Effect of antibiotics therapy on serum vitamin K level
Vitamin K deficiency has occurred in patients receiving broad-spectrum antibiotics. The mechanism of hypoprothrombinemia in patients treated with antibiotics is still unknown, although it is suggested to result from impared synthesis of vitamin K by suppression of intestinal bacteria or interference...
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| Published in | Blood & Vessel Vol. 18; no. 3; pp. 274 - 277 |
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| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
| Published |
The Japanese Society on Thrombosis and Hemostasis
1987
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0386-9717 1884-2372 1884-2372 |
| DOI | 10.2491/jjsth1970.18.274 |
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| Abstract | Vitamin K deficiency has occurred in patients receiving broad-spectrum antibiotics. The mechanism of hypoprothrombinemia in patients treated with antibiotics is still unknown, although it is suggested to result from impared synthesis of vitamin K by suppression of intestinal bacteria or interference of vitamin K utilization in the liver. We studied the serum vitamin K concentration in patients receiving broad-spectrum antibiotics for 7 days or more, in order to clarify the mechanism of antibiotics induced vitamin K deficiency. The coagulation abnormalities compatible with vitamin K deficiency were seen in 7 patients in whom predisposing factors for vitamin K deficiency were male, poor dietary intake and therapy of antibiotics with N-methyl-tetrazol thiol. In these patients, serum vitamin K1 and vitamin K2 (menaquinone-7) levels was extremly lower when compared to normal adult levels. On the other hand, vitamin K1 levels in 5 of 6 patients with normal coagulation status moderately decreased to the levels under minus 1 standard deviation of normal adults, and serum vitamin K2 in 3 patients with normal coagulation status and very poor dietary intake was not detected. These results may suggest that vitamin K deficiency in patients receiving antibiotics is induced by poor oral intake, altered absorption of vitamin K in the intestine and/or impaired synthesis of vitamin K by suppression of intestinal bacteria. |
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| AbstractList | Vitamin K deficiency has occurred in patients receiving broad-spectrum antibiotics. The mechanism of hypoprothrombinemia in patients treated with antibiotics is still unknown, although it is suggested to result from impared synthesis of vitamin K by suppression of intestinal bacteria or interference of vitamin K utilization in the liver. We studied the serum vitamin K concentration in patients receiving broad-spectrum antibiotics for 7 days or more, in order to clarify the mechanism of antibiotics induced vitamin K deficiency. The coagulation abnormalities compatible with vitamin K deficiency were seen in 7 patients in whom predisposing factors for vitamin K deficiency were male, poor dietary intake and therapy of antibiotics with N-methyl-tetrazol thiol. In these patients, serum vitamin K1 and vitamin K2 (menaquinone-7) levels was extremly lower when compared to normal adult levels. On the other hand, vitamin K1 levels in 5 of 6 patients with normal coagulation status moderately decreased to the levels under minus 1 standard deviation of normal adults, and serum vitamin K2 in 3 patients with normal coagulation status and very poor dietary intake was not detected. These results may suggest that vitamin K deficiency in patients receiving antibiotics is induced by poor oral intake, altered absorption of vitamin K in the intestine and/or impaired synthesis of vitamin K by suppression of intestinal bacteria. |
| Author | KOMATSU, Keiko ASAKURA, Akio NAKAMURA, Toshio KAYASHIMA, Narumi SHIRAHATA, Akira |
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| References | 2) Hooper, C. A., Haney, B. B. and Stone, A. H.: Gastrointestinal bleeding due to vitamin K deficiency in patients on parenteral cefamandole. Lancet, 1; 39-40, 1980. 7) Uotila, L. and Suttie, J. W.: Inhibition of vitamin K-dependent carboxylase in vitro by cefamandole and its structural analogs. J. Infect. Dis., 148; 571-578, 1983. 10) Bechtolod, H., Lorenz, J., Weilemann, L. S., Meinertz, T., Trenk, D., Andrassy, K. and Jähnchen, E.: Possible coumarin-like mechanism of action for cephalosporins. Klin. Wochenschr., 62; 885-886, 1984. 11) 白幡聡, 萱嶌成美: ビタミンKの高感度測定法. Medical Way, 2; 71-74, 1985. 5) Kammer, R. B.: Moxalactam: clinical summary of efficacy and safety. Rev. Infect. Dis., 4 (Suppl.): 712-719, 1982. 8) Lipsky, J. J.: N-methyl-thio-tetrazol inhibition of the gamma carboxylation of gultamic acid: possible mechanism for antibiotic-associated hypoprothrombinaemia. Lancet, 2; 192-193, 1983. 3) Rymer, W. and Greenlaw, C. W.: Hypoprothrombinemia associated with cefamandole. Drug Intelligence and Clinical Pharmacy, 14; 780-783, 1980. 4) Reddy, J. and Bailey, R. R.: Vitamin K deficiency developing in patient with renal failure treated with cephalosporin antibiotics. N. Z. Med. J., 92; 378-379, 1980. 12) 白幡聡, 中村外士雄: ヒト生体試料中の vitamin K1 (phylloquinone) および vitamin K2 (menaquinone) 同族体の個別測定. 血液と脈管, 16; 395-401, 1985. 9) Neu, H. C.: Adverse effects of new cephalosporins. Ann. Intern. Med., 93; 415-416, 1983. 6) 岩田敏: 抗生剤投与中の腸内細菌叢及び血液凝固系の変動に関する検討. 感染症学会雑誌, 58; 903-919, 1984. 1) Pineo, G. F., Gallus, A. S. and Hirsh, J.: Unexpected vitamin K deficiency in hospitalized patients. Canad. Med. Assoc. J., 109; 880-883, 1973. |
| References_xml | – reference: 6) 岩田敏: 抗生剤投与中の腸内細菌叢及び血液凝固系の変動に関する検討. 感染症学会雑誌, 58; 903-919, 1984. – reference: 8) Lipsky, J. J.: N-methyl-thio-tetrazol inhibition of the gamma carboxylation of gultamic acid: possible mechanism for antibiotic-associated hypoprothrombinaemia. Lancet, 2; 192-193, 1983. – reference: 3) Rymer, W. and Greenlaw, C. W.: Hypoprothrombinemia associated with cefamandole. Drug Intelligence and Clinical Pharmacy, 14; 780-783, 1980. – reference: 12) 白幡聡, 中村外士雄: ヒト生体試料中の vitamin K1 (phylloquinone) および vitamin K2 (menaquinone) 同族体の個別測定. 血液と脈管, 16; 395-401, 1985. – reference: 2) Hooper, C. A., Haney, B. B. and Stone, A. H.: Gastrointestinal bleeding due to vitamin K deficiency in patients on parenteral cefamandole. Lancet, 1; 39-40, 1980. – reference: 7) Uotila, L. and Suttie, J. W.: Inhibition of vitamin K-dependent carboxylase in vitro by cefamandole and its structural analogs. J. Infect. Dis., 148; 571-578, 1983. – reference: 9) Neu, H. C.: Adverse effects of new cephalosporins. Ann. Intern. Med., 93; 415-416, 1983. – reference: 11) 白幡聡, 萱嶌成美: ビタミンKの高感度測定法. Medical Way, 2; 71-74, 1985. – reference: 1) Pineo, G. F., Gallus, A. S. and Hirsh, J.: Unexpected vitamin K deficiency in hospitalized patients. Canad. Med. Assoc. J., 109; 880-883, 1973. – reference: 10) Bechtolod, H., Lorenz, J., Weilemann, L. S., Meinertz, T., Trenk, D., Andrassy, K. and Jähnchen, E.: Possible coumarin-like mechanism of action for cephalosporins. Klin. Wochenschr., 62; 885-886, 1984. – reference: 4) Reddy, J. and Bailey, R. R.: Vitamin K deficiency developing in patient with renal failure treated with cephalosporin antibiotics. N. Z. Med. J., 92; 378-379, 1980. – reference: 5) Kammer, R. B.: Moxalactam: clinical summary of efficacy and safety. Rev. Infect. Dis., 4 (Suppl.): 712-719, 1982. |
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| SubjectTerms | antibiotics menaquinone N-metyl-tetrazol tiol phylloquinone vitamin K deficiency |
| Title | Effect of antibiotics therapy on serum vitamin K level |
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