digoxin and Pseudomonas-Infections

A 27 year old female with a complex history of congenital heart disease, cardiac surgery, heart failure, and arrhythmias was admitted for a Pseudomonas aeruginosa sternal wound infection and treated with intravenous antibiotics. After discharge and completion of an outpatient course of intravenous antibiotics, suppressive antibiotic therapy with ciprofloxacin was initiated. She presented to clinic with nausea and anorexia within a few days of addition of ciprofloxacin to her current regimen of medications, which included digoxin. The digoxin was discontinued, with all other medications remaining the same, and the symptoms resolved in 48 h. The dose of digoxin was restarted at 50 % of the previous dose with no further complications. The proposed cause of the nausea and anorexia was digoxin toxicity secondary to a drug-drug interaction with ciprofloxacin.. Patients receiving ciprofloxacin and digoxin should be monitored closely for the risk of digoxin toxicity.

Topics: Adult; Anorexia; Anti-Bacterial Agents; Cardiotonic Agents; Ciprofloxacin; Digoxin; Drug Interactions; Drug Monitoring; Female; Heart Failure; Humans; Nausea; Pacemaker, Artificial; Pseudomonas aeruginosa; Pseudomonas Infections; Reoperation; Surgical Wound Infection; Treatment Outcome

Topics: Aged; Anuria; Bacterial Infections; Bandages; Burns; Child; Debridement; Digoxin; Hospital Units; Humans; Infusions, Parenteral; Male; Mannitol; Penicillins; Plasma; Postoperative Care; Pseudomonas Infections; Skin Transplantation; Sulfanilamides; Transplantation, Autologous; Transplantation, Homologous; Wound Infection

Topics: Adult; Ampicillin; Anemia, Hemolytic; Aspirin; Burns; Carbenicillin; Cloxacillin; Digoxin; Erythrocytes; Female; Gentamicins; Glucosephosphate Dehydrogenase; Heinz Bodies; Humans; Infant; Male; Probenecid; Pseudomonas aeruginosa; Pseudomonas Infections; Staphylococcal Infections

Topics: Adult; Age Factors; Aminoglycosides; Anti-Bacterial Agents; Carbenicillin; Diabetes Complications; Digoxin; Drug Hypersensitivity; Drug Therapy, Combination; Endocarditis, Bacterial; Gentamicins; Heart Failure; Humans; Kanamycin; Male; Neurologic Manifestations; Penicillin Resistance; Penicillins; Pseudomonas aeruginosa; Pseudomonas Infections; Sex Factors; Substance-Related Disorders

Topics: Animals; Cardiac Catheterization; Digoxin; Dogs; Heart Failure; Heart Valve Diseases; Heart Valve Prosthesis; Heroin; Humans; Injections, Intravenous; Male; Postoperative Complications; Pseudomonas Infections; Self Medication; Staphylococcal Infections; Substance-Related Disorders; Tricuspid Valve; Tricuspid Valve Insufficiency; Venous Pressure