Skip to main content
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1991 Sep;44(9):738–741. doi: 10.1136/jcp.44.9.738

Antibiotic treatment and associated prolonged prothrombin time.

K J Williams 1, R P Bax 1, H Brown 1, S J Machin 1
PMCID: PMC496719  PMID: 1918399

Abstract

The incidence and type of pathology causing a prolonged prothrombin time and clinical bleeding episodes were assessed in a multicentre study of 1109 patients receiving cefotetan, a N-methyl-thiotetrazole (NMTT), or equivalent antibiotics. There was no significant difference in the incidence of a prolonged prothrombin time (9.9% with cefotetan, 8.0% with comparable antibiotics) of clinical bleeding episodes. However, prothrombin time increases of greater than 12 seconds were significantly (p = 0.002) greater with cefotetan (3.8%) than with comparators (0.8%). In both antibiotic groups increases in prothrombin time were more likely following surgery and in patients who were older, with a high platelet count, low albumin, or higher urea and creatinine concentrations. All antibiotic treatment can be associated with prolonged prothrombin times and new agents should always be assessed in a large multicentre study before the practical, clinical importance of haemostatic defects can be defined.

Full text

PDF
738

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bang N. U., Tessler S. S., Heidenreich R. O., Marks C. A., Mattler L. E. Effects of moxalactam on blood coagulation and platelet function. Rev Infect Dis. 1982 Nov-Dec;4 (Suppl):S546–S554. doi: 10.1093/clinids/4.supplement_3.s546. [DOI] [PubMed] [Google Scholar]
  2. Baxter J. G., Marble D. A., Whitfield L. R., Wels P. B., Walczak P., Schentag J. J. Clinical risk factors for prolonged PT/PTT in abdominal sepsis patients treated with moxalactam or tobramycin plus clindamycin. Ann Surg. 1985 Jan;201(1):96–102. [PMC free article] [PubMed] [Google Scholar]
  3. Bechtold H., Andrassy K., Jähnchen E., Koderisch J., Koderisch H., Weilemann L. S., Sonntag H. G., Ritz E. Evidence for impaired hepatic vitamin K1 metabolism in patients treated with N-methyl-thiotetrazole cephalosporins. Thromb Haemost. 1984 Jul 29;51(3):358–361. [PubMed] [Google Scholar]
  4. Bowcock S., Mackie I. J., Ho D., Moulsdale M., Billings P., Machin S. J. Effects of various doses of latamoxef (moxalactam) on haemostasis. J Hosp Infect. 1986 Sep;8(2):193–199. doi: 10.1016/0195-6701(86)90046-0. [DOI] [PubMed] [Google Scholar]
  5. Brown C. H., 3rd, Natelson E. A., Bradshaw W., Williams T. W., Jr, Alfrey C. P., Jr The hemostatic defect produced by carbenicillin. N Engl J Med. 1974 Aug 8;291(6):265–270. doi: 10.1056/NEJM197408082910601. [DOI] [PubMed] [Google Scholar]
  6. Cohen H., Scott S. D., Mackie I. J., Shearer M., Bax R., Karran S. J., Machin S. J. The development of hypoprothrombinaemia following antibiotic therapy in malnourished patients with low serum vitamin K1 levels. Br J Haematol. 1988 Jan;68(1):63–66. doi: 10.1111/j.1365-2141.1988.tb04180.x. [DOI] [PubMed] [Google Scholar]
  7. Ham J. M. Hypoprothrombinaemia in patients undergoing prolonged intensive care. Med J Aust. 1971 Oct 2;2(14):716–718. doi: 10.5694/j.1326-5377.1971.tb92503.x. [DOI] [PubMed] [Google Scholar]
  8. Holt J. Hypoprothrombinemia and bleeding diathesis associated with cefotetan therapy in surgical patients. Arch Surg. 1988 Apr;123(4):523–523. doi: 10.1001/archsurg.1988.01400280137028. [DOI] [PubMed] [Google Scholar]
  9. Hooper C. A., Haney B. B., Stone H. H. Gastrointestinal bleeding due to vitamin K deficiency in patients on parenteral cefamandole. Lancet. 1980 Jan 5;1(8158):39–40. doi: 10.1016/s0140-6736(80)90571-1. [DOI] [PubMed] [Google Scholar]
  10. Lipsky J. J. Mechanism of the inhibition of the gamma-carboxylation of glutamic acid by N-methylthiotetrazole-containing antibiotics. Proc Natl Acad Sci U S A. 1984 May;81(9):2893–2897. doi: 10.1073/pnas.81.9.2893. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Mackie I. J., Walshe K., Cohen H., McCarthy P., Shearer M., Scott S. D., Karran S. J., Machin S. J. Effects of N-methyl-thiotetrazole cephalosporin on haemostasis in patients with reduced serum vitamin K1 concentrations. J Clin Pathol. 1986 Nov;39(11):1245–1249. doi: 10.1136/jcp.39.11.1245. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Pakter R. L., Russell T. R., Mielke C. H., West D. Coagulopathy associated with the use of moxalactam. JAMA. 1982 Sep 3;248(9):1100–1100. [PubMed] [Google Scholar]
  13. Remuzzi G. Bleeding in renal failure. Lancet. 1988 May 28;1(8596):1205–1208. doi: 10.1016/s0140-6736(88)92019-3. [DOI] [PubMed] [Google Scholar]
  14. Smith K. S., Quintiliani R., Nightingale C. H. Cefotetan-associated coagulopathies. Arch Surg. 1989 Mar;124(3):388–388. doi: 10.1001/archsurg.1989.01410030138024. [DOI] [PubMed] [Google Scholar]
  15. Weitekamp M. R., Caputo G. M., Al-Mondhiry H. A., Aber R. C. The effects of latamoxef, cefotaxime, and cefoperazone on platelet function and coagulation in normal volunteers. J Antimicrob Chemother. 1985 Jul;16(1):95–101. doi: 10.1093/jac/16.1.95. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES