Beta-Lactam Antibiotics and Vitamin K
Authors: Albano Del Favero, Giancarlo Agnelli, Pasquale Parise
Journal: Annals of Internal Medicine (1992)

Letters15 June 1992Beta-Lactam Antibiotics and Vitamin KAlbano Del Favero, MD, Giancarlo Agnelli, MD, Pasquale Parise, MDAlbano Del Favero, MDSearch for more papers by this author, Giancarlo Agnelli, MDSearch for more papers by this author, Pasquale Parise, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-116-12-1034_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editors: In their recent study, Winston and coworkers (1) administered prophylactic vitamin K to all their patients to prevent hypoprothrombinemia and bleeding associated with the use of some β-lactam antibiotics (2). We disagree with their conclusion that "it may be prudent to give prophylactic vitamin K to all granulocytopenic patients regardless of the antibiotic regimen" on the basis that hypoprothrombinemia has been reported not only in patients receiving β-lactams containing the N-methylthiotetrazole (MTT) side chain but also in patients receiving other antibiotics not containing the MTT group.Structurally different β-lactams exert different effects on vitamin K-dependent clotting factor...References1. WinstonHoBrucknerChamplin DGDR. Beta-lactam antibiotic therapy in febrile granulocytopenic patients: a randomized trial comparing cefoperazone plus piperacilline, ceftazidime plus piperacilline and imipenem alone. Ann Intern Med. 1991;115:849-59. LinkGoogle Scholar2. SattlerWeitekampBalland FMJ. Potential for bleeding with the beta-lactam antibiotics. Ann Intern Med. 1986;105:924-31. LinkGoogle Scholar3. AgnelliDel FaveroParise GAP. Cephalosporininduced hypoprothrombinemia: is the N-methylthiotetrazole side chain the culprit? Antimicrob Agents Chemother. 1986;29:1108-9. CrossrefMedlineGoogle Scholar1. SattlerWeitekampBallard FMJ. Potential for bleeding with the beta-lactam antibiotics. Ann Intern Med. 1986;105:924-31. LinkGoogle Scholar2. WinstonHoBrucknerChamplin DWDR. Beta-lactam antibiotic therapy in febrile granulocytopenic patients: a randomized trial comparing cefoperazone plus piperacillin, ceftazidime plus piperacillin, and imipenem alone. Ann Intern Med. 1991;115:849-59. LinkGoogle Scholar3. GreselaWalawanderWelage TCL. Prospective surveillance of antibiotic-associated coagulopathy in 970 patients. Pharmacotherapy. 1989;3:158-64. CrossrefGoogle Scholar1. WinstonHoBrucknerChamplin DWDR. Beta-lactam antibiotic therapy in febrile granulocytopenic patients. Ann Intern Med. 1991;115:849-59. LinkGoogle Scholar1. WinstonHoBrucknerChamplin DWDR. Beta-lactam antibiotic therapy in febrile granulocytopenic patients. Ann Intern Med. 1991;115:849-59. LinkGoogle Scholar2. . Ethics Manual. Philadelphia: American College of Physicians; 1989:14-5. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: University of Perugia Perugia Italy PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 June 1992Volume 116, Issue 12_Part_1Page: 1034-1035KeywordsAntibioticsHemorrhageVitamin K Issue Published: 15 June 1992 PDF DownloadLoading ...