Bleeding diathesis associated with beta‐lactam antibiotics

J, Fornells; Grau, Enrique Bassas; Montserrat, I; Muñoz, Carolina; Alperi-López, Mercedes; Fontcuberta, J; Félez, Jordi

doi:10.1111/j.1600-0609.1990.tb00474.x

Cited by 2 publications

(2 citation statements)

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“…Furthermore, prolonged bleeding time, and clinically significant bleeding episodes, have also been reported (Brown et al 1974;Weitekamp & Aber 1983;Sattler et al 1986;Fornells et al 1990). There are no clinical references to bleeding episodes or antiplatelet effects after therapeutic administration of the b-lactams selected for this study (Tartaglione et al 1986;Agnelli et al 1987;Fass et al 1987;Graninger et al 1987).…”

mentioning

confidence: 99%

“…It has been demonstrated that some antibiotics sharing the b-lactam structure show platelet anti-aggregatory effects in vitro at high concentrations, greatly in excess of therapeutic range (Shattil et al 1980;Bang et al 1982;Fletcher et al 1986;Tartaglione et al 1986;Nakano et al 1987;Mihara et al 1988;Burroughs & Johnson 1990;Pastakia et al 1993) and also in some patients receiving repeated therapeutic doses (Brown et al 1974;Bang et al 1982;Burroughs & Johnson 1990;Fornells et al 1990). Furthermore, prolonged bleeding time, and clinically significant bleeding episodes, have also been reported (Brown et al 1974;Weitekamp & Aber 1983;Sattler et al 1986;Fornells et al 1990).…”

mentioning

confidence: 99%

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β‐Lactam Antibiotic‐Mediated Changes in Platelet Reactivity and Vascular Endothelial Functions

Togna¹,

Togna

Caprino

2001

Pharmacology & Toxicology

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To evaluate vascular and platelet compatibility of intravenous administration of b-lactam antibiotics, we assessed the effects of therapeutic concentrations of ceftriaxone, aztreonam, and ceftazidime on platelet reactivity to different agonists (sodium arachidonate, collagen and adenosine diphosphate) and on selected vascular endothelial functions (adenosine diphosphatase activity, prostacyclin production and t-PA release). Ceftriaxone and, to a lesser degree, aztreonam, enhanced platelet reactivity, evaluated as onset of platelet aggregating response, and increased thromboxane production to subthreshold concentrations of arachidonate. There was no modification in platelet reactivity after ceftazidime treatment. Ceftriaxone and ceftazidime, but not aztreonam, inhibited endothelial adenosine diphosphatase activity. Prostacyclin production and t-PA release were inhibited only by ceftriaxone at high concentrations. While it is difficult to establish which marker (platelet or endothelial functions) has more clinical reference in human vascular compatibility, it seems feasible to consider aztreonam the most compatible of the b-lactams studied.

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