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ALDEN 5) and highlights the need for heightened vigilance when prescribing high-risk agents (e.g., fluoroquinolones) to patients recently exposed to ICIs, particularly during systemic inflammation and polypharmacy

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Escherichia coli, Streptococcus faecalis, Clostridium difficile and certain Salmonella species can bind Se from the body to their own enzymes to use amino acids instead of thiamine-containing amino acids, and can also convert the soluble form of Se to an insoluble form, making it unavailable for absorption by the body (114)