Antimicrobials: Cell wall synthesis inhibitors

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piperacillin. cloxacillin) ‡ Anti-pseudomonal penicillin (mezlocillin. azlocillin. ticarcillin) ‡ Extended spectrum penicillin (ampicillin. nafcillin. oxacillin. amoxicillin) . dicloxacillin. carbenicillin.Classification of penicillin ‡ Natural penicillin ‡ Anti-staphylococcal penicillin (methicillin.

Piperacillin Piperacillin + tazobactam ‡ May decrease serum concentrations of the active Nafcillin metabolite(s) of Mycophenolate.Drug-drug interaction ‡ Chloroquine may decrease the Amoxicillin serum concentration of the drug Ampicillin ‡ Fusidic Acid may diminish the therapeutic effect of the drug. Drug . Ampicillin sulbactam ‡ Tetracycline Derivatives may Amoxicillin diminish the therapeutic effect of Amoxicillin clavalunic the drug acid ‡ Uricosuric Agents may decrease Cloxacillin the excretion of the drugs Dicloxacillin ‡ May diminish the therapeutic Oxacillin effect of Typhoid Vaccine and BCG. ‡ May decrease the excretion of Penicillin Methotrexate.

*amoxicillin. nilotonib. ampicillin may decrease the plasma levels of estrogen *amoxicillin. ampicillin may have longer half life if used with probenecid *aspirin. sorafenib. indomethacin. thiazide diuretics. guanfacine. sulfonamides. tadalafil.*ampicillin may decrease the bioavailability of Atenolol. nafcillin may diminish the anticoagulant effect of Vitamin K Antagonists *dicloxacillin. furosemide and ethacrynic acid may prolong half-life of penicillin * Bacteriostatic antibacterials may antagonize the bactericidal effect of penicillin *dicloxacillin. cyclosporine *nafcillin may decrease the serum concentration of dronedarone. tolvaptan . maravir. romidepsin. nafcillin may decrease the serum concentration of Saxagliptin *naficillin may increase the metabolism of Calcium Channel Blockers except Clevidipine. phenylbutazone. everolimus. pazopanib.

. Benedict's Solution. or Fehling's Solution are used.Drug Amoxicillin Ampicillin Ampicillin + sulbactam Amoxicillin Amoxicillin + clavalunic acid Cloxacillin Dicloxacillin Oxacillin Penicillin Piperacillin Piperacillin + tazobactam Nafcillin Drug-non drug interaction ‡ false-positive glucose reactions may occur if Clinitest.

dicloxacillin: absorption may be decreased by food *amoxicillin + clavulanic acid: absorption may be increased with food *cloxacillin. penicillin. dicloxacillin: false-positive urine and serum proteins *cloxacillin. urinary steroids *dicloxacilli: may have increased prothrombin time if administered with warfarin *penicillin. dicloxacillin: false-positive in uric acid. cloxacillion. piperacillin: positive Coombs test *penicillin: pseudoproteinuria by certain test methods *piperacillin: may result in false positive results with the Platelia® Aspergillus enzyme immunoassay . oxacillin.*ampicillin: transient elevation of serum transaminase *ampicillin.

*amoxicillin+ clavulanic acid. ampicillin: pateints Infectious mononucleosis may develop rashes. high serum levels. *cloxacillin. penicillin: Use with caution in patients with a history of seizure disorder. particularly in the presence of renal impairment.Drug. may increase risk for seizures *piperacllin: patients with cystic fibrosis may have an increased frequency of fever and rash .disease interaction Drug Amoxicillin Ampicillin Ampicillin + sulbactam Amoxicillin Amoxicillin + clavalunic acid Cloxacillin Dicloxacillin Oxacillin Penicillin Piperacillin Piperacillin + tazobactam Nafcillin ‡ Hypersensitivity to penicillin ‡ Renal impairment: dosage adjustment recommended *ampicillin. nafcillin: Use with caution in patients with hepatic impairment.

Flucloxacillin Drug-drug interaction Drug-nondrug interaction Drug-disease interaction Hypersensitivity Porphyria May decrease the excretion of Methotrexate. Probenecid prolongs T1/2 of may prolong bleeding time flucloxacillin .

Carbenicillin Drug-drug interaction May reduce efficacy of oral contraceptives. Tetracyclines may impair bactericidal effects of carbenicillin. Probenecid may increase and prolong carbenicillin blood levels. Drug.non drug interaction Mild AST elevation Drug-disease interaction Hypersensitivity Renal impairment: dose adjustment should be done .

ticarcillin + clavulanic acid Drug-drug interaction Increase effect of Anticoagulants and heparin Chloramphenicol Erythromycin Synergism or antagonism may develop. biuret reaction. and nitric acid test but not with bromphenol blue test . Probenecid may increase ticarcillin concentration. acetic acid test. Tetracyclines May impair bactericidal effects of ticarcillin. Drug-nondrug interaction Drug-disease interaction May increase bleeding risks Renal impairment: may of anticoagulant by adjust dose prolonging bleeding time. hypersensitivity May cause false-positive May cause further urine glucose test results hypokalemia false-positive direct Coombs' test result False-positive protein reactions with sulfosalicylic acid and boiling test. May reduce efficacy of oral contraceptives.

Benedict test.Mezlocillin Drug-drug interaction May reduce efficacy of oral contraceptives. biuret reaction . Tetracyclines may impair bactericidal effects of mezlocillin Drug-nondrug interaction Drug-disease interaction false positive Coomb s test Hypersensitivity Drug may cause falsepositive results with copper sulfate tests (eg. acetic acid test. or Clinitest tablets) Drug may cause falsepositives with sulfosalicylic acid and boiling test. Fehling test.

Drug-nondrug interaction Drug-disease interaction Hypersensitivity . gentamicin. netilmicin. or tobramycin.Azlocillin Drug-drug interaction May antagonize effect of amikacin. ciprofloxacin.

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