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Review
. 2021 Jan;25(1):67-76.
doi: 10.5005/jp-journals-10071-23439.

Drug Interactions between Antimicrobial and Immunosuppressive Agents in Solid Organ Transplant Recipients

Vikas Bhagat  1 , Rahul A Pandit  2 , Shwetha Ambapurkar  3 , Manju Sengar  4 , Atul P Kulkarni  5
Affiliations
Review

Drug Interactions between Antimicrobial and Immunosuppressive Agents in Solid Organ Transplant Recipients

Vikas Bhagat et al. Indian J Crit Care Med. 2021 Jan.

Abstract

The number of allogeneic solid organ and bone marrow transplants is increasing all over the world. To prevent transplant rejection and treat acute rejection of transplant, immunosuppressant drugs are used. The outcomes of solid organ transplants have dramatically improved over last 30 years, due to availability of multiple immunosuppressive agents, with varied mechanisms of action. The use of intense immunosuppression makes the individual having undergone solid organ transplant at the risk of several serious infections, which may prove fatal. To prevent and treat these infections (when they occur), patients are often given antimicrobial prophylaxis and therapy. The use of antimicrobials can interfere with the metabolism of the immunosuppressants, and may put the patient at risk of developing severe adverse effects due to unwanted increase or decrease in the serum levels of immunosuppressive agents. Knowledge of these interactions is essential for successful management of solid organ transplant patients. We therefore decided to review the literature and present the interactions that commonly occur between these two life-saving groups of drugs. How to cite this article: Bhagat V, Pandit RA, Ambapurkar S, Sengar M, Kulkarni AP. Drug Interactions between Antimicrobial and Immunosuppressive Agents in Solid Organ Transplant Recipients. Indian J Crit Care Med 2021;25(1):67-76.

Keywords: Antimicrobials; Calcineurin inhibitors; Corticosteroids; Drug–drug interaction; Immunosuppressants; Intravenous immunoglobulin; Monoclonal antibodies; Solid organ transplant; mTOR inhibitors.

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Conflict of interest statement

Source of support: Nil Conflict of interest: None

Figures

Fig. 1
Fig. 1
Phenytoin induction of CYP3A4. P, phenytoin molecule; PXR, pregnane X receptor
See this image and copyright information in PMC

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