Reduced oral contraceptive effectiveness with concurrent antibiotic use: a protocol for prescribing antibiotics to women of childbearing age
Autor: | T G, Donley, R F, Smith, B, Roy |
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Rok vydání: | 1990 |
Předmět: | |
Zdroj: | Compendium (Newtown, Pa.). 11(6) |
ISSN: | 0894-1009 |
Popis: | A brief literature review and update on the effect of concurrent antibiotic administration with oral contraceptive use is presented for dentists, with advice on how to manage antibiotic prescription to minimize legal repercussions in case of contraceptive failure. In the U.S. approximately 30% of women of childbearing age are using oral contraceptives, so it is quite likely that a dentist prescribing antibiotics may encounter patients on these agents. Since 1971 reports of breakthrough bleeding or contraceptive failure have concerned rifampicin, penicillins, tetracyclines, erythromycin, metronidazlole, sulfonamides, griseofulvin and cephalosporins. There have been 63 reported contraceptive failures to the British Committee on Safety of Medicine, and 29 reports to the U.S. Dept. of Health and Human Services. A case of contraceptive failure in a woman prescribed antibiotics by her dentist has been ruled in favor of the woman, making the dentist responsible for child support. The probable mechanisms for these failures are diminished enterohepatic re-circulation due to elimination of bacteria that regenerate active estrogens from conjugated estrogens in the gut, and induction of liver cytochrome P450 enzymes resulting in faster catabolism of the drugs. There are conflicting reports in the literature on how or whether these mechanisms are active in clinical situations. For the working dental practitioner it is recommended that a history of contraceptive use be taken and signed by the patient; that the dentist inform the patient of possible lower contraceptive efficacy; that the woman taking antibiotics be advised to use additional means of contraception throughout the cycle; and that women on long-term antibiotics be urged to consult their physician about increasing the does of oral contraceptives. All this advice and the antibiotic prescription should be documented in the patient's chart. |
Databáze: | OpenAIRE |
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