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

Imai, Shungo; Kadomura, Shota; Momo, Kenji; Kashiwagi, Hitoshi; Sato, Yuki; Miyai, Takayuki; Sugawara, Mitsuru; Takekuma, Yoh

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

Imai, Shungo; Kadomura, Shota; Momo, Kenji et al.

Journal of infection and chemotherapy, 2020, 26(11), 1224-1228

Permalink : https://hdl.handle.net/2115/83144

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論文情報

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アクセス権	open access
URI	https://hdl.handle.net/2115/83144
タイトル	Comparison of interactions between warfarin and cephalosporins with and without the N-methyl-thio-tetrazole side chain
著者	Imai, Shungo ; Kadomura, Shota ; Momo, Kenji ; Kashiwagi, Hitoshi ; Sato, Yuki ; Miyai, Takayuki ; Sugawara, Mitsuru ; Takekuma, Yoh
e-Rad_Researcher 40845070 著者名 Imai, Shungo
著者名 Kadomura, Shota
e-Rad_Researcher 30645552 著者名 Momo, Kenji
e-Rad_Researcher 60510609 著者名 Kashiwagi, Hitoshi
e-Rad_Researcher 00564981 著者名 Sato, Yuki
著者名 Miyai, Takayuki
e-Rad_Researcher 60332467 著者名 Sugawara, Mitsuru
e-Rad_Researcher 00396293 著者名 Takekuma, Yoh
言語	英語
キーワード	Cephalosporin
	Claims database
	Drug-drug interaction
	Bleeding
	Warfarin
発行日	2020-11
出版者	Elsevier
収録物名	Journal of infection and chemotherapy
巻(号)	26(11)
ページ	1224-1228
抄録	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.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
権利情報	Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
権利情報	© 2020. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
PISSN	1341-321X
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1016/j.jiac.2020.07.014