Prospective evaluation of risk factors for antibiotic-associated bleeding in critically ill patients.

Abstract

A prospective surveillance program was initiated to determine the relative role of antibiotics containing N-methylthiotetrazole (NMTT) versus patient risk factors in producing antibiotic-associated bleeding. Five hundred forty-six critically ill patients with serum albumin 30 g/L or below were evaluated for evidence of a bleeding event as documented by clinical observation, hemoglobin changes, and transfusions. Bleeding events occurred in 16% of patients receiving an aminoglycoside combination, 10% receiving antibiotics with the NMTT side chain, and 14.5% receiving antibiotics not containing NMTT (p greater than 0.05). The bleeding rate was highest in febrile patients with cancer (14.5%) and lowest in those with a suspected or documented abdominal infection (10%) (p = 0.04), but within each patient group there was no difference among the antibiotics. We conclude that the use of NMTT-containing antibiotics is not an independent risk factor for bleeding, but the role of severity of illness may be underappreciated.

• Authors: T F Goss, C A Walawander, T H Grasela Jr, S Meisel, B Katona, K Jaynes
• Journal: Pharmacotherapy (Pharmacotherapy) Vol. 12 Issue 4 Pg. 283-91 ( 1992) ISSN: 0277-0008 [Print] United States
• PMID: 1518727 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Aminoglycosides
• Anti-Bacterial Agents
• Serum Albumin
• Tetrazoles
• 1-N-methyl-5-thiotetrazole

Topics

• Abdomen (microbiology)
• Adolescent
• Adult
• Aminoglycosides
• Anti-Bacterial Agents (adverse effects)
• Bacterial Infections (drug therapy, microbiology, physiopathology)
• Critical Illness
• Fever (complications)
• Hemorrhage (chemically induced)
• Humans
• Neoplasms (complications)
• Prospective Studies
• Risk Factors
• Serum Albumin (analysis)
• Tetrazoles (adverse effects)