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Published on: November 30, 2018
[Effects of polymyxin B and E (colistin) on blood coagulation, thrombocyte function, and fibrin structure (author's
Abstract:
Polymyxins are known to form complexes with endotoxins and phospholipids. Therefore patients with septicaemia were treated in some studies with polymyxin. We investigated the effect of polymyxin B and E (colistin) on some blood coagulation parameters, spreading of platelets and fibrin polymerisation. With increased concentrations of polymyxin (1, 5, 10, 20, 100 mg%) we found a significant prolongation of prothrombin, partial thromboplastin and TEG reaction times. Spreading of platelets was also reduced. There was, however, no effect on fibrin polymerisation. The coagulation inhibitory effects of polymyxins could be reduced by adding phospholipids as procoagulant. These results indicate: 1. There are anticoagulant effects of polymyxins even in therapeutic doses and therefore it should not be applied in cases of haemorrhagic diathesis or renal insufficiency. 2. In septicaemia the disseminated intravascular coagulation can be prevented because due to consumption of polymyxin, endotoxinaemia persists.
Insights
Polymyxins, including polymyxin B and colistin, exhibit anticoagulant effects, prolonging clotting times and inhibiting platelet function. These findings suggest caution in patients with bleeding disorders or kidney issues.
Area of Science:
- Pharmacology
- Hematology
- Microbiology
Background:
- Polymyxins (polymyxin B and E/colistin) are antibiotics known for their endotoxin-binding properties.
- Their use in sepsis, a condition often involving endotoxemia and coagulation abnormalities, has been explored.
Purpose of the Study:
- To investigate the impact of polymyxins on key blood coagulation parameters.
- To assess the effects on platelet spreading and fibrin polymerization.
Main Methods:
- In vitro study evaluating polymyxin B and E (colistin) at varying concentrations (1-100 mg%).
- Assessed prothrombin time, partial thromboplastin time, thromboelastography (TEG) reaction time, platelet spreading, and fibrin polymerization.
- Investigated the influence of phospholipids on polymyxin's coagulation effects.
Main Results:
- Significant prolongation of prothrombin time, partial thromboplastin time, and TEG reaction times observed with increasing polymyxin concentrations.
- Reduced platelet spreading was noted.
- No significant effect on fibrin polymerization was found.
- Coagulation inhibitory effects were mitigated by the addition of phospholipids.
Conclusions:
- Polymyxins possess inherent anticoagulant properties, even at therapeutic doses.
- Caution is advised when administering polymyxins to patients with hemorrhagic diathesis or renal insufficiency.
- Polymyxins may help prevent disseminated intravascular coagulation in sepsis by persisting endotoxemia due to polymyxin consumption.
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