The hematologic effects of latamoxef sodium when used as a prophylaxis during surgical treatment

Latamoxef sodium, a third generation cephalosporin antibiotic, has been shown to provide good prophylaxis against postoperative infection. It has, however, been implicated as causing disturbances of hemostasis particularly when used in treatment. We have studied 40 patients who required antibiotic prophylaxis prior to surgical treatment randomizing and stratifying them according to age and type of operation, to receive either latamoxef or piperacillin. Five hematologic parameters were studied, prothrombin time, activated partial thromboplastin time, plasma factor II concentration, plasma factor VII concentration and platelet count. Minor differences were noted with latamoxef producing mild persistant elevation of prothrombin time (0.7 second) associated with depression of factor II and factor VII. In our study, we found that, when used as three dose, single agent prophylaxis, there was no difference between latamoxef and piperacillin in producing clinical disturbances of hemostasis. However, attention is drawn to the importance of recognizing that hemostatic disturbances can occur after the use of broad spectrum antibiotics as prophylaxis for surgical treatment Mechanisms of hemostatic disorders are reviewed and alternative hypotheses are suggested.