Original Articles
Vol. 10 (2018): Review Articles, Original Articles, Scientific Letters, Case Reports
https://doi.org/10.4084/mjhid.2018.010

NEGATIVE IMPACT OF PROLONGED ANTIBIOTICS OR PERSISTENT DIARRHEA ON VITAMIN K1 LEVELS IN 2-24 WEEKS AGED EGYPTIAN INFANTS

Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Received: November 13, 2017
Accepted: December 22, 2017
Published: January 1, 2018
5029
Views
771
Downloads
933
HTML
Prolonged Antibiotics, Persistent Diarrhoea, Vitamin K1, Egyptian
Hematology

Authors

Mohsen Elalfy
Faculty of Medicine, Ain Shams university, Egypt.
Fatma S E Ebeid
Faculty of Medicine, Ain Shams University, Cairo, Egypt, Egypt.
Iman Elagouza
imanali@yahoo.com
Faculty of Medicine, Ain Shams University, Cairo, Egypt, Egypt.
Fatma Ibrahim
Biochemistry Department, Genetic Engineering & Biotechnology Division, National Research Centre, Cairo, Egypt, Egypt.
Noura Hassan
Faculty of Medicine, Ain Shams University, Cairo, Egypt, Egypt.
Beshoy Botros
Faculty of Medicine, Ain Shams University, Cairo, Egypt, Egypt.

Objectives: To evaluate the hazard of prolonged antibiotic therapy and/or persistent diarrhea on vitamin K1 (VK1) level and bleeding profile in infants (2-24 weeks). Methods: A one-year case-control study, conducted at Ain Shams University, Egypt. 338 infants (2-24 weeks) were recruited and divided into 3 groups (1:1:3 ratios); group A (n= 67) patients who received antibiotics for ?10 days, group B (n= 67) who had persistent diarrhea ? 14 days and group C (n=204) age- and gender-matched infants who were not either received antibiotics nor had diarrhea. All subjected to clinical assessment, bleeding history and had their complete blood count (CBC), PT and PTT, liver transaminases and VK1 level assayed.  Results: There was a significant increase in the frequency of VKDB (vitamin K deficiency bleeding) and abnormal bleeding profile in cases than the control group. There was a significant negative correlation between VK1 level and duration of diarrhea, length of antibiotics used and bleeding profile. Antibiotic usage has a dangerous effect on the VK1 level in those with diarrhea; more patients were receiving antibiotic in those with persistent diarrhea and VKDB (N=55) than those with persistent diarrhea and normal VK1 (N=12). The longer duration of antibiotic therapy the lower level of VK1.  Combining cephalosporins/penicillins therapy and/or diarrhea, in particular, had an impact on the VK1 level. Conclusion: VKDB, a preventable cause of life-threatening hemorrhage, is still a major health problem in Egyptian infants, where persistent diarrhea and misuse of antibiotics are prevalent, necessitate a booster dose of VK in those high risk infants.

Keyword: Prolonged Antibiotics; Persistent Diarrhea; Vitamin K1; Egyptian

 

 

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Pooni, P.A., Singh, D., Singh, H., Jain. B.K. Intracranial hemorrhage in late hemorrhagic disease of the newborn. Indian Pediatrics. 2003; 40, 243-248.
Sutor, A. Vitamin K Deficiency Bleeding in Infants and Children. Semin Thromb Hemost.1995; 21(3), 317-329.
Enz, R., Anderson, R.S Jr. A Blown Pupil and Intracranial Hemorrhage in a 4-Week-Old: A Case of Delayed Onset Vitamin K Deficiency Bleeding, a Rare "Can't Miss" Diagnosis. J Emerg Med. 2016; 51(2), 164-7.
Wolpert, K., Szadkowski, M., Miescier, M., Hewes, H.A. The Presentation of a Fussy Infant With Bruising: Late-Onset Vitamin K Deficiency Bleeding. Pediatr Emerg Care. 2017; [Epub ahead of print ]
Hamrick, H.J., Gable, E.K., Freeman, E.H., Dunn, L.L., Zimmerman, S.P., Rusin, M.M., Linthavong, O.R., Wright, M.E., Moss LA, Skinner, A.C. Reasons for Refusal of Newborn Vitamin K Prophylaxis: Implications for Management and Education. Hosp Pediatr. 2016; 6 (1), 15-21.
Langsten, R. and Hill, K. Treatment of childhood diarrhea in rural Egypt. Social Science & Medicine. 1995; 40 (7), 989-1001
Elalfy, M., Elagouza, I., Ibrahim, F., Abdelmessieh, S., Gadallah, M. Intracranial haemorrhage is linked to late onset vitamin K deficiency in infants aged 2–24 weeks. Acta Paediatr.2014; 17, 12598.
Bhandari, M.K., Bhan, M.K. and Sazawal, S. Mortality associated with acute watery diarrhea, dysentery and persistent diarrhea in rural North India. Acta Paediatr Suppl. 1992; 381:3-6.
Corrigan, J.J. Jr. The vitamin K dependent proteins. Adv Pediatr. 1981; 28, 57-74.
Sankar, M.J., Chandrasekaran, A., Kumar, P., Thukral, A., Agarwal, R., Paul, V.K. Vitamin K prophylaxis for prevention of vitamin K deficiency bleeding: a systematic review. J Perinatol. 2016; 36 Suppl 1, S29-35.
Bhat, R.V. and Deshmukh, C.T. A study of vitamin K status in children on prolonged antibiotic therapy. Indian Pediatrics. 2003; 40, 36-40.
Cekinmez, M., Cemil, T., Cekinmez, E.K., Altinors, N. Intracranial hemorrhages due to late – type vitamin K deficiency. Child’s Nervous System. 2008; 24 (7), 821-25.
Sutor, A.H., von Kries, R., Cornelissen, E.A.M., McNinich, A.W. and Andrew, M. ISTH Pediatric/Perinatal Subcommittee International Society on Thrombosis and Haemostasis. Vitamin K deficiency bleeding (VKDB) in infancy. Thromb Haemost. 1999; 81, 456–61.
Thaiss, H. (1986) Vorkommen, Resorption und Transport von Vitamin K. In: Sutor, A.H, W Künzer (Eds): Physiologie und Pathophysiologie des Vitamins K. Editiones Roche, Basel Grenzach-Wyhlen; 21-27.
.Shearer, M.J. Vitamin K. Lancet. 1995; 345, 229–34.
Shearer, M.J. Vitamin K metabolism and nutriture. Blood Rev.1992; 6, 92–104.
Thijssen, H.H., Drittij-Reijnders, M.J. Vitamin K status in human tissues: tissue-specific accumulation of phylloquinone and menaquinone. Br J Nutr. 1996; 75, 121-127.
Gentili, A., Cafolla, A., Gasperi, T., Bellante, S., Caretti, F., Curini, R., Fernández, V.P. Rapid, high performance method for the determination of vitamin K (1), menaquinone-4 and vitamin K (1) 2,3-epoxide in human serum and plasma using liquid chromatography-hybrid quadrupole linear ion trap mass spectrometry. J Chromatogr A. 2014; 1338, 102-10.
Suhara, Y., Kamao, M., Tsugawa, N., and Okano, T. Method for the Determination of Vitamin K Homologues in Human Plasma Using High-Performance Liquid Chromatography-Tandem Mass Spectrometry. Anal. Chem. 2005; 77 (3), 757–763.
Kumar, R., Marwaha, N., Marwaha, R.K., Garewal, G. Vitamin K deficiency in diarrhoea. The Indian Journal of Pediatrics. 2001; 68 (3), 235-238.
Ozdemir, M.A., Karakukcu, M., Per, H., Unal, E., Gumus, H., Patiroglu, T. Late-type vitamin K deficiency bleeding: experience from 120 patients. Childs Nerv Syst. 2012; 28 (2), 247-51.
Ahmet, F.O., Ali, B., Vefik, C. and Abdurahman, U. Evaluation of Vitamin K Deficiency in Children with Acute and Intractable Diarrhea. Advances in Therapy. 2006; 2 (3), 469-474.
Izquierdo, R.J., Arriaga, G.M., Kuri, N.J., et al. Blood coagulation disorders in infants with infectious gastroenteritis. Bol Med Hosp Infant Mex. 1977; 34, 981-992.
Firkin, F., Chesterman, C., Penington, D. (1989) Coagulation Disorders. In: de Gruchy’s Clinical Hematology in Medical Practice, 5th ed. Delhi: Oxford university pres; 436-437.
Shearer, M.J., Bechtold, H., Andrassy, K., Koderisch, J., McCarthy, P.T., Trenk, D., Jähnchen, E., Ritz, E. Mechanism of cephalosporin-induced hypoprothrombinemia: relation to cephalosporin side chain, vitamin K metabolism, and vitamin K status. J Clin Pharmacol. 1988; 28(1), 88-95
Fainstein, V., Bodey, G.P., McCredie, K.B., Keating, M.J., Estey, E.H., Bolivar, R., Elting, L. Coagulation abnormalities induced by beta-lactam antibiotics in cancer patients. J Infect Dis. 1983; 148(4), 745-50.
Bolat, A., Vurucu, S., Tascilar, E., Gursel, O., Karaoglu, A., Kurekci, A.E. Late Type Vitamin K Deficiency Related with Prolonged Antibiotic Therapy in a 7-month-old Infant. International Journal of Hematology and Oncology. 2010; 20 (2), 106-109.
Darwish, D.A., Abdelmalek, S., Dayyih, W.A., Hamadi, S. Awareness of antibiotic use and antimicrobial resistance in the Iraqi community in Jordan. J Infect Dev Ctries. 2014; 8 (5), 616-623.
Al-Bakri, A.G., Bustanji, Y.B., Yousef, A.M. Community consumption of antibacterial drugs within the Jordanian population: sources, patterns and appropriateness. International Journal of Antimicrobial Agents. 2005; 26, 389–395.

Ethics Approval

Original Articles

How to Cite



“NEGATIVE IMPACT OF PROLONGED ANTIBIOTICS OR PERSISTENT DIARRHEA ON VITAMIN K1 LEVELS IN 2-24 WEEKS AGED EGYPTIAN INFANTS” (2018) Mediterranean Journal of Hematology and Infectious Diseases, 10(1), p. e2018010. doi:10.4084/mjhid.2018.010.