| Benzylpenicillin |
Hypersensitivity reactions; anaphylaxis (<0.05% of patients) |
Joint pain; diarrhoea; rashes; urticaria |
Cerebral irritation; coagulation disorders; haemolytic anaemia; leucopenia; thrombocytopenia |
Antagonised by tetracyclines |
| Allergic reactions occur in up to 10% of exposed individuals |
| Ampicillin; Amoxicillin |
As for benzylpenicillin |
Erythematous rashes may occur with CMV or EBV infections |
As for benzylpenicillin |
As for benzylpenicillin |
| Gentamicin |
Hypersensitivity reactions |
Nausea; stomatitis; vomiting |
Nephrotoxicity, especially in children with impaired renal function, of note when administering to children presenting with severe dehydration in complicated SAM |
Plasma concentration of gentamicin in neonates possibly increased by indomethacin |
| -All aminoglycosides have increased risk of nephrotoxicity when administered with amphoterocin, capreomycin, cephalosporins, polymyxins, tacrolimus, vancomycin, cyclosporin, and loop diuretics |
| Antibiotic associated colitis; electrolyte disturbances; auditory damage; irreversible ototoxicity; vestibular damage |
| Plasma monitoring is recommended after 3-4 doses |
| Amoxicillin-Clavulanate |
Hypersensitivity reactions |
Cholestatic jaundice; hepatitis; nausea; vomiting; dizziness; headache |
Vasculitis |
As for benzylpenicillin |
| Metronidazole |
Hypersensitivity reactions |
Anorexia; gastrointestinal disturbance; nausea; taste disturbance; vomiting |
Aseptic meningitis; ataxia; pancytopenia |
|
| Co-trimoxazole |
Agranulocytosis; bone marrow suppression |
Diarrhoea; headache; hyperkalaemia; nausea; rash; vomiting |
Antibiotic-associated colitis; myocarditis; pericarditis; pancreatitis; vasculitis |
Increase toxicity of anti-neoplastic drugs |
| Chloramphenicol |
Grey syndrome may occur with intravenous use in neonates (abdominal distension, pallid cyanosis, circulatory collapse) |
Diarrhoea; depression; erythema multiforme; headache; nausea; urticaria; vomiting |
Nocturnal haemoglobinuria; optic or peripheral neuritis |
Increases plasma concentration of cyclosporin, anti-epileptic therapies |
| Metabolism of chloramphenicol is accelerated by rifampicin |
| Chloramphenicol enhances effects of sulfonylureas |
| Bone marrow toxicity: reversible and irreversible aplastic anaemia |
| Fluoroquinolones: ciprofloxacin |
Hypersensitivity reactions; Prolonged QT syndrome |
Dyspepsia, headache, diarrhoea, vomiting, hypotension |
Tendinitis and tendon rupture; peripheral neuropathy |
All fluoroquinolones should be used with caution in patients receiving drugs known to prolong the QT interval (see below) |
| The toxicity of fluoroquinolones is increased by the concurrent use of systemic steroidal medications |
| Fluoroquinolones’ effects are reduced by the co-administration of iron- and zinc- containing products, of importance when zinc-containing products are used to treat diarrhoea in children |
| Fluoroquinolones cause additive toxicity with non-steroidal anti-inflammatory drugs (ibuprofen, meloxicam, naproxen) |
| Azithromycin |
Hypersensitivity reactions; Prolonged QT syndrome |
Dyspepsia, flatulence, headache, disturbance in taste, anorexia |
Malaise, paraesthesia |
All macrolides are advised to be avoided concomitantly with other drugs which prolong the QT interval, (including anti-malarial medications such as artemether-lumefantrine) owing to the risk of ventricular arrhythmias (see below) |
| Plasma concentrations of azithromycin are increased by ritonavir |
| Azithromycin in combination with rifabutin results in increased |
| side effects of ritabutin, including neutropenia |
| Ceftriaxone |
Hypersensitivity reactions |
Diarrhoea, headache, abdominal discomfort |
Transient cholestatic jaundice owing to biliary sludge formation |
Relevant interactions for all cephalosporins: increased risk of nephrotoxicity when co-administered with aminoglycosides. |
| Enhance anticoagulant effect of coumarins |
| Cefixime (specific cefdinir side effects and interactions not published) |
Hypersensitivity reactions; immune-mediated haemolytic anaemia |
Flatulence, headache, abdominal pain, defaecation urgency, nausea, constipation, vomiting |
Transient cholestatic jaundice owing to biliary sludge formation |
As per ceftriaxone |
