Hemorrhagic diathesis associated with high doses of beta-lactam antibiotics: presentation of 3 cases
Grau, E.; Estivill, X.; Muñiz, E.; Domingo, P.; de Castellarnau, C.; Fontcuberta, J.; Félez, J.
Medicina Clinica 86(10): 420-424
1986
ISSN/ISBN: 0025-7753 PMID: 3713296 Document Number: 285851
High doses of beta-lactamic antibiotics cause a defective platelet aggregation which do not usually lead to hemorrhage. However, hemorrhagic complications may occur when associated risk factors are present. We report three cases of hemorrhagic complications due to high doses of ampicillin and sodic penicillin G. Concurrent therapy with heparin 500 IU/kg/24 hr was being given to two patients. The third patient suffered an acute hemorrhagic gastritis, but severe tissue hypoxia was also present. Platelet aggregation induced by ADP or other aggregating agents was completely inhibited in the three cases. The coagulation profile was normal in all the patients sort of one who had an increased APTT. The amount of blood loose and the localization of the hemorrhage were variable. The three patients improved after withdrawal of the antibiotic, showing a progressive normalization of the aggregation profile together with cesation of blood loose. However, hemorrhagic diathesis was so severe in a patient to cause acute renal failure which made him die.