Upper Gastrointestinal Hemorrhage During Warfarin Therapy Associated with Co-Trimoxazole and other Urinary Tract Anti-infectives
Year: 2010
Type: dissertation
Study design: Observational Study
Abstract: Some antibiotics, including co-trimoxazole, inhibit warfarin’s metabolism and may be associated with greater risk of hemorrhage in warfarin-treated patients. This thesis examines the risk of upper gastrointestinal (UGI) hemorrhage in older patients receiving warfarin and antibiotics commonly used to treat urinary tract infections, with a focus on co-trimoxazole. This population-based nested case-control study using Ontario healthcare databases, identified residents aged 66 years or older continuously on warfarin (n=134,637). Cases were those hospitalized with UGI hemorrhage (n=2151). Cases were nearly 4 times more likely than controls to have recently received co-trimoxazole (adjusted odds ratio (OR), 3.84; 95% confidence interval (CI) 2.33 – 6.33). Ciprofloxacin was also associated with an increased risk (adjusted OR 1.94; 95% CI 1.28 – 2.95), but no significant association was observed with amoxicillin, ampicillin, nitrofurantoin or norfloxacin. Among older patients receiving warfarin, co-trimoxazole is associated with a significantly higher risk of UGI hemorrhage than other commonly used antibiotics.
Source: TSpace (University of Toronto)
Author: Hadas D. Fischer
Language: English
Subfield: Gastroenterology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2735627810