Platelet-mediated bleeding caused by broad-spectrum penicillins.

Area of Science:

• Pharmacology
• Hematology

Background:

• Antibiotics like ticarcillin, piperacillin, and mezlocillin are frequently used in hospitalized patients.
• Platelet dysfunction and bleeding are potential adverse effects of certain antibiotic therapies.

Purpose of the Study:

• To prospectively determine the frequencies of platelet dysfunction and bleeding in patients treated with ticarcillin, piperacillin, mezlocillin, or cefotaxime.
• To identify risk factors associated with antibiotic-induced bleeding.

Main Methods:

• Prospective observation of 156 hospitalized adult patients.
• Assessment of bleeding times and occurrence of significant bleeding.
• Statistical analysis of covariables including age, chemotherapy, and pre-existing conditions.

Main Results:

• Elevated bleeding times occurred in 73% of ticarcillin, 43% of piperacillin, 25% of mezlocillin, and 17% of cefotaxime recipients.
• Significant bleeding was observed in 34% of ticarcillin, 17% of piperacillin, 2% of mezlocillin, and 5% of cefotaxime recipients.
• Chemotherapy, thrombocytopenia, older age, higher dose, and longer treatment duration were significant risk factors for bleeding.

Conclusions:

• Ticarcillin and piperacillin are associated with a higher incidence of platelet dysfunction and bleeding compared to mezlocillin and cefotaxime.
• Bleeding risk is influenced by patient-specific factors and treatment parameters, necessitating careful monitoring.