Key result
Adding antibiotics to warfarin linked to over-anticoagulation and potentially fatal retroperitoneal haematoma.
Why the study?
Several commonly prescribed antibiotics interact with warfarin, increasing anticoagulant effect and causing potentially fatal retroperitoneal haematoma complications.
Case Report (n=2)
Commonly prescribed antibiotics can interact with warfarin to cause severe over-anticoagulation, leading to potentially fatal retroperitoneal haematoma.
May warrant closer INR monitoring with antibiotic co-prescription in warfarin patients; hypothesis-generating and should not yet change practice.
Several commonly prescribed antibiotics are known to interact with warfarin, increasing its anticoagulant effect by different mechanisms. Retroperitoneal bleeding with consequent haematoma is recognised as a complication of over-anticoagulation. Consequences, which are potentially fatal, include hypovolaemic shock and compression of retroperitoneal structures such as the ureter and inferior vena cava.
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S Phillips (2005) conducted a case report in Retroperitoneal haematoma (n=2). Antibiotics and warfarin interaction was evaluated on Retroperitoneal bleeding with consequent haematoma. Interaction between commonly prescribed antibiotics and warfarin can cause over-anticoagulation resulting in potentially fatal retroperitoneal haematoma.
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