[The interaction between anticoagulant therapy with vitamin K-antagonists and treatment with antibiotics: a practical recommendation].

M Zelis, S Zweegman, F J M van der Meer, M H H Kramer, Y M Smulders

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--In users of vitamin K-antagonists (VKA), antibiotics can lead to excessive anticoagulation. --It is unclear what the optimal policy is for prevention of an excessive anticoagulant effect during use of antibiotics. --This article describes the increased sensitivity to VKA during use of antibiotics, and also provides a practical recommendation for the correct method for use of antibiotics in combination with VKA treatment. --During use of antibiotics for more than one day, the prothrombin time-'international normalized ratio' (PTT-INR) must be checked both after 3 and after 7 days, and the dose of VKA must be adapted if necessary. --Use of co-trimoxazole for more than one day should, if possible, be avoided.
Original languageEnglish
Pages (from-to)1042-1046
Number of pages5
JournalNederlands Tijdschrift voor Geneeskunde
Issue number18
Publication statusPublished - May 2008


  • Anti-Bacterial Agents
  • Anticoagulants
  • Drug Interactions
  • Hemorrhage
  • Humans
  • International Normalized Ratio
  • Risk Factors
  • Vitamin K
  • antagonists & inhibitors
  • chemically induced
  • prevention & control
  • therapeutic use

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