Drug-laboratory interaction between beta-lactam antibiotics and the galactomannan antigen test used to detect mould infections

Braz J Infect Dis. 2014 Sep-Oct;18(5):544-7. doi: 10.1016/j.bjid.2014.03.009. Epub 2014 May 13.

Abstract

Several studies have demonstrated that piperacillin/tazobactam produces a false-positive result for the galactomannan antigen test. However, the most recent literature has demonstrated that this interaction is no longer a concern. There is little information regarding the drug-laboratory interaction with the generics of piperacillin/tazobactam or other broad-spectrum beta-lactams, such as ceftaroline, doripenem, imipenem/cilastatin, and meropenem. The purpose of this study was to determine if a drug-laboratory interaction exists with these antibiotics. Tests showed that one lot of imipenem/cilastatin by Hospira Healthcare India Private Limited produced a false-positive result for the galactomannan antigen test. All other medications tested, including piperacillin/tazobactam from seven manufacturers and imipenem/cilastatin by Hospira Inc., did not produce positive results. Since the reason for this drug-laboratory interaction with imipenem/cilastatin is unknown, more studies are needed to further investigate this interaction. Providers also should be educated of these findings: no drug-laboratory interaction with piperacillin/tazobactam and a possible drug-laboratory interaction with imipenem/cilastatin (Hospira Healthcare India Private Limited).

Keywords: Beta-lactams; Drug interaction; Galactomannan; Piperacillin–tazobactam.

MeSH terms

  • Antigens, Fungal / pharmacology*
  • Aspergillus / drug effects
  • Aspergillus / immunology*
  • Drug Interactions
  • Drugs, Generic / pharmacology*
  • False Positive Reactions
  • Galactose / analogs & derivatives
  • Humans
  • Mannans / immunology*
  • Penicillanic Acid / analogs & derivatives
  • Penicillanic Acid / pharmacology
  • Piperacillin / pharmacology
  • Piperacillin, Tazobactam Drug Combination
  • beta-Lactams / pharmacology*

Substances

  • Antigens, Fungal
  • Drugs, Generic
  • Mannans
  • beta-Lactams
  • galactomannan
  • Piperacillin, Tazobactam Drug Combination
  • Penicillanic Acid
  • Piperacillin
  • Galactose