Zhanel G G, Siemens S, Slayter K, Mandell L
Department of Medical Microbiology, Faculty of Medicine and.
Can J Infect Dis. 1999 Nov;10(6):429-33. doi: 10.1155/1999/539376.
To assess the clinical significant of antibiotic and oral contraceptive drug interactions.
MEDLINE search from 1975 to 1998 (September) inclusive. Search terms 'antitiobic', 'oral contraceptive' and 'pregnancy' were included. Published papers as well as references from these papers were reviewed. Papers documenting mechanistic interactions between antibiotics and oral contraceptives were included.
Studies reporting oral contraceptive pharmacokinetics, mechanisms, incidence, implicated antibiotics and clinical consequences of antibiotic/oral contraceptive drug interactions.
Reports of oral contraceptive failure seem to be most numerous in women using preparations containing 30 μg of ethinylestradiol and 150 μ g of levonorgestrel. Rifampin is the only antibiotic that has been reported to reduce plasma estrogen concentrations. When taking rifampin, oral contraceptives cannot be relied upon and a second method of contraception is mandatory. Amoxicillin, ampicillin, griseofulvin, metronidazole and tetracycline have been associated with contraceptive failure in three or more clinical cases. When these agents are used, the clinician should discuss the available data with the patient and suggest a second form of birth control. Other antibiotics are most likely safe to use concomitantly with oral contraceptives.
Rifampin is the only antibiotic to date that has been reported to reduce plasma estrogen concentrations. Oral contraceptives cannot be relied upon for birth control while taking rifampin.
评估抗生素与口服避孕药药物相互作用的临床意义。
检索1975年至1998年9月的MEDLINE数据库。检索词包括“抗生素”、“口服避孕药”和“妊娠”。对发表的论文以及这些论文的参考文献进行了综述。纳入记录抗生素与口服避孕药之间机制性相互作用的论文。
报告口服避孕药药代动力学、作用机制、发生率、相关抗生素以及抗生素/口服避孕药药物相互作用临床后果的研究。
在使用含30μg炔雌醇和150μg左炔诺孕酮制剂的女性中，口服避孕药失败的报告似乎最多。利福平是唯一被报道可降低血浆雌激素浓度的抗生素。服用利福平时，不能依赖口服避孕药，必须采用第二种避孕方法。阿莫西林、氨苄西林、灰黄霉素、甲硝唑和四环素在三个或更多临床病例中与避孕失败有关。使用这些药物时，临床医生应与患者讨论现有数据，并建议采用第二种避孕方式。其他抗生素与口服避孕药同时使用很可能是安全的。
利福平是迄今为止唯一被报道可降低血浆雌激素浓度的抗生素。服用利福平时，不能依赖口服避孕药进行避孕。
