Gentamicin
Adverse Effect: Loss of Gentamicin efficacy Clinical Management: Monitor patients for Gentamicin effectiveness.
Methotrexate
Adverse Effect: an increased risk of methotrexate toxicity Clinical Management: Avoid the concurrent use of methotrexate and penicillin if possible. If concomitant therapy is unavoidable, consider decreasing the methotrexate dose.
Netilmicin
Adverse Effect: Loss of Netilmicin efficacy Clinical Management: Monitor patients for Netilmicin effectiveness.
Probenecid
Adverse Effect: an increased risk of elevated piperacillin serum concentrations Clinical Management: If concurrent probenecid and piperacillin therapy is necessary, monitor the patient for an increase in piperacillin adverse effects, including diarrhea, headache, and skin rashes.
Streptomycin
Adverse Effect: Loss of Streptomycin efficacy Clinical Management: Monitor patients for Streptomycin effectiveness.
Tetracycline
Adverse Effect: decreased antibacterial effectiveness Clinical Management: If possible avoid this drug combination. Monitor decreased antibacterial efficacy.
Tobramycin
Adverse Effect: Loss of Tobramycin efficacy Clinical Management: Monitor patients for Tobramycin effectiveness.
Vecuronium
Adverse Effect: Enhanced and/or prolonged neuromuscular blockade which may lead to respiratory depression and paralysis Clinical Management: Concurrent use of piperacillin and vecuronium requires close monitoring of the patients clinical condition, especially respiratory and oxygenation status. Edrophonium, neostigmine, or atropine may provide partial reversal of hypoventilation. As the block is reversible with time, artificial ventilation may be required and should be maintained until adequate respiration returns |