(HealthDay News) — Sulfonamide antibiotics and cephalosporins are most strongly associated with serious cutaneous adverse drug reactions (cADRs), according to a study published online Aug. 8 in the Journal of the American Medical Association.
Erika Y. Lee, M.D., from the University of Toronto, and colleagues explored the risk for serious cADRs associated with commonly prescribed oral antibiotics and characterized outcomes of patients hospitalized for them in a nested case-control study using data for adults aged 66 years or older who received at least one oral antibiotic between 2002 and 2022. Cases were those with an emergency department visit or hospitalization for serious cADRs within 60 days of the prescription (21,758 older adults); each case was matched to four controls without emergency department visit or hospitalization for cADRs (87,025 matched controls).
The researchers found that sulfonamide antibiotics and cephalosporins were most strongly associated with serious cADRs relative to macrolides in the primary analysis (adjusted odds ratios, 2.9 and 2.6, respectively). In addition, associations were seen for nitrofurantoin, penicillins, and fluoroquinolones (adjusted odds ratios, 2.2, 1.4, and 1.3, respectively). The highest crude rate of emergency department visits or hospitalization for cADRs was seen for cephalosporins and sulfonamide antibiotics (4.92 and 3.22 per 1,000 prescriptions, respectively). The median length of stay was six days among the 2,852 patients hospitalized for cADRs; 9.6 and 5.3 percent required transfer to a critical care unit and died in the hospital, respectively.
“The findings highlight the risk of serious cADRs following commonly prescribed antibiotics and underscore the importance of judicious prescribing, with preferential use of those associated with a lower risk when clinically appropriate,” the authors write.
One author disclosed ties to the publishing industry; a second author disclosed ties to the pharmaceutical industry.
What are sulfonamide antibiotics?
Sulfonamide antibiotics are a class of drugs that were among the first effective antibiotics developed. They function by interfering with bacterial metabolism, specifically the production of folic acid, a vital nutrient for bacterial growth. While they don’t kill bacteria directly, they prevent them from multiplying, a process known as bacteriostatic action. Historically significant, sulfonamides have been used to treat various infections, though their use has declined due to the emergence of antibiotic resistance and the availability of newer, broader-spectrum antibiotics.
Sulfonamide antibiotics were groundbreaking in their time, offering a potent weapon against bacterial infections. They effectively halt microbial proliferation by inhibiting folic acid synthesis, a crucial step in bacterial growth. While once a mainstay in treatment, their utility has diminished due to the rise of antibiotic resistance and the development of newer, broader-spectrum alternatives. Nevertheless, sulfonamides remain valuable in certain cases and continue to be studied for potential new applications.
What are cephalosporins?
Cephalosporins are a group of antibiotics derived from a fungus. They are classified into generations based on their effectiveness against different types of bacteria. First-generation cephalosporins primarily target gram-positive bacteria, while subsequent generations expand coverage to include more gram-negative organisms. These antibiotics work by inhibiting bacterial cell wall synthesis, ultimately leading to cell death. Cephalosporins are widely used in treating a range of infections, including respiratory, urinary tract, and skin infections. Like other antibiotics, their overuse can contribute to antibiotic resistance.
What shouldn’t you take with antibiotics?
It’s crucial to be aware of potential drug interactions when taking antibiotics. Certain medications can interfere with the antibiotic’s effectiveness or increase the risk of side effects. For instance, some antibiotics can reduce the efficacy of birth control pills, necessitating additional contraceptive measures. Additionally, combining antibiotics with specific medications can strain the liver or kidneys. Common culprits include blood thinners, certain pain relievers, and drugs used to treat heart conditions. Alcohol can also interact negatively with some antibiotics, causing nausea, vomiting, and even more severe reactions.
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