Interaction of antibiotics and warfarin in pediatric cardiology patients.
Antibiotics are known to alter the anticoagulation induced by warfarin in adults, but little is known about this interaction in children. In a retrospective review of patients under the age of 21 years, we found that antibiotic therapy (89 courses of antibiotics in 23 patients) was associated with an increase in the mean international normalized ratio (INR) from 2.7 to 3.6. The change in INR correlated inversely with patient age. These data suggest that more intensive monitoring of the INR after starting antibiotics may help to mitigate excessive anticoagulation in children receiving warfarin.
Johnson
M C
MC
Division of Pediatric Cardiology, Department of Pediatrics, Washington University School of Medicine/St. Louis Children's Hospital, 1 Children's Place, St. Louis, MO 63110, USA. Johnson_m@kids.wustl.edu
Wood
M
M
Vaughn
V
V
Cowan
L
L
Sharkey
A M
AM
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D000925:Anticoagulants / Q000494:pharmacology* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004347:Drug Interactions; D006330:Heart Defects, Congenital / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019934:International Normalized Ratio; D012189:Retrospective Studies; D016896:Treatment Outcome; D014859:Warfarin / Q000494:pharmacology* / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D000925:Anticoagulants; D014859:Warfarin