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This is a rare interaction between high dose flucloxacillin and paracetamol, and is an important complication to recognize.<\/jats:p>","DOI":"10.1093\/omcr\/omad048","type":"journal-article","created":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T11:51:15Z","timestamp":1685447475000},"source":"Crossref","is-referenced-by-count":4,"title":["Pyroglutamic acidosis caused by the combination of two common medicines prescribed in everyday practice"],"prefix":"10.1093","volume":"2023","author":[{"given":"A","family":"Duncan","sequence":"first","affiliation":[{"name":"Bon Secours Hospital Department of Medicine, , Dublin, Ireland"},{"name":"Bon Secours Department of Microbiology, , Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H","family":"McDermott","sequence":"additional","affiliation":[{"name":"Bon Secours Hospital Department of Medicine, , Dublin, Ireland"},{"name":"Bon Secours Department of Microbiology, , Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Corcoran","sequence":"additional","affiliation":[{"name":"Bon Secours Hospital Department of Medicine, , Dublin, Ireland"},{"name":"Bon Secours Department of Microbiology, , Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Devine","sequence":"additional","affiliation":[{"name":"Bon Secours Hospital Department of Medicine, , Dublin, Ireland"},{"name":"Bon Secours Department of Microbiology, , Dublin, Ireland"},{"name":"Bon Secours Department of Pharmacy, , Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Barry","sequence":"additional","affiliation":[{"name":"Bon Secours Hospital Department of Medicine, , Dublin, Ireland"},{"name":"Bon Secours Department of Microbiology, , Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,5,30]]},"reference":[{"key":"2023053011463465100_ref1","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2019-233306","article-title":"Acquired pyroglutamic acidosis due to long-term dicloxacillin and paracetamol use","volume":"13","author":"Zand, Irani","year":"2020","journal-title":"BMJ Case Rep"},{"key":"2023053011463465100_ref2","volume-title":"HPRA Drug Safety Newsletter","author":"HPRA","year":"2017","edition":"83rd"},{"key":"2023053011463465100_ref3","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2020-237536","article-title":"Flucloxacillin and paracetamol induced pyroglutamic acidosis","volume":"14","author":"Zand Irani","year":"2021","journal-title":"BMJ Case Rep"},{"key":"2023053011463465100_ref4","doi-asserted-by":"crossref","DOI":"10.1016\/S0140-6736(08)61398-7","article-title":"GOLD MARK: an anion gap mnemonic for the 21st century","volume":"372","author":"Mehta","year":"2008","journal-title":"Lancet"},{"key":"2023053011463465100_ref5","doi-asserted-by":"crossref","DOI":"10.1007\/s00228-017-2311-6","article-title":"Metabolic acidosis caused by concomitant use of paracetamol (acetaminophen) and flucloxacillin? A case report and a retrospective study","volume":"73","author":"Berbee","year":"2017","journal-title":"Eur J Clin Pharmacol"},{"key":"2023053011463465100_ref6","doi-asserted-by":"crossref","DOI":"10.2215\/CJN.07730713","article-title":"Acetaminophen toxicity and 5-oxoproline (pyroglutamic acid): a tale of two cycles, one an ATP-depleting futile cycle and the other a useful cycle","volume":"9","author":"Emmett","year":"2014","journal-title":"Clin J Am Soc Nephrol"},{"article-title":"HPSC Surveillance Data S. 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