Ambăruş V, Cosovanu A
Clinica a III-a Medicală Cardiologică I. Enescu, Universitatea de Medicină şi Farmacie Gr.T. Popa Iaşi.
Rev Med Chir Soc Med Nat Iasi. 2000 Jul-Sep;104(3):123-6.
Any type hemorrhagic manifestation may occur 12 hours to 5 weeks after the administration of beta-lactam antibiotics. The mechanisms of blood losses proved to be by: 1) immunologic thrombocytopenia (penicillins); 2) alteration of platelet functions (semisynthetic penicillins); 3) hypoprothrombinemia (cephalosporins). The risk factors for the occurrence of hemorrhage under beta-lactam antibiotics therapy are: concomitant administration of cytostatics for a neoplastic malignancy; b) acute or chronic renal failure; c) concomitant treatment for duodenal and gastric ulcer; d) malnutrition; e) dosage and duration of antibiotic administration. The frequency of bleeding under beta-lactams is not determined as yet. A severe case diagnosed at the IIIrd Medical Clinic of Iasi presenting spontaneous daily nasal bleedings that occurred 24 hours after the initiation of the treatment with cephalosporins (Kefurox) is presented. In this patient the risk factor was chronic renal failure.
在使用β-内酰胺类抗生素后12小时至5周内，可能会出现任何类型的出血表现。已证实失血的机制为：1）免疫性血小板减少（青霉素类）；2）血小板功能改变（半合成青霉素类）；3）低凝血酶原血症（头孢菌素类）。β-内酰胺类抗生素治疗期间发生出血的危险因素有：a）因恶性肿瘤同时使用细胞毒性药物；b）急性或慢性肾衰竭；c）十二指肠和胃溃疡的同时治疗；d）营养不良；e）抗生素的给药剂量和持续时间。β-内酰胺类药物引起出血的频率尚未确定。本文介绍了在雅西第三医疗诊所诊断的一例严重病例，该患者在用头孢菌素（头孢呋辛）治疗24小时后出现自发性每日鼻出血。该患者的危险因素是慢性肾衰竭。
