[Effects of cefotetan on PIVKA-II changes in the treatment of infections and prophylaxis of surgical infections in the fields of obstetrics and gynecology].

Cephem antibiotics possessing 1-methyl-1-H-tetrazole-5-yl-thiomethyl moiety at the 3 position of beta-lactam skeleton are known to play a significant role in the disturbance of coagulation and bleeding caused by the deficiency of vitamin K-dependent clotting factors. Among those factors, abnormal prothrombin, protein specifically induced by vitamin K absence or antagonist (PIVKA-II), is recognized to be important. Cefotetan (CTT) is a cephem antibiotic with the above mentioned side chain at the 3 position. In the study reported here, CTT was administered to patients in the fields of obstetrics and gynecology for the treatment of infections (5 patients) and prophylaxis of surgical infections (142 patients). Changes in PIVKA-II levels, hematological and biochemical profiles, and the adverse effects are investigated during the cefotetan treatment. 1. Changes in PIVKA-II levels were observed in 1.2% (1 out of 81) of the patients prior to the CTT treatment and 7.4% (6 out of 81) of patients on the 14th day after the initiation of CTT treatment. 2. Although 6.8% (8 out of 117) of the patients showed slight diarrhoea on day-2 to day-5 after the initiation of CTT treatment, no patients showed any bleeding episodes or adverse effects such as abnormality of biochemical test values and physical signs after the completion of the CTT treatment.