INFLUENCE OF THIRD-GENERATION CEPHEMS ON COAGULABILITY

DIFFERENCE BETWEEN TWO GROUPS TREATED WITH OR WITHOUT N-METHYLTETRAZOLETHIOL

Abstract

We compared the effect on coagulability of third-generation cephems with and without a N-methyltetrazolethiol base (NMTT). Cefotaxime (CTX) and ceftazidime (CAZ) were selected as the drugs without NMTT and administered in 48 cases. Cefmenoxime (CMX) and latamoxef (LMOX) were selected as the drugs with NMTT and administered in 46 cases. Prothrombin time (PT), activated partial thromboplastin time (APTT), thrombotest, hepaplastin test and PIVKA-II were examined before and after treatment.
No definite change in PT, APTT and thrombotest before and after treatment was observed. Although a significant decrease in hepaplastin test after treatment was observed, no significant difference in hepaplastin time was shown between the groups with and without NMTT base. The coagulability of each group changed after treatment as follows: In the CTX and CAZ groups, PT decreased by 2.1%, APTT 4.2%, thrombotest 2.1%, hepaplastin test 4.2%, and PIVKA-II 0%. In the CMX and LMOX groups, PT decreased by 8.7%, APTT 8.7%, thrombotest 10.9%, hepaplastin test 13.0% and PIVKA-II 10.9%. The CMX and LMOX groups showed a higher incidence of abnormal coagulability.
Most cases showing abnormal coagulability were accompanied by malnutrition.
These results suggest that antibiotics which have an NMTT base show a higher tendency to abnormal coagulability, especially in patients with malnutrition. Accordingly, when administered to such patients, careful observation with frequent measurement of coagulatory function is necessary.