Meyboom R H, Heere F J, Egberts A C, Lastdrager C J
Stichting Landelijke Registratie Evaluatie Bijwerkingen, Tilburg.
Ned Tijdschr Geneeskd. 1996 Feb 17;140(7):375-7.
Two patients, a women of 70 and a man of 75 years old, who were using phenprocoumon chronically, and were monitored by a regional thrombosis service, received a macrolide antibiotic, clarithromycin and roxithromycin respectively, for an airway infection. Both patients developed a serious increase in hypocoagulability, requiring administration of phytomenadione and temporary decreases in phenprocoumon dose. There were no bleeding complications. After the antibiotics were discontinued, the original dosage of phenprocoumon was needed again. It is suggested that in these patients the macrolide antibiotics may have potentiated the effect of phenprocoumon, perhaps as a result of inhibition of phenprocoumon transformation by liver enzymes. In patients receiving chronic treatment with phenprocoumon, coagulation parameters should be regularly checked if they are given a macrolide antibiotic such as clarithromycin, roxithromycin or erythromycin.
两名长期服用苯丙香豆素的患者，一名70岁女性和一名75岁男性，由当地血栓形成服务机构进行监测，他们分别因呼吸道感染接受了大环内酯类抗生素克拉霉素和罗红霉素治疗。两名患者的低凝性均严重增加，需要给予植物甲萘醌并暂时减少苯丙香豆素剂量。未出现出血并发症。停用抗生素后，又需要恢复苯丙香豆素的原剂量。提示在这些患者中，大环内酯类抗生素可能增强了苯丙香豆素的作用，这可能是由于肝酶对苯丙香豆素转化的抑制作用所致。在接受苯丙香豆素长期治疗的患者中，如果给予克拉霉素、罗红霉素或红霉素等大环内酯类抗生素，应定期检查凝血参数。
