期刊
ANTIBIOTICS-BASEL
卷 10, 期 1, 页码 -出版社
MDPI
DOI: 10.3390/antibiotics10010038
关键词
drug interactions; endocarditis; rifampicin; vitamin K antagonists
资金
- [02-091Warsaw]
Management of staphylococcal prosthetic valve endocarditis patients requires consideration of drug interactions between rifampicin and vitamin K antagonists. Two different strategies, including up-titrating warfarin dose and modifying warfarin dosage based on pharmacological aspects, have been applied to address the adverse drug interactions in clinical cases.
According to current European Society of Cardiology guidelines, for staphylococcal prosthetic valve endocarditis, rifampicin should be one of the drugs used. However, there is a concomitant need for vitamin K antagonists in patients with mechanical prostheses. It is widely known that rifampicin interacts with vitamin K antagonists (VKA), and this interaction makes it difficult to maintain the INR (international normalized ratio) value in the therapeutic range. We present two clinical cases of staphylococcal prosthetic valve endocarditis patients. Two different strategies for dealing with adverse drug interactions have been applied. In the first case, the dose of warfarin was up-titrated until the optimal INR value was obtained. In the second case, due to the history of labile INR values, a decision was made to modify the dosage of warfarin, taking into account pharmacological aspects of drug interactions.
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