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Ciprofloxacin for gum disease and the combination of this antiviral for a period of 10 days is associated with reduction in the duration of gums for one group patients and a slight improvement in the visual outcome of another patient, who was on ciprofloxacin monotherapy in clinical trial, but no trial data exist on this drug. However, the combination is not considered safe in patients below the age of 25 years and if a patient is already on concomitant agent and is given the treatment with ciprofloxacin, oral medication administration should be discontinued.
The safety and effectiveness of combination cefotaxime amikacin are not well established. Some patients may experience a severe and sometimes fatal anaphylaxis as a result of exposure to the amikacin in combination with cefotaxime; patients should be carefully observed for signs of anaphylaxis and the use precautions. As there is a potential increased incidence of death in patients any age who have taken amikacin or cefotaxime and have also taken aminoglycosides, care should be and dosage adjustments are recommended for patients taking oral aminoglycosides.
The efficacy of any single antiviral used in combination with each other is variable and it essential that the drug therapy prescribed be carefully evaluated. The effectiveness of combinations aminoglycosides and aminoglycoside-treatments are limited by drug interactions and the need for prescriber to make individual drug therapy decisions.
The use of metronidazole in combination with the following antivirals has been reported as effective in treating the common cold, but results vary from 1% to 3%, so the treatment must not be taken without consulting with a specialist in infectious diseases and other specialist doctors, including a pulmonologist.
The use of pyrithione zinc sulfate in combination with other antimicrobial drugs has been linked with severe hepatotoxicity. If required, pyrithione zinc is contraindicated with the following antimicrobial agents: gentamicin; tetracycline; tigecycline
Acyclovir
Cimetidine
Corticosteroids such as doxorubicin or rifampicin have not been studied in the treatment of acute infectious diseases.
Some of the older antibiotics, including chloramphenicol, chloramphenicol and tetracycline, are often recommended in combination with the following agents in patients who are on certain medications for a variety of reasons. Combining these antibiotics with such as ampicillin, isoniazid and tigecycline may result in a significant worsening of the drug-resistant infection. As these agents are generally only effective for several days after their treatment has finished, it is important that these therapies should not be used with the antibiotics indicated for treating MRSA and Acinetobacter species in patients with compromised immune systems and gastrointestinal infections.
Cephalosporins are often used in the treatment of MRSA. There are no published clinical data relating to the use of cephalosporins in combination with the following antibiotics: meropenem and linezolid or cefoperazone. However, many patients require treatment with cephalosporins and the clinical response may be delayed for about 3 - 4 days after treatment with these antibiotics finishes.
Clindamycin has been the first-line drug for several months in patients with MRSA and Acinetobacter baumannii infections on long term oral therapy. However, recent data from the European Multicentre Antimicrobial Resistance Surveillance System indicated that cefazolin, the active ingredient in cefoperazone (Cefdinir)-generic combination, is an alternative to clindamycin for the treatment of severe S. aureus infections in adults (over 21 years of age) following extensive oral antibiotic therapy and in children aged 3 years and younger after single-drug therapy alone. The cefazolin -generic combination was also indicated for adult patients with Acinetobacter baumannii MRSA, who received long-term oral therapy, which was not effective. The results of this study demonstrated significantly better compliance with long term oral therapy compared to clindamycin alone in adults with severe S. aureus infections.
Moxifloxacin, clarithromycin, amoxicillin, and vancomycin are commonly used in combination with the following antimicrobials: gentamicin; tetracycline; aminoglycosides, such as penicillin; daptomycin and erythromycin; trimethoprim/sulfamethoxazole or tigecycline; macrolides, such as doxycycline, clindamycin, and clarithromy.
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