The impact of anti-infective therapy on patients undergoing warfarin treatment.

IF 1.2 4区医学 Q4 INFECTIOUS DISEASES Journal of Infection in Developing Countries Pub Date : 2024-12-30 DOI:10.3855/jidc.19802

Linlin Fu, Huimin Yao, Wei Xu, Li Li, Baoyan Wang

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Abstract

Introduction: The combination of antibiotics and warfarin is used frequently in clinical practice. However, the impact of this combination on the anticoagulant efficacy of warfarin remains uncertain, posing challenges to clinical decision-making. This study aimed to evaluate the influence of various antibiotics on the international normalized ratio (INR) values in hospitalized patients who were concurrently administered warfarin.

Methodology: This retrospective cohort study enrolled patients who received concomitant warfarin and antibiotic therapy at the Nanjing Drum Tower Hospital, between January 2013 and December 2022. The patients were categorized into 8 groups based on the type of antibiotics they were received. The demographic characteristics were recorded, and the clinical outcomes were focused on changes in INR values after combining antibiotics in warfarin users.

Results: A total of 623 patients were enrolled in this study. Based on analysis of covariance (ANCOVA), the maximum INR values of the combinations were as follows: 2.72 for oxazolidinones, 2.86 for β-lactams, 2.86 for carbapenems, 2.91 for glycopeptides, 2.91 for macrolides, 3.77 for quinolones, 4.13 for sulfonamides, and 4.37 for antifungal agents. Pairwise comparisons revealed that quinolones, sulfonamides, and antifungal agents manifested the most substantial elevation in INR values when co-administered with warfarin. β-lactams, glycopeptides, oxazolidinones, macrolides, and carbapenems demonstrated a comparatively weaker impact on INR values.

Conclusions: Co-administration of warfarin with antibiotics led to an elevation in INR values in patients. Quinolones, sulfonamides, and antifungal agents had the most pronounced impact.

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抗感染治疗对接受华法林治疗患者的影响。

抗生素与华法林联用是临床上常用的治疗方法。然而，这种组合对华法林抗凝疗效的影响仍不确定，对临床决策提出了挑战。本研究旨在评价各种抗生素对合并华法林的住院患者国际标准化比值（INR）的影响。方法：这项回顾性队列研究纳入了2013年1月至2022年12月期间在南京鼓楼医院接受华法林和抗生素联合治疗的患者。根据患者使用的抗生素类型将患者分为8组。记录人口学特征，临床结果关注华法林使用者联合使用抗生素后INR值的变化。结果：本研究共纳入623例患者。经协方差分析（ANCOVA），各组合的最大INR值分别为：恶唑烷酮类2.72、β-内酰胺类2.86、碳青霉烯类2.86、糖肽类2.91、大环内酯类2.91、喹诺酮类3.77、磺胺类4.13、抗真菌药物4.37。两两比较显示，喹诺酮类药物、磺胺类药物和抗真菌药物与华法林合用时，INR值的升高最为显著。β-内酰胺类、糖肽类、恶唑烷酮类、大环内酯类和碳青霉烯类对INR值的影响相对较弱。结论：华法林与抗生素合用可导致患者INR值升高。喹诺酮类药物、磺胺类药物和抗真菌药物的影响最为显著。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection in Developing Countries INFECTIOUS DISEASES-

CiteScore

3.70

自引率

5.30%

发文量

239

审稿时长

4-8 weeks

期刊介绍： The Journal of Infection in Developing Countries (JIDC) is an international journal, intended for the publication of scientific articles from Developing Countries by scientists from Developing Countries. JIDC is an independent, on-line publication with an international editorial board. JIDC is open access with no cost to view or download articles and reasonable cost for publication of research artcles, making JIDC easily availiable to scientists from resource restricted regions.