tetracycline and secnidazole

Many antibiotics carry caution stickers that warn against alcohol consumption. Data regarding concurrent use are sparse. An awareness of data that address this common clinical scenario is important so health care professionals can make informed clinical decisions and address questions in an evidence-based manner. The purpose of this systematic review was to determine the evidence behind alcohol warnings issued for many common antimicrobials. The search was conducted from inception of each database to 2018 using PubMed, Medline via Ovid, and Embase. It included studies that involved interactions, effects on efficacy, and toxicity/adverse drug reactions (ADR) due to concomitant alcohol consumption and antimicrobials. All interactions were considered in terms of three components: (i) alteration in pharmacokinetics/pharmacodynamics (PK/PD) of antimicrobials and/or alcohol, (ii) change in antimicrobial efficacy, and (iii) development of toxicity/ADR. Available data support that oral penicillins, cefdinir, cefpodoxime, fluoroquinolones, azithromycin, tetracycline, nitrofurantoin, secnidazole, tinidazole, and fluconazole can be safely used with concomitant alcohol consumption. Data are equivocal for trimethoprim-sulfamethoxazole. Erythromycin may have reduced efficacy with alcohol consumption, and doxycycline may have reduced efficacy in chronic alcoholism. Alcohol low in tyramine may be consumed with oxazolidinones. The disulfiram-like reaction, though classically associated with metronidazole, occurs with uncertain frequency and with varied severity. Cephalosporins with a methylthiotetrazole (MTT) side chain or a methylthiodioxotriazine (MTDT) ring, ketoconazole, and griseofulvin have an increased risk of a disulfiram-like reaction. Alcohol and antimicrobial interactions are often lacking evidence. This review questions common beliefs due to poor, often conflicting data and identifies important knowledge gaps.

Topics: Alcohols; Anti-Bacterial Agents; Anti-Infective Agents; Azithromycin; Cephalosporins; Doxycycline; Drug Interactions; Erythromycin; Fluoroquinolones; Metronidazole; Penicillins; Tetracycline

A study was carried out in 80 patients with acute intestinal amoebiasis to compare the efficacy of treatment with a single oral dose of 2 g secnidazole and a 5-day course of 750 mg tetracycline plus 1 g clioquinol per day. Patients were allocated at random into one or other treatment group and returned for clinical assessment and microscopic examination of stools for the presence of the trophozoite or haematophagous form of Entamoeba histolytica on Days 1 to 7, 14, 21 and 28. The results showed that secnidazole produced significantly faster and more effective treatment than tetracycline/clioquinol. At the end of the follow-up period, 7 of the 40 patients in the tetracycline/clioquinol group were classified as 'parasitological' failures but there were none in the secnidazole group. Moreover, there were no cases of relapse or persistence of clinical signs in the secnidazole-treated patients. Both treatments were well tolerated.

Topics: Acute Disease; Adolescent; Adult; Aged; Child; Clinical Trials as Topic; Clioquinol; Drug Therapy, Combination; Dysentery, Amebic; Female; Humans; Hydroxyquinolines; Male; Metronidazole; Middle Aged; Random Allocation; Tetracycline; Time Factors