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Keflex

Interactions

Aminoglycosides/Cephalosporins

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

The cause of this interaction is not known.

What might happen:

Taking these two medicines together may cause kidney problems. This problem may be more likely if you are elderly.

What you should do about this interaction:

Make sure that your doctor knows all of the medicines that you are taking.You should try to avoid taking these two medicines together if you have kidney problems or if you are elderly.Tell your doctor if you have any unusual swelling, especially in your hands or feet. Tell your doctor if you have nausea, vomiting or blood in your urine.Your doctor may also monitor your kidney tests and aminoglycoside antibiotic blood levels more regularly while on these two medicines.Your healthcare professionals (e.g. doctor or pharmacist) may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

References:

1.Bobrow SN, Jaffe E, Young RC. Anuria and acute tubular necrosis associated with gentamicin and cephalothin. JAMA 1972 Dec 18;222(12):1546-7.

2.Cabanillas F, Burgos RC, Rodriguez C, Baldizon C. Nephrotoxicity of combined cephalothin-gentamicin regimen. Arch Intern Med 1975 Jun; 135(6):850-2.

3.Fillastre JP, Laumonier R, Humbert G, Dubois D, Metayer J, Delpech A, Leroy J, Robert M. Acute renal failure associated with combined gentamicin and cephalothin therapy. Br Med J 1973 May 19;2(5863):396-7.

4.Klastersky J, Henri A, Hensgens C, Daneau D. Gram-negative infections in cancer. Study of empiric therapy comparing carbenicillin-cephalothin with and without gentamicin. JAMA 1974 Jan 7;227(1):45-8.

5.Bloomfield CD, Kennedy BJ. Cephalothin, carbenicillin, and gentamicin combination therapy for febrile patients with acute non-lymphocytic leukemia. Cancer 1974 Aug;34(2):431-7.

6.Harrison WO, Silverblatt FJ, Turck M. Gentamicin nephrotoxicity: failure of three cephalosporins to potentiate injury in rats. Antimicrob Agents Chemother 1975 Aug;8(2):209-15.

7.Klastersky J, Hensgens C, Debusscher L. Empiric therapy for cancer patients: comparative study of ticarcillin- tobramycin, ticarcillin-cephalothin, and cephalothin-tobramycin. Antimicrob Agents Chemother 1975 May;7(5):640-5.

8.Fanning WL, Gump D, Jick H. Gentamicin- and cephalothin-associated rises in blood urea nitrogen. Antimicrob Agents Chemother 1976 Jul;10(1):80-2.

9.Plager JE. Association of renal injury with combined cephalothin-gentamicin therapy among patients severely ill with malignant disease. Cancer 1976 Apr;37(4):1937-43.

10.Hansen MM, Kaaber K. Nephrotoxicity in combined cephalothin and gentamicin therapy. Acta Med Scand 1977;201(5):463-7.

11.Wade JC, Smith CR, Petty BG, Lipsky JJ, Conrad G, Ellner J, Lietman PS. Cephalothin plus an aminoglycoside is more nephrotoxic than methicillin plus an aminoglycoside. Lancet 1978 Sep 16;2(8090):604-6.

12.Schimpff SC, Gaya H, Klastersky J, Tattersall MH, Zinner SH. Three antibiotic regimens in the treatment of infection in febrile granulocytopenic patients with cancer. The EORTC international antimicrobial therapy project group. J Infect Dis 1978 Jan;137(1):14-29.

13.Brown AE, Quesada O, Armstrong D. Minimal nephrotoxicity with cephalosporin-aminoglycoside combinations in patients with neoplastic disease. Antimicrob Agents Chemother 1982 Apr;21(4):592-4.

14.Kuhlmann J, Seidel G, Grotsch H. Tobramycin nephrotoxicity: failure of cefotaxime to potentiate renal toxicity. Infection 1982;10(4):233-9.

15.Mondorf AW, Heynold FT, Scherberich JE, Hess H, Schoeppe W. Assessment of the nephrotoxic potential of ceftazidime and a ceftazidime/tobramycin combination in volunteers. Infection 1983;11 Suppl 1:S57-62.

16.Van der Auwera P, Klastersky J, Lagast H, Husson M. Serum bactericidal activity and killing rate for volunteers receiving imipenem, imipenem plus amikacin, and ceftazidime plus amikacin against Pseudomonas aeruginosa. Antimicrob Agents Chemother 1986 Jul;30(1):122-6.

17.Braveny I, Machka K, Milatovic D. Evaluation of novel antipseudomonal drugs using the serum bactericidal activity test. Eur J Clin Microbiol 1986 Feb;5(1):119-23.

18.Wagenvoort JH, Brus-Weijer L, Michel MF. Bactericidal effect of combinations of cephalosporins with tobramycin on clinical isolates of Escherichia coli, Klebsiella and Staphylococcus aureus. Arzneimittelforschung 1986 Sep;36(9):1301-2.

19.Giamarellou H. Aminoglycosides plus beta-lactams against gram-negative organisms. Evaluation of in vitro synergy and chemical interactions. Am J Med 1986 Jun 30;80(6B):126-37.

20.Bergeron MG, LeBel M, Charest A, Forcier JF, Morin J, Vallee F. Comparative study of serum bactericidal activity of cefotaxime alone or in combination with tobramycin. Antimicrob Agents Chemother 1986 Feb; 29(2):379-81.

21.Pascual-Lopez A, Lagast H, Klastersky J. Serum bactericidal activity against Klebsiella pneumoniae in volunteers receiving increasing doses of tobramycin with or without cefamandole. Int J Clin Pharmacol Res 1987; 7(1):45-9.

22.Bingen E, Lambert-Zechovsky N, Aujard Y, Mariani P, Lemer G, Sauzeau C, Mathieu H. Early synergistic killing activity at concentrations attainable in CSF of amoxicillin or cefotaxime and aminoglycosides against Haemophilus influenzae. Infection 1988 Mar-Apr;16(2):121-5.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, expect as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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