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Anabolic steroids , eg testosterone, nandrolone, stanozolol ace inhibitors , eg captopril these can cause unpredictable drops in blood sugar azole antifungals such as itraconazole or ketoconazole beta-blockers , eg propranolol ciclosporin clopidogrel should be avoided where possible in people taking repaglinide; blood sugar levels should be carefully monitored if it is essential disopyramide gemfibrozil gemfibrozil, used for lowering cholesterol levels, must not be taken in combination with repaglinide as this may cause severe or prolonged low blood sugar macrolide antibiotics such as clarithromycin maoi antidepressants , eg phenelzine non-steroidal anti-inflammatory drugs nsaids , eg ibuprofen, diclofenac other antidiabetic medicines , eg metformin octreotide large doses of salicylates, eg aspirin small pain relieving doses do not normally have this effect trimethoprim or co-trimoxazole should be avoided where possible in people taking repaglinide; blood sugar levels should be carefully monitored if trimethoprim is needed to treat an infection .

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Treatment depends on the underlying cause granulocyte colony stimulating factors g-csf are now available and may be of benefit control infections viridans streptococci are usually sensitive to penicillin, beta-lactams, vancomycin, roxithromycin , rifampicin, macrolides, teicoplanin, lincosamides and aminoglycosides; co-trimoxazole is not effective and there is increasing resistance to penicillin after prolonged exposure to it gram-negative infections should be treated with ticarcillin, mecillinam or a third generation cephalosporin such as ceftazidime or cefotaxime if fever develops, samples of blood, urine, sputum and faeces should be taken for culture to exclude septicaemia; the patient should be started on empirical systemic antibiotics, usually initially piperacillin tazobactam plus gentamicin or, if penicillin-allergic, ceftazidime.

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it was concluded that cotrimoxazole or one of the newer quinolones can be considered for treatment of aeromonas-associated diarrhea.

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