Effect of single-dose extended-release oral azithromycin on anticoagulation status in warfarinized patients

Kusafuka, Yuji; Kitamura, Hiroshi; Sakurai, Shinichi; Suzuki, Shigeru; Nakanishi, Yoshitaka; Katsuyama, Yoshihiko; Ohmori, Shigeru

doi:10.1016/j.oooo.2012.08.449

Cited by 12 publications

(21 citation statements)

References 14 publications

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“…Several reports have investigated the relationship between various antibiotics and INR values [6,9,10,18]. Ghaswalla et al reported that there was a signi cant interaction between time and antibiotics on the INR values of elderly (> 65 years old) patients who were on stable warfarin therapy (AMPC, AZM, levo oxacin…”

Section: Discussionmentioning

confidence: 99%

“…[LVFX]) [18]. AZM in particular, which has a signi cantly long half-life, has been widely discussed in this context [6,10]. Glasheen et al reported that INR value increased beyond the therapeutic range in 31% of AZM cases and 33% of levo oxacin LVFX cases one week after oral administration.…”

Section: Discussionmentioning

confidence: 99%

“…This was seen in patients on stable warfarin therapy [10]. On the other hand, Kusafuka et al reported that changes in INR values one week before and after tooth extraction were not statistically signi cant (2-factor analysis of variance, Not Signi cant [NS]) when 18 patients taking warfarin were administered AZM [6]. In the present study, changes in INR values throughout the study were not statistically signi cant (2-factor analysis of variance, NS) for all antibiotics, including AZM.…”

Section: Discussionmentioning

confidence: 99%

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Does tooth extraction and perioperative medication affect PT-INR of patients taking warfarin?

Iwata¹,

Tachibana²,

Kusumoto³

et al. 2020

Preprint

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Background: Various antibiotics and analgesics have been reported to interact with　warfarin. Reports that investigate the effects of medication taken for just a few days during tooth extraction on the prothrombin time-international normalized ratio (PT-INR) are rare. Methods: A total of 110 patients receiving long-term stable warfarin therapy underwent tooth extraction without interruption of warfarin treatment. INR values were measured one month before the tooth extraction, the day of the extraction, and one week after the extraction. We investigated the changes of INR values between the day of extraction and one week after the extraction, as well as the various risk factors for increases in INR values.Results: Before and after tooth extraction, the number of patients taking cefcapene pivoxil, amoxicillin, and azithromycin was 57, 36, and 8, respectively. Nine patients were administered ampicillin before tooth extraction and received amoxicillin after their tooth extraction. One week after tooth extraction, the INR values increased beyond the therapeutic range in 3 out of 110 patients (2.7%). The INR values before tooth extraction in these three patients were close to 3.0. The INR value increased by more than twice as much in 1 of 110 patients (0.9%).Conclusion: When a tooth extraction is performed in patients taking warfarin, certain factors could increase the INR, such as interaction between warfarin and antibiotics or analgesics, post-extraction inflammation or infection, and eating disorders due to post-extraction pain. However, our results suggest that it has little effect on the INR values one week after extraction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Does tooth extraction and perioperative medication affect PT-INR of patients taking warfarin?

Iwata¹,

Tachibana²,

Kusumoto³

et al. 2020

Preprint

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show abstract

“…However, most previous reports were on long-term treatment cases and cases where oral intake was not possible [1][2][3][4][5]. To our knowledge, there is only one report to have investigated the effects of prophylactic antibiotic administration for tooth extraction on the prothrombin time-international normalized ratio (PT-INR) in patients taking warfarin [6].…”

Section: Introductionmentioning

confidence: 99%

“…This study investigated the effect of azithromycin (AZM) on INR values in patients taking warfarin [6].…”

Section: Introductionmentioning

confidence: 99%

Does prophylactic antibiotic administration for tooth extraction affect PT-INR in patients taking warfarin?

Iwata

Tachibana

Kusumoto

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Various antibiotics have been reported to interact with　warfarin. Reports to have investigated the effects of prophylactic antibiotic administration for tooth extraction in patients taking warfarin on the prothrombin time-international normalized ratio (PT-INR) are rare.Methods: A total of 110 patients receiving long-term stable warfarin therapy underwent tooth extraction without interruption of warfarin treatment. INR values were measured one month before the tooth extraction, the day of the extraction, and one week after the extraction. We investigated the changes of INR values between the day of extraction and one week after the extraction, as well as the various risk factors for increases in INR values.Results: Before and after tooth extraction, the number of patients taking cefcapene pivoxil, amoxicillin, and azithromycin was 57, 36, and 8, respectively. Nine patients were administered ampicillin before tooth extraction and received amoxicillin after their tooth extraction. One week after tooth extraction, the INR values increased beyond the therapeutic range in 3 out of 110 patients (2.7%). The INR values before tooth extraction in these three patients were close to 3.0. The INR value increased by more than twice as much in 1 of 110 patients (0.9%).Conclusion: Our results suggest that prophylactic antibiotic administration has little effect on their INR values when patients on stable warfarin therapy undergo tooth extraction. Surgeons have to take attention if the patients whose INR values are close to 3.0 before their extraction.

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Perioperative Management of Dental Patients on Anticoagulants

Wahl

2018

Hemostasis in Dentistry

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Effect of single-dose extended-release oral azithromycin on anticoagulation status in warfarinized patients

Cited by 12 publications

References 14 publications

Does tooth extraction and perioperative medication affect PT-INR of patients taking warfarin?

Does tooth extraction and perioperative medication affect PT-INR of patients taking warfarin?

Does prophylactic antibiotic administration for tooth extraction affect PT-INR in patients taking warfarin?

Perioperative Management of Dental Patients on Anticoagulants

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