title: Amoxicillin-related postextraction bleeding in an anticoagulated patient with tranexamic acid rinses.
abstract: This report describes a patient who had significant postoperative bleeding 4 days after undergoing surgery while using a tranexamic acid (4.8%) mouth rinse protocol for local control of hemostatis. Patients undergoing dentoalveolar surgery who are receiving chronic oral anticoagulants are treated with a tranexamic acid mouth rinse at our hospital. No systemic modification of their coagulation status is attempted. The postoperative bleeding problem that developed was determined to be caused by an antibiotic-induced vitamin K deficiency rather than a failure of the tranexamic acid protocol.
authors.affiliation: Madigan Army Medical Center, Tacoma, Wash, USA.
authors.forename: T
authors.initials: T
authors.lastname: Bandrowsky
authors.forename: A A
authors.initials: AA
authors.lastname: Vorono
authors.forename: T J
authors.initials: TJ
authors.lastname: Borris
authors.forename: H W
authors.initials: HW
authors.lastname: Marcantoni
mesh_terms: D000368:Aged; D000658:Amoxicillin / Q000009:adverse effects*; D000925:Anticoagulants / Q000009:adverse effects*; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D017742:Dental Care for Chronically Ill / Q000009:adverse effects*; D004347:Drug Interactions; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D010406:Penicillins / Q000009:adverse effects*; D019106:Postoperative Hemorrhage / Q000209:etiology*; D014081:Tooth Extraction / Q000009:adverse effects; D014148:Tranexamic Acid / Q000627:therapeutic use*; D014813:Vitamin K Deficiency / Q000150:complications* / Q000209:etiology*; D014859:Warfarin / Q000009:adverse effects
chemical_list: D000925:Anticoagulants; D000933:Antifibrinolytic Agents; D010406:Penicillins; D014859:Warfarin; D014148:Tranexamic Acid; D000658:Amoxicillin