduced Adsorption or steatorrhoea Parsons and Paddock (1975) Sulphathiazole Antacids Increased Faster dissolution rate Barlow and Climenko (1941) Tetracycline Ferrous sulphate Reduced Chelation Neuvonen et al (1970); Gothoni et al (1972) Harcourt and Hamburger (1957) Proteolytic enzymes Unaffected or increased Bradbrook et al (1978); Seneca and Peer (1965) """ 0 """""'0,, cP cP al CP'''' cP cP cP CI> cP gg~ggggg~g "'0"""0""0""0 "0 CI> CI> CI> CI> CI> CI> CI> CI> 0 CI> a:a:oa:a:a:a:a:za: I-408 sorption rates of paracetamol (acetaminophen) [Nimmo et aI., 1973], ethanol (Gibbons and Lant, 1975), levodopa (Morris et al, 1976), and lithium (Crammer et aI., 1974). Propantheline, on the other hand, decreased the absorption rate of paracetamol (Nimmo et aI., 1973), ethanol (Gibbons and Lant, 1975), hydrochlorothiazide (Beermann and Groschinsky-Grind, 1978a), and lithium (Crammer et aI., 1974).…”

Section: Increase (In Rats)mentioning

confidence: 99%

Interactions Affecting Drug Absorption

Welling¹

1984

Clinical Pharmacokinetics

157

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The influence of drug-drug and drug-food interactions affecting the absorption of orally administered medication is reviewed. Drug-drug interactions can be classified in terms of indirect effects by one drug on gastrointestinal tract physiology influencing the absorption of other drugs, or direct interactions involving altered pH, adsorption, absorption, or chelation. Most, but not all, drug-drug interactions result in reduced or delayed systemic drug availability. Drug-food interactions may result in reduced, delayed, or increased systemic drug availability. The absorption of only a small number of drugs is unaffected by concomitant food intake. The degree of interaction and whether it positively or negatively affects drug absorption depends on a number of factors including the physical and chemical nature of the drug, the formulation, the type of meal, and the time interval between eating and dosing. Mechanisms of drug-food interactions are not well characterised. They clearly involve both direct and indirect factors in a similar fashion to drug-drug interactions, but indirect factors probably predominate. Reduced or delayed drug absorption is generally attributed, at least in part, to delayed stomach-emptying due to food. Increased absorption may also result from delayed stomach-emptying facilitating greater drug dissolution before it passes from the stomach into the small intestine. Increased bioavailability of some drugs, e.g. propranolol, metoprolol and labetalol, may be related to reduced presystemic clearance. The potential clinical implications of drug-drug and drug-food interactions must be taken into account with oral medications in order to minimise variations in systemic drug availability and hence in clinical efficacy.

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“…There are no published reports of adverse drug interactions with cephalexin (but absorption can be reduced by choles tyramine [Parsons and Paddock, 1975] and excretion is delayed by probenecid).…”

Section: Discussionmentioning

confidence: 99%

“…Studies of cephalexin in the presence of such diseases as small bowel diverticulosis and Crohn's disease have shown that its absorption is unimpaired and is often enhanced [Davis and Holt, 1975]. Parsons and Paddock [1975] have suggest ed that cephalexin is the antibiotic of choice for patients with malabsorption.…”

Section: Discussionmentioning

confidence: 99%

“…Since the introduction of the broad spec trum antibiotic cephalexin (Ceporex), it has been demonstrated that good absorption oc curs in elderly patients [Raeburn et al, 1975] and in many disease states affecting gastro-intestinal function [Davis and Holt, 1975;Parsons and Paddock, 1975]. It has also proved to be remarkably free from problems of side effects and drug interac tions [Speight et al, 1972].…”

Section: The Studymentioning

confidence: 99%

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Cephalexin Therapy for Infections Complicated by Age and Concurrent Diseases

Cooke¹

1979

Chemotherapy

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A broad spectrum antibiotic, cephalexin, was used to treat 64 patients in whom the problems of age, underlying conditions and multiple drug therapy could adversely affect the outcome of antibiotic treatment. The majority of patients were given the antibiotic for a lower respiratory tract infection. Treatment was successful in 50 patients after 5 days, and in a further 3 after 10 days. In 25 patients another antibiotic had been used unsuccessfully to treat infection: 19 of these patients responded to cephalexin therapy. Minor gastro-intestinal side effects were reported in 4 patients.

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Absorption of two antibacterial drugs, cephalexin and co-trimoxazole, in malabsorption syndromes

Cited by 19 publications

References 4 publications

Influence of ranitidine, pirenzepine, and aluminum magnesium hydroxide on the bioavailability of various antibiotics, including amoxicillin, cephalexin, doxycycline, and amoxicillin-clavulanic acid

Influence of ranitidine, pirenzepine, and aluminum magnesium hydroxide on the bioavailability of various antibiotics, including amoxicillin, cephalexin, doxycycline, and amoxicillin-clavulanic acid

Interactions Affecting Drug Absorption

Cephalexin Therapy for Infections Complicated by Age and Concurrent Diseases

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