Potential for bleeding with the new beta-lactam antibiotics

F. R. Scattler, M. R. Weitekamp, James Ballard

Research output: Contribution to journalReview article

67 Citations (Scopus)

Abstract

Several new beta-lactam antibiotics impair normal hemostasis. Hypoprothrombinemia has occurred frequently with cephalosporins that possess a methylthiotetrazole substitution (cefamandole, moxalactam, and cefoperazone). The incidence ranges from 4% to 68%, and the risk is greatest in debilitated patients with cancer, intra-abdominal infection, or renal failure. Impaired platelet function caused by perturbation of agonist receptors on the platelet surface has occurred primarily with beta-lactam antibiotics having an alpha-carboxyl substitution (moxalactam, carbenicillin, and ticarcillin). These antibiotics often cause the template bleeding time to be markedly prolonged (> 20 minutes). Acylureidopenicillins, which lack the alpha-carboxyl marker, impair platelet function less frequently and only modestly prolong the bleeding time. If serious hemorrhage occurs, hypoprothrombinemia associated with methylthiotetrazole-substituted cephalosporins should be treated with fresh frozen plasma. Likewise, dangerous bleeding due to impaired platelet aggretation requires treatment with platelet concentrates.

Original languageEnglish (US)
Pages (from-to)924-931
Number of pages8
JournalAnnals of internal medicine
Volume105
Issue number6
StatePublished - Dec 1 1986

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beta-Lactams
Blood Platelets
Hemorrhage
Anti-Bacterial Agents
Hypoprothrombinemias
Moxalactam
Bleeding Time
Cephalosporins
Cefamandole
Ticarcillin
Intraabdominal Infections
Carbenicillin
Cefoperazone
Hemostasis
Renal Insufficiency
Incidence
Neoplasms

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

Scattler, F. R., Weitekamp, M. R., & Ballard, J. (1986). Potential for bleeding with the new beta-lactam antibiotics. Annals of internal medicine, 105(6), 924-931.
Scattler, F. R. ; Weitekamp, M. R. ; Ballard, James. / Potential for bleeding with the new beta-lactam antibiotics. In: Annals of internal medicine. 1986 ; Vol. 105, No. 6. pp. 924-931.
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Scattler, FR, Weitekamp, MR & Ballard, J 1986, 'Potential for bleeding with the new beta-lactam antibiotics', Annals of internal medicine, vol. 105, no. 6, pp. 924-931.

Potential for bleeding with the new beta-lactam antibiotics. / Scattler, F. R.; Weitekamp, M. R.; Ballard, James.

In: Annals of internal medicine, Vol. 105, No. 6, 01.12.1986, p. 924-931.

Research output: Contribution to journalReview article

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Scattler FR, Weitekamp MR, Ballard J. Potential for bleeding with the new beta-lactam antibiotics. Annals of internal medicine. 1986 Dec 1;105(6):924-931.