Positive Direct Coombs Tests Due to Cephalothin

Molthan, Lyndall; Reidenberg, Marcus M.; Eichman, Mary F.

doi:10.1056/nejm196707202770303

Cited by 114 publications

(28 citation statements)

References 2 publications

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“…Reports of cephalothin-induced nonimmunologic DATs appeared to be related to azotemia with subsequent decreased drug clearance or to hypoalbuminemia with decreased drug binding (3,5). Serum clavulanic acid levels, duration of therapy, and serum albumin levels were not significantly different between DAT-positive and -negative patients in this study.…”

Section: Discussioncontrasting

confidence: 51%

“…Microgram amounts were effective in vitro only under conditions of high pH. As postulated for cephalothin, high concentrations of drug at the site of intravenous infusion may account for the RBC membrane modification (5).…”

Section: Discussionmentioning

confidence: 85%

“…A two-stage assay was modified from that of Molthan et al (5). In the first stage, 0.5 ml of fresh whole blood from six normal volunteers was incubated at 37°C for 3 h with 0.5 ml of normal saline containing the following antibiotics in final concentration: ticarcillin (100 mg/ml), clavulanic acid (5 mg/ml), or a 30:1 fixed combination of ticarcillin-clavulanic acid (100 mg/ml).…”

Section: Methodsmentioning

confidence: 99%

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Positive direct antiglobulin tests due to clavulanic acid

Williams¹,

Thomas²,

Harman³

et al. 1985

Antimicrob Agents Chemother

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Clavulanic acid, a beta-lactamase inhibitor, was found to be associated with the development of a positive direct antiglobulin test. Of 23 antibiotic courses in patients treated with ticarcillin, clavulanic acid, and tobramycin, 10 (43.5%) developed positive direct antiglobulin tests versus 2 of 26 (7.7%) patients treated with piperacillin and tobramycin (P = 0.0044). In vitro immunohematological studies showed that clavulanic acid caused a nonimmunologic adsorption of plasma proteins onto the erythrocyte surface. Hemolysis was not associated with such nonimmunologic adsorption. However, the resulting positive antiglobulin test might delay cross matching of blood products for transfusions or interfere with the evaluation of true immune-mediated hemolytic anemia.

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Section: Discussioncontrasting

confidence: 51%

Section: Discussionmentioning

confidence: 85%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Positive direct antiglobulin tests due to clavulanic acid

Williams¹,

Thomas²,

Harman³

et al. 1985

Antimicrob Agents Chemother

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“…This side effect may limit the intramuscular route of administration. Positive Coombs tests have been detected in 10 to 15% of patients treated with cephalosporins (9), and its detection here in a single case is not surprising. Mild and transient elevation of serum transaminase has been described frequently with cephalosporin administration in the past (5,13).…”

supporting

confidence: 50%

Clinical trial of cefonicid for treatment of skin infections

Gremillion¹,

Winn²,

Vandenbout³

1983

Antimicrob Agents Chemother

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Twenty patients with skin and soft-tissue infections were treated with parenteral cefonicid. Cultures obtained in cellulitis cases from an aspirate of a leading edge of inflammation were positive in 42% of these patients. Pathogens isolated were Staphylococcus aureus (six strains), Proteus mirabilis (one strain), and Streptococcus agalactiae. Adverse effects were pain on intramuscular injection (two patients), rash (one patient), and positive Coombs test (one patient). All side effects were mild and none required discontinuing antibiotic therapy. A single treatment failure occurred in a patient with an undrained perirectal abscess. Cefonicid may be a useful drug in the treatment of skin and soft-tissue infections. The long half-life of cefonicid (4.8 h) is a valuable advantage and may facilitate patient compliance and convenience.

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“…Some cells in the cen-Surface ultramicroscopy ter or in the rim presented a few round and large pro tuberances. It is suggested that the morphologic abnormalities can be ascribed to an alteration of the cell membrane, already demonstrated with serological and enzymatic investigations.It has recently been shown that normal human red cells treated in vitro with the antibiotic cephalothin under suitable experimental conditions develop a positive direct Coombs test [11] and became abnormally sensitive to the lytic action of complement [17]. Moreover acethylcholinesterase, which is located in the outer surface of the erythrocyte, is markedly reduced [6,7]; similarly the oxygen uptake in the presence of methylene blue, which reflects the membrane metabolism, is subnormal [6].…”

mentioning

confidence: 99%

Normal Human Red Cells Treated in vitro with Cephalothin

Ferrone¹,

Lambertenghi‐Deliliers²,

Ranzi³

1971

Acta Haematol

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Normal human erythrocytes treated in vitro with cephalothin were studied by scanning electron microscope. On the surface of the majority of the erythrocytes numerous tiny projections, uniform in size and length were observed. Some cells in the center or in the rim presented a few round and large protuberances. It is suggested that the morphologic abnormalities can be ascribed to an alteration of the cell membrane, already demonstrated with serological and enzymatic investigations

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Positive Direct Coombs Tests Due to Cephalothin

Cited by 114 publications

References 2 publications

Positive direct antiglobulin tests due to clavulanic acid

Positive direct antiglobulin tests due to clavulanic acid

Clinical trial of cefonicid for treatment of skin infections

Normal Human Red Cells Treated in vitro with Cephalothin

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