Risiko Kejadian Perdarahan Pasca Rawat Inap pada Penggunaan Bersamaan Warfarin dan Antibiotik

Abstract

Concomitant use of warfarin and antibiotics is known to increase bleeding risk. Major bleeding related to warfarin use can be fatal and lead to patient’s death. This research aimed to analyze the interaction of warfarin with antibiotics and its effect on bleeding event at the first hospital visit following inpatient discharge in RSUD Wates. This was a retrospective cohort study of 67 warfarin uses in inpatient settings with/without antibiotic coadministration. All the data including diagnosis, medication in use, laboratory test results, and bleeding event at hospitalization and first hospital visit were extracted from the patient’s medical record from January 2018 to September 2020. Statistical analysis was performed using Chi-square test or Fisher exact test and Independent t-test or Mann Whitney U test. Statistical difference was found in the bleeding event throughout seven days following inpatient discharge between antibiotic and control group (16%; 0%; p = 0.017). Antibiotics related to the bleeding event were azithromycin, ampicillin-sulbactam, cephalosporins, and quinolones. Types of the bleeding event were hematemesis melena (25%), hematuria (50%), and unknown (25%). This study concludes that concurrent use of warfarin and antibiotics in hospitalized patients may influence the risk of bleeding events for seven days post-hospitalization.