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A study of Vitamin K status in children on prolonged antibiotic therapy
1Department of Pediatrics, Seth GS Medical College KEM Hospital, Parel, Mumbai 400012, India. rukhmi@yahoo.com
Insights
Prolonged antibiotic use in children can lead to vitamin K deficiency, causing coagulopathy. Vitamin K prophylaxis is recommended for critically ill children on extended antibiotic therapy to prevent bleeding complications.
Area of Science:
- Pediatrics
- Hematology
- Nutritional Science
Background:
- Vitamin K deficiency is a known cause of coagulopathy and bleeding.
- Prolonged antibiotic therapy can disrupt vitamin K metabolism.
- The impact on hospitalized children requires further investigation.
Purpose of the Study:
- To evaluate vitamin K deficiency status in hospitalized children on prolonged antibiotic therapy.
- To assess the role of vitamin K deficiency in coagulopathy in this population.
- To identify risk factors associated with coagulopathy.
Main Methods:
- Prospective non-randomized study.
- Inclusion of hospitalized children on antibiotic therapy at a tertiary care hospital.
- Analysis of coagulation abnormalities across different age groups, malnutrition severity, antibiotic duration, and critical illness status.
Main Results:
- Children aged 1 month to 1 year showed significant coagulopathy.
- Coagulation abnormalities were more prevalent in severely malnourished children, those on prolonged antibiotics, and critically ill patients.
- Hypoprothrombinemia occurred with antibiotics both with and without the N-Methyl Thio Tetrazole (NMTT) group, suggesting intestinal flora disruption.
Conclusions:
- Vitamin K deficiency contributes to coagulopathy in children on prolonged antibiotics.
- Risk factors include young age, malnutrition, extended antibiotic courses, and critical illness.
- Vitamin K prophylaxis is suggested for high-risk pediatric patients to prevent adverse outcomes.
Abstract:
Vitamin K deficiency is known to cause coagulopathy and bleeding in patients on prolonged antibiotic therapy. This study was conducted to evaluate the status of vitamin K deficiency in hospitalized children on prolonged antibiotic therapy and its role in reversing the coagulopathy. A prospective non-randomized study was conducted on children on antibiotic therapy at a tertiary care hospital. Children in the 1 month-1 year age group developed significant coagulopathy as compared to other age groups. Coagulation abnormalities were also seen to be more in children with greater grades of malnutrition, on a more prolonged course of antibiotics and in children who were critically ill in intensive care. Hypoprothrombinemia previously reported to be due to B-lactam antibiotics containing the N-Methyl Thio Tetrazole (NMTT) group also resulted from antibiotics without this side chain. Inhibition of intestinal microorganisms by antibiotics was thought to be a likely explanation of this phenomenon. We suggest Vitamin K prophylaxis in severely ill patients, on extended periods of antibiotics and inadequate diet to prevent morbidity and mortality.