[Dosage of long-term streptokinase fibrinolytic administration (author's transl)]

Using generalyy accepted dosage schedules during long-term fibrinolytic treatment with streptokinase, anticoagulatory protection against recurrent thromboses can no longer be guaranteed after two to three days, unless heparin is also administered. In contrast, no heparin was needed in 11 out of 13 patients on fibrinolytic treatment of at least five days when maintenance dose was adjusted in accordance with results of coagulation tests. In this way prolonged fibrinolysis was maintained together with adequate anticoagulation by circulating fibrin(ogen) breakdown products for the entire duration of streptokinase treatment. This required the gradual reduction of maintenance dose to between 40 000 U/h and 80 000 U/h in the majority of patients. This form of fibrinolytic treatment with individually adjusted dosages can be undertaken without undue strain on laboratory resources; the risk of haemorrhage is no higher than with the customary form using higher and constant maintenance doses.