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Two Strategies for the Dosage of Acenocoumarol Co-Administered with Rifampicin in Staphylococcal Prosthetic Valve Endocarditis

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 inte...

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Autores principales: Wełnicki, Marcin, Buksińska-Lisik, Małgorzata, Mamcarz, Artur
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7824006/
https://www.ncbi.nlm.nih.gov/pubmed/33401531
http://dx.doi.org/10.3390/antibiotics10010038
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author Wełnicki, Marcin
Buksińska-Lisik, Małgorzata
Mamcarz, Artur
author_facet Wełnicki, Marcin
Buksińska-Lisik, Małgorzata
Mamcarz, Artur
author_sort Wełnicki, Marcin
collection PubMed
description 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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spelling pubmed-78240062021-01-24 Two Strategies for the Dosage of Acenocoumarol Co-Administered with Rifampicin in Staphylococcal Prosthetic Valve Endocarditis Wełnicki, Marcin Buksińska-Lisik, Małgorzata Mamcarz, Artur Antibiotics (Basel) Case Report 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. MDPI 2021-01-03 /pmc/articles/PMC7824006/ /pubmed/33401531 http://dx.doi.org/10.3390/antibiotics10010038 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Wełnicki, Marcin
Buksińska-Lisik, Małgorzata
Mamcarz, Artur
Two Strategies for the Dosage of Acenocoumarol Co-Administered with Rifampicin in Staphylococcal Prosthetic Valve Endocarditis
title Two Strategies for the Dosage of Acenocoumarol Co-Administered with Rifampicin in Staphylococcal Prosthetic Valve Endocarditis
title_full Two Strategies for the Dosage of Acenocoumarol Co-Administered with Rifampicin in Staphylococcal Prosthetic Valve Endocarditis
title_fullStr Two Strategies for the Dosage of Acenocoumarol Co-Administered with Rifampicin in Staphylococcal Prosthetic Valve Endocarditis
title_full_unstemmed Two Strategies for the Dosage of Acenocoumarol Co-Administered with Rifampicin in Staphylococcal Prosthetic Valve Endocarditis
title_short Two Strategies for the Dosage of Acenocoumarol Co-Administered with Rifampicin in Staphylococcal Prosthetic Valve Endocarditis
title_sort two strategies for the dosage of acenocoumarol co-administered with rifampicin in staphylococcal prosthetic valve endocarditis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7824006/
https://www.ncbi.nlm.nih.gov/pubmed/33401531
http://dx.doi.org/10.3390/antibiotics10010038
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