Abstract |
Serial, twice-weekly prothrombin times were determined in 108 febrile, granulocytopenic patients with cancer who were prospectively randomized to receive empiric antimicrobial therapy with moxalactam plus ticarcillin (M/T) or tobramycin plus ticarcillin (T/T). Thirty of 54 patients given M/T and 13 of 54 patients given T/T developed prothrombin times that were greater than or equal to 2 sec beyond control values (P less than .001) after a mean of 6.5 days of antimicrobial therapy. Serious bleeding episodes were more frequent in the group given M/T than in that given T/T (10 and two patients, respectively; P less than or equal to .05). Serial quantitative stool cultures revealed that both Escherichia coli and Bacteroides species were suppressed by greater than or equal to 5 log10 in eight of nine patients given M/T and in three of nine given T/T (P less than .05, Fisher's exact test). A significant reduction of the population of E. coli and Bacteroides fragilis, organisms that are major producers of bacterially synthesized menaquinones, was associated with a high incidence of hypoprothrombinemia. These observations support the hypothesis that menaquinones may play an important physiological role in the maintenance of blood coagulation during episodic dietary deficiency of phylloquinone.
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Authors | J M Conly, K Ramotar, H Chubb, E J Bow, T J Louie |
Journal | The Journal of infectious diseases
(J Infect Dis)
Vol. 150
Issue 2
Pg. 202-12
(Aug 1984)
ISSN: 0022-1899 [Print] United States |
PMID | 6381612
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anti-Bacterial Agents
- Ticarcillin
- Moxalactam
- Tobramycin
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Topics |
- Anti-Bacterial Agents
(adverse effects, therapeutic use)
- Bacterial Infections
(complications, drug therapy)
- Bacteroides
(growth & development)
- Drug Therapy, Combination
- Escherichia coli
(growth & development)
- Feces
(microbiology)
- Hemorrhagic Disorders
(etiology)
- Humans
- Hypoprothrombinemias
(etiology)
- Intestines
(microbiology)
- Moxalactam
(adverse effects)
- Neoplasms
(complications)
- Neutropenia
(complications)
- Prothrombin Time
- Ticarcillin
(adverse effects)
- Tobramycin
(adverse effects)
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