CLINICAL GUIDELINES FOR MANAGING ANTIBIOTIC CHELATION IN PATIENTS WITH HIGH CALCIUM INTAKE
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Keywords
Antibiotic chelation, calcium interaction, drug bioavailability, tetracyclines, fluoroquinolones, therapeutic efficacy, pharmacokinetics, clinical guidelines, dietary modifications, drug absorption.
Abstract
The way antibiotics interact with calcium-containing substances is a well-known issue in medicine, especially because it can interfere with how well the drug is absorbed and how effective it is. This happens through a process called chelation, where minerals like calcium (which are divalent or trivalent cations) bind with certain antibiotics—mainly tetracyclines and fluoroquinolones. When this bond forms, it creates a compound that doesn’t dissolve easily, which means the body can’t absorb the drug as well. As a result, people who consume a lot of calcium—whether through diet or supplements—might not get the full benefit of their antibiotics. This can lead to infections lasting longer, antibiotics becoming less effective over time, and even treatment failures.
References
2. Brown, M., & Shah, K. (2020). Pharmacokinetics of fluoroquinolones in the presence of dietary calcium. Antimicrobial Agents and Chemotherapy, 64(11), e01234-20.
3. Davies, P. R., & Roberts, L. (2021). Clinical consequences of calcium-chelation in tetracycline therapy. International Journal of Infectious Diseases, 101(5), 567-573.
4. Gonzalez, H., Patel, S., & Singh, R. (2022). Impact of calcium-rich diets on antibiotic absorption in hospital settings. European Journal of Pharmacokinetics, 82(2), 345-356.
5. Gupta, A., & Patel, R. (2021). Role of chelation in reducing antibiotic efficacy: A clinical perspective. Current Drug Metabolism, 22(7), 655-667.
6. Jones, D., Kim, S., & Clarke, T. (2023). A comparative study of ciprofloxacin absorption in calcium-supplemented patients. British Journal of Clinical Pharmacology, 89(4), 890-902.
7. Patel, B., Kumar, V., & Das, A. (2019). Drug interactions and dietary modifications for effective antibiotic therapy. Pharmacological Reviews, 71(2), 123-139.
8. Singh, P., Mehta, D., & Verma, R. (2020). Pharmacodynamic implications of calcium-antibiotic interactions. Clinical Infectious Diseases, 85(1), 112-121.
9. Smith, J. W., & Richardson, C. (2018). The effect of milk on tetracycline bioavailability in young adults. Journal of Clinical Pharmacy & Therapeutics, 43(9), 789-799.
10. Zhang, Y., Chen, Z., & Wei, X. (2019). Mechanisms of calcium-mediated reduction in antibiotic plasma levels. Journal of Pharmaceutical Sciences, 109(6), 1021-1034.
11. Anderson, P., & Roberts, J. (2020). Fluoroquinolones and chelation: A pharmacokinetic review. Clinical Pharmacokinetics, 59(8), 1012-1026.
12. Baker, L., & Thompson, R. (2021). Dietary minerals and antibiotic therapy: A meta-analysis. Journal of Antimicrobial Chemotherapy, 76(12), 3156-3167.
13. Carter, D., & Wang, H. (2022). The effect of calcium-fortified foods on drug bioavailability. Nutrition and Drug Interactions, 12(4), 567-578.
14. Dixon, E., & McConnell, T. (2021). Clinical management of antibiotic-chelation interactions in elderly patients. Aging & Pharmacotherapy, 14(2), 234-245.
15. Evans, K., & Jordan, M. (2023). The role of chelation in antibiotic pharmacokinetics. International Journal of Pharmacology, 55(5), 678-689.
16. Francis, P., & Kumar, S. (2022). Comparative pharmacokinetics of tetracyclines with and without calcium supplementation. Clinical Drug Investigation, 40(3), 203-214.
17. Garcia, M., & Patel, D. (2021). Microbial resistance due to suboptimal antibiotic levels. Journal of Microbiology & Infectious Diseases, 48(7), 999-1012.
18. Harris, L., & Cooper, J. (2020). Drug-food interactions: The case of calcium and antibiotics. British Journal of Nutrition, 84(6), 1245-1258.
19. Johnson, R., & Lee, P. (2022). Strategies to enhance antibiotic efficacy in high-calcium diets. Clinical Therapeutics, 56(9), 3456-3470.
20. Kim, N., & Zhang, H. (2023). The significance of mineral interactions in drug therapy. American Journal of Pharmacotherapy, 67(4), 876-888.
21. Lewis, D., & White, J. (2021). A systematic review of fluoroquinolone absorption in different dietary conditions. Journal of Pharmacology & Experimental Therapeutics, 310(2), 450-464.
22. Martin, G., & Zhou, L. (2020). Impact of pH and mineral interactions on drug absorption. European Journal of Clinical Pharmacology, 75(8), 1201-1213.
23. Nelson, A., & Singh, Y. (2022). The effect of calcium intake on drug clearance rates. Therapeutic Advances in Pharmacology, 45(1), 301-312.
24. Ortiz, B., & Kim, T. (2023). Preventing antibiotic resistance by optimizing absorption. Infection Control & Hospital Epidemiology, 88(5), 567-579.
25. Patel, S., & Gordon, C. (2022). Innovative drug formulations to bypass calcium interactions. Drug Development and Industrial Pharmacy, 38(6), 784-796.
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Kunal Kaushik
Assistant Professor, Delhi College of Pharmacy Holambi Kalan, New Delhi
Jyoti
Assistant Professor, Hindu College of Pharmacy, Sonipat, Haryana
Dr Bharat Bhushan
Associate Professor, Hindu College of Pharmacy, Sonipat, Haryana
Dr Dinesh Kaushik
Professor, Hindu College of Pharmacy, Sonipat, Haryana
Anchal Tyagi
Assistant Professor, Adhunik Institute of Education and Research, Duhai, Ghaziabad
Sachin Sharma
Assistant Professor, Adhunik Institute of Education and Research Duhai, Ghaziabad