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Please use this identifier to cite or link to this item: http://hdl.handle.net/1807/18297

Title: Upper Gastrointestinal Hemorrhage During Warfarin Therapy Associated with Co-Trimoxazole and other Urinary Tract Anti-infectives
Authors: Fischer, Hadas Daisy
Advisor: Laupacis, Andreas
Department: Health Policy, Management and Evaluation
Keywords: warfarin
antibiotics
Issue Date: 18-Jan-2010
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.
URI: http://hdl.handle.net/1807/18297
Appears in Collections:Master
The Institute of Health Policy, Management and Evaluation - Master theses

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