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Related Experiment Videos

Bleeding in uremic patients after carbenicillin.

K Andrassy, E Weischedel, E Ritz

    Thrombosis and Haemostasis
    |August 31, 1976
    PubMed
    Summary

    Carbenicillin can cause bleeding by affecting both platelet function and the plasmatic coagulation system, particularly in patients with renal insufficiency. Protamine chloride effectively reverses these bleeding effects without compromising antibiotic activity.

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    Area of Science:

    • Pharmacology
    • Hematology
    • Clinical Medicine

    Background:

    • Penicillin derivatives, including carbenicillin, are known to interfere with hemostasis and cause hemorrhagic diathesis.
    • Previous studies suggest carbenicillin primarily affects platelet function, with limited impact on fibrin formation in patients with normal renal function.

    Purpose of the Study:

    • To investigate the comprehensive effects of carbenicillin on both platelet function and the plasmatic coagulation system.
    • To determine the clinical significance of carbenicillin-induced hemostatic disturbances and potential therapeutic interventions.

    Main Methods:

    • Assessed coagulation parameters including prothrombin time (PT), activated partial thromboplastin time (aPTT), platelet counts, and specific coagulation factors.
    • Evaluated platelet aggregation and release reactions in response to various stimuli.

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  • Investigated the fibrinogen-fibrin conversion process and antithrombin III activity in vitro and in vivo.

    • Main Results:

    • Carbenicillin at serum levels >300 mug/ml in patients with renal insufficiency was associated with hemorrhagic diathesis.
    • Disturbances in platelet function and plasmatic coagulation were observed, including prolonged thrombin times and inhibition of fibrinogen-fibrin conversion.
    • In vivo, enhanced antithrombin III activity suggested a heparin-like effect, which was not replicated in vitro.

    Conclusions:

    • Carbenicillin not only affects platelet function but also significantly disturbs the plasmatic coagulation system, leading to hemorrhagic diathesis.
    • The observed effects are clinically relevant, and protamine chloride demonstrates efficacy in reversing bleeding without impacting antibacterial activity.