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Comparison of interactions between warfarin and cephalosporins with and without the N-methyl-thio-tetrazole side chain

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Title: Comparison of interactions between warfarin and cephalosporins with and without the N-methyl-thio-tetrazole side chain
Authors: Imai, Shungo Browse this author →KAKEN DB
Kadomura, Shota Browse this author
Momo, Kenji Browse this author →KAKEN DB
Kashiwagi, Hitoshi Browse this author →KAKEN DB
Sato, Yuki Browse this author →KAKEN DB
Miyai, Takayuki Browse this author
Sugawara, Mitsuru Browse this author →KAKEN DB
Takekuma, Yoh Browse this author →KAKEN DB
Keywords: Cephalosporin
Claims database
Drug-drug interaction
Issue Date: Nov-2020
Publisher: Elsevier
Journal Title: Journal of infection and chemotherapy
Volume: 26
Issue: 11
Start Page: 1224
End Page: 1228
Publisher DOI: 10.1016/j.jiac.2020.07.014
Abstract: Cephalosporins with an N-methyl-thio-tetrazole (NMTT) side chain interact with warfarin by reducing the production of blood clotting factors. However, cephalosporins without the NMTT side chain also enhance the effects of warfarin. Thus, we aimed to compare the effects of warfarin modified by cephalosporins with and without the NMTT side chain, using a Japanese health insurance claims database. The inclusion criteria were patients who (1) intravenously received secondor third-generation cephalosporins between April 2010 and March 2017 and (2) received warfarin during cephalosporin therapy. Patients were administered either cephalosporins with the NMTT side chain (NMTT group) or those without NMTT (non-NMTT group). After matching patient data by propensity score, the following outcomes were compared between the two groups: (1) proportion of patients administered vitamin K, (2) proportion of bleeding events, and (3) changes in the daily dose of warfarin. Among 203 patients, 100 patients (50 per group) were matched by the propensity score. The proportion of patients administered vitamin K was 6.0% in both groups. These patients intravenously received a single dose of menatetrenone; no bleeding was observed. The proportion of patients subjected to a reduction in the daily dose of warfarin was 6.5% and 4.3% in the NMTT and non-NMTT groups, respectively. As our study had a small sample size, we could not determine whether the risk of over anticoagulation of warfarin is affected by cephalosporins with or without NMTT side chain. However, we showed the bleeding risk was sufficiently low regardless of the presence/absence of the NMTT side chain. (c) 2020 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Rights: © 2020. This manuscript version is made available under the CC-BY-NC-ND 4.0 license
Type: article (author version)
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 武隈 洋

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