Williams M E, Thomas D, Harman C P, Mintz P D, Donowitz G R
Antimicrob Agents Chemother. 1985 Jan;27(1):125-7. doi: 10.1128/AAC.27.1.125.
Clavulanic acid, a beta-lactamase inhibitor, was found to be associated with the development of a positive direct antiglobulin test. Of 23 antibiotic courses in patients treated with ticarcillin, clavulanic acid, and tobramycin, 10 (43.5%) developed positive direct antiglobulin tests versus 2 of 26 (7.7%) patients treated with piperacillin and tobramycin (P = 0.0044). In vitro immunohematological studies showed that clavulanic acid caused a nonimmunologic adsorption of plasma proteins onto the erythrocyte surface. Hemolysis was not associated with such nonimmunologic adsorption. However, the resulting positive antiglobulin test might delay cross matching of blood products for transfusions or interfere with the evaluation of true immune-mediated hemolytic anemia.
克拉维酸是一种β-内酰胺酶抑制剂，被发现与直接抗球蛋白试验阳性的发生有关。在接受替卡西林、克拉维酸和妥布霉素治疗的患者中，23个抗生素疗程中有10个（43.5%）直接抗球蛋白试验呈阳性，而在接受哌拉西林和妥布霉素治疗的26名患者中有2个（7.7%）呈阳性（P = 0.0044）。体外免疫血液学研究表明，克拉维酸会导致血浆蛋白非免疫性吸附到红细胞表面。溶血与这种非免疫性吸附无关。然而，由此产生的阳性抗球蛋白试验可能会延迟输血用血制品的交叉配血，或干扰对真正免疫介导的溶血性贫血的评估。
