[Antibiotics and blood coagulation--current references for the ENT physician]

A rare but important side effect of antibiotics is their inhibitory effect on haemostasis and blood coagulation. Modern antibiotics with a wide spectrum like cephalosporins of the 2nd and 3rd generation, as well as semisynthetic penicillins, can imitate warfarin in its effect on the blood clotting system. Other antibiotics can enhance the effect of warfarin derivatives when given simultaneously. The mechanism by which penicillin and its derivatives inhibit platelet aggregation is not yet clear. Other antibiotics can induce thrombo-cytopenia. Before antibiotic treatment is started the doctor should consider liver and kidney function, a possible malnutrition, interaction with other drugs (especially inhibitors of platelet aggregation and warfarin derivatives), and other diseases of the patient that also prolong bleeding time.