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Drug Interaction With Quinolone Antibiotics in Intensive Care Unit Patients

Temple W. Willams Jr, MD; Jae H. Yuk, PharmD
Arch Intern Med. 1991;151(12):2485. doi:10.1001/archinte.1991.00400120113031.
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To the Editor. —  It is not uncommon for the patients in an intensive care unit (ICU) to become colonized with resistant organisms after a course of antibiotics. These organisms are frequently resistant to most antibiotics, and ciprofloxacin often becomes one of the few options for oral treatment. The majority of the patients in the ICU, however, also receive prophylactic antacid therapy to prevent stress ulcers. Despite the profound negative effect of antacids or sucralfate on the absorption of ciprofloxacin,1,2 an effort to avoid this significant drug-drug interaction to ensure adequate drug levels does not always seem to occur when the antibiotic or antacid treatment is initiated.We reviewed retrospectively the medication orders for our ICU patients to determine the incidence of this combination. During a 3-month period (November 1989 through January 1990), ciprofloxacin was prescribed in 54 ICU patients. In 41 (76%) of these patients, antacids and/or sucralfate


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