Abstract | BACKGROUND: OBJECTIVE: METHODS: We analyzed a retrospective cohort study including all users of acenocoumarol or phenprocoumon in the PHARMO Record Linkage System (age range: 40-80 years). All patients were followed up until end of last coumarin treatment, hospitalization for bleeding, death, or end of study period. For each patient, the number of days on either coumarins alone, or on coumarins in combination with antibiotic drugs was determined. From these data, the relative risks of major bleeding were calculated. RESULTS: A total of 52,102 users of acenocoumarol and 7885 users of phenprocoumon met the inclusion criteria of our study cohort and contributed 139,159 person-years of follow-up. During follow-up, 838 patients (1.4%) were hospitalized for a bleeding while taking coumarins. Of the 62 different antibiotics taken by study members, 19 were associated with a bleeding episode. Of these, 10 were associated with a statistically significant increased bleeding risk. The relative risk of bleeding was three to five for doxycycline, amoxicillin, amoxicillin/clavulanic acid, ciprofloxacin, cotrimoxazole, azithromycin and pheneticillin, nine for tetracycline and 43 for cefradine and neomycin. CONCLUSION:
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Authors | F J A Penning-van Beest, J Koerselman, R M C Herings |
Journal | Journal of thrombosis and haemostasis : JTH
(J Thromb Haemost)
Vol. 6
Issue 2
Pg. 284-90
(02 2008)
ISSN: 1538-7836 [Electronic] England |
PMID | 18031295
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anti-Bacterial Agents
- Anticoagulants
- Amoxicillin
- Acenocoumarol
- Doxycycline
- Phenprocoumon
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Topics |
- Acenocoumarol
(adverse effects, pharmacology)
- Adult
- Aged
- Aged, 80 and over
- Amoxicillin
(adverse effects, pharmacology)
- Anti-Bacterial Agents
(adverse effects, pharmacology)
- Anticoagulants
(adverse effects, pharmacology)
- Doxycycline
(adverse effects, pharmacology)
- Drug Synergism
- Female
- Follow-Up Studies
- Hemorrhage
(chemically induced, epidemiology)
- Hemorrhagic Disorders
(chemically induced)
- Hospitalization
- Humans
- Male
- Middle Aged
- Netherlands
(epidemiology)
- Phenprocoumon
(adverse effects, pharmacology)
- Retrospective Studies
- Risk
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