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[Drug effect on the rotation thromboelastogram in newborn infants]
Insights
Carbenicillin significantly inhibits newborn platelet aggregation, while gentamicin has no effect. Rotation thrombelastography is not recommended for assessing drug-induced platelet function disturbances.
Area of Science:
- Neonatal Medicine
- Hematology
- Pharmacology
Context:
- Antibiotics are frequently administered to newborns.
- Platelet function is critical for hemostasis.
- Assessing drug effects on neonatal platelets is important.
Purpose:
- To investigate the impact of carbenicillin and gentamicin on neonatal thrombocyte (platelet) aggregation and adhesiveness.
- To evaluate the utility of rotation thrombelastography (TEG) in assessing drug-induced changes in platelet function in newborns.
Summary:
- Carbenicillin markedly inhibited thrombocyte aggregation in healthy newborns; gentamicin had no significant effect.
- Thrombocyte adhesiveness was minimally affected by both antibiotics.
- Rotation thrombelastography parameters (reaction time, clot-forming time, thrombus elasticity, index) were analyzed before and after rotation, with and without antibiotics.
- Carbenicillin exposure resulted in prolonged clot-forming time and decreased thrombus elasticity after rotation.
Impact:
- The study highlights carbenicillin's potent anti-aggregatory effect on neonatal platelets.
- Rotation thrombelastography requires careful interpretation, comparing pre- and post-rotation values with and without drug exposure.
- Current rotation thrombelastography methods are not recommended for evaluating drug-induced platelet dysfunction in neonates.
Abstract:
The impact of the antibiotics carbenicilin and gentamycin on the aggregation and adhesiveness of thrombocytes and on the rotation thrombelastogramme is investigated in healthy newborns. Thrombocyte aggregation was markedly inhibited by carbenicilline; gentamycine had no influence. Thrombocyte adhesiveness was less influenced by both medicaments. The parameters of TEG, viz. reaction time, clotforming time, thrombus elasticity and index were compared before and after rotation and with and without medicaments. Under carbenicilline a prolongation of the clotforming time and a decrease of thrombus elasticity could be shown to exist after rotation. The impact of medicaments on the rotation thrombelastogramme can only be conceived by comparing the values before and after rotation in each case with and without medicament and not simply evaluating it, so that the rotation thrombelastogramms cannot be recommended to be used for assessing the disturbance of thrombocyte function induced by medicaments.