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Please use this identifier to cite or link to this item: https://scholars.lib.ntu.edu.tw/handle/123456789/532649
Title: Use of hypoprothrombinemia-inducing cephalosporins and the risk of hemorrhagic events: A nationwide nested case-control study
Authors: Chen L.-J.
FEI-YUAN HSIAO 
LI-JIUAN SHEN 
FE-LIN LIN WU 
Tsay W.
CHIEN-CHING HUNG 
SHU-WEN LIN 
Issue Date: 2016
Journal Volume: 11
Journal Issue: 7
Start page/Pages: e0158407
Source: PLoS ONE
Abstract: 
Objective Existing data regarding the risk of hemorrhagic events associated with exposure to hypoprothrombinemia-inducing cephalosporins are limited by the small sample size. This population-based study aimed to examine the association between exposure to hypoprothrombinemia-inducing cephalosporins and hemorrhagic events using National Health Insurance Research Database in Taiwan. Design A nationwide nested case-control study. Setting National Health Insurance Research database. Participants We conducted a nested case-control study within a cohort of 6191 patients who received hypoprothrombinemia-inducing cephalosporins and other antibiotics for more than 48 hours. Multivariable conditional logistic regressions were used to calculate the adjusted odds ratio (aOR) and 95% confidence interval (CI) for hemorrhagic events associated with exposure to hypoprothrombinemia-inducing cephalosporins (overall, cumulative dose measured as defined daily dose (DDD), and individual cephalosporins). Results Within the cohort, we identified 704 patients with hemorrhagic events and 2816 matched controls. Use of hypoprothrombinemia-inducing cephalosporins was associated with increased risk of hemorrhagic events (aOR, 1.71; 95% CI, 1.42–2.06), which increased with higher cumulative doses (<3 DDDs, aOR 1.62; 3–5 DDDs, aOR 1.78; and >5 DDDs, aOR 1.89). The aOR for individual cephalosporin was 2.88 (95% CI, 2.08–4.00), 1.35 (1.09–1.67) and 4.57 (2.63–7.95) for cefmetazole, flomoxef, and cefoperazone, respectively. Other risk factors included use of anticoagulants (aOR 2.08 [95% CI, 1.64–2.63]), liver failure (aOR 1.69 [1.30–2.18]), poor nutritional status (aOR 1.41 [1.15–1.73]), and history of hemorrhagic events (aOR 2.57 [1.94–3.41]) 6 months prior to the index date. Conclusions Use of hypoprothrombinemia-inducing cephalosporins increases risk of hemorrhagic events. Close watch for hemorrhagic events is recommended when prescribing these cephalosporins, especially in patients who are at higher risk. ? 2016 Chen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
URI: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85024393175&doi=10.1371%2fjournal.pone.0158407&partnerID=40&md5=57c418a0c7d200bce03bae0ff4df2a51
https://scholars.lib.ntu.edu.tw/handle/123456789/532649
ISSN: 19326203
DOI: 10.1371/journal.pone.0158407
SDG/Keyword: cephalosporin derivative; adult; aged; case control study; chemically induced; cohort analysis; female; Hemorrhage; human; hypoprothrombinemia; male; middle aged; Taiwan; young adult; Adult; Aged; Case-Control Studies; Cephalosporins; Cohort Studies; Female; Hemorrhage; Humans; Hypoprothrombinemias; Male; Middle Aged; Taiwan; Young Adult
[SDGs]SDG3
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