27 January 2014 : Case report
Acute warfarin toxicity: An unanticipated consequence of amoxicillin/clavulanate administration
Unusual clinical course, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Unexpected drug reaction, Educational Purpose (only if useful for a systematic review or synthesis)
Timothy LarsenABCDEFG, Alehegn GelayeABCDEFG, Christopher DurandoABCDEFGDOI: 10.12659/AJCR.889866
Am J Case Rep 2014; 15:45-48
Abstract
Background: Warfarin remains the most common anticoagulant in the management of thromboembolic diseases. However, its extensive drug interaction requires frequent monitoring and dose adjustments. Almost all antibiotics, including penicillins, have the potential to interact with warfarin causing either under or over anticoagulation which increases the risk for thrombus formation and significant bleeding respectively.
Case Report: A 53-year-old Caucasian male with a history of protein C deficiency and recurrent intravascular thrombosis developed a dental abscess. He was treated with amoxicillin/clavulanate 500/125 mg twice daily and referred to a dentist. He developed significant bleeding after tooth extraction. INR was 20.4. He received fresh frozen plasma and vitamin K with resolution of bleeding.
Conclusions: While rare, clinically significant prolonged prothrombin time and potentially life threatening bleeding can occur when amoxicillin/clavulanate is concomitantly administered with warfarin. Prompt recognition and intervention is necessary to avoid life threatening complications from warfarin-amoxicillin/clavulanate interaction
Keywords: Warfarin - adverse effects, supratherapeutic INR, Amoxicillin, Protein C Deficiency, Clavulanic Acid
In Press
18 Mar 2024 : Case report
Perineal Benign Symmetric Lipomatosis in a Female Patient: A Case ReportAm J Case Rep In Press; DOI: 10.12659/AJCR.943803
18 Mar 2024 : Case report
Successful Endovascular Microembolization for Post-Traumatic High-Flow Priapism: A Case ReportAm J Case Rep In Press; DOI: 10.12659/AJCR.943467
19 Mar 2024 : Case report
Jejunal Diverticulosis Causing Small Intestinal Volvulus and Closed Loop ObstructionAm J Case Rep In Press; DOI: 10.12659/AJCR.943376
19 Mar 2024 : Case report
Excimer Laser Therapy for Pigmented Purpuric Dermatosis: A Case StudyAm J Case Rep In Press; DOI: 10.12659/AJCR.942853
Most Viewed Current Articles
07 Mar 2024 : Case report
Neurocysticercosis Presenting as Migraine in the United StatesDOI :10.12659/AJCR.943133
Am J Case Rep 2024; 25:e943133
10 Jan 2022 : Case report
A Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...DOI :10.12659/AJCR.935263
Am J Case Rep 2022; 23:e935263
19 Jul 2022 : Case report
Atlantoaxial Subluxation Secondary to SARS-CoV-2 Infection: A Rare Orthopedic Complication from COVID-19DOI :10.12659/AJCR.936128
Am J Case Rep 2022; 23:e936128
23 Feb 2022 : Case report
Penile Necrosis Associated with Local Intravenous Injection of CocaineDOI :10.12659/AJCR.935250
Am J Case Rep 2022; 23:e935250