Premium
Prospective Evaluation of Risk Factors for Antibiotic‐Associated Bleeding in Critically III Patients
Author(s) -
Goss Thomas F.,
Walawander Cynthia A.,
Grasela Thaddeus H.,
Meisel Steven,
Katona Brian,
Jaynes Karen
Publication year - 1992
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/j.1875-9114.1992.tb04462.x
Subject(s) - antibiotics , medicine , prospective cohort study , risk factor , critically ill , intensive care medicine , surgery , microbiology and biotechnology , biology
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>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.