Albano Del Favero, MD; Giancarlo Agnelli, MD; Pasquale Parise, MD
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To the Editors: In their recent study, Winston and coworkers (1) administered prophylactic vitamin K to all their patients to prevent hypoprothrombinemia and bleeding associated with the use of some β-lactam antibiotics (2). We disagree with their conclusion that "it may be prudent to give prophylactic vitamin K to all granulocytopenic patients regardless of the antibiotic regimen" on the basis that hypoprothrombinemia has been reported not only in patients receiving β-lactams containing the N-methylthiotetrazole (MTT) side chain but also in patients receiving other antibiotics not containing the MTT group.
Structurally different β-lactams exert different effects on vitamin K-dependent clotting factor
Del Favero A, Agnelli G, Parise P. Beta-Lactam Antibiotics and Vitamin K. Ann Intern Med. ;116:1034–1035. doi: 10.7326/0003-4819-116-12-1034_2
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Published: Ann Intern Med. 1992;116(12_Part_1):1034-1035.
DOI: 10.7326/0003-4819-116-12-1034_2