PMID: 3746096Sep 1, 1986Paper

In vitro comparison of antiplatelet effects of beta-lactam penicillins

The Journal of Laboratory and Clinical Medicine
C FletcherG D Qureshi

Abstract

beta-Lactam antibiotics have been shown to cause platelet dysfunction and bleeding in some patients. However, relative antiplatelet activity of various beta-lactams has remained controversial. Results of clinical studies have been variable because of the presence of underlying disease in the study patients, in addition to inherent difficulties of in vivo experimentation such as individual variations of drug metabolism and drug kinetics. Thus, we designed in vitro experiments to study the direct effect of penicillin G, carbenicillin, ticarcillin, mezlocillin, piperacillin, nafcillin, and azlocillin on platelets. Platelets obtained from normal volunteers were exposed in vitro for 15 minutes to increasing concentrations of the test penicillins (10.0, 12.5, 15.0, and 20.0 mmol/L), and the platelet aggregation response determined after the additional of adenosine diphosphate (2.5 to 5.0 mumol/L), epinephrine (0.1 X 10(-3) mol/L), thrombin (0.01 to 0.02 U/ml), and collagen (11.62 micrograms/ml). All tested penicillins inhibited platelet aggregation in a saturable dose-dependent manner that was reversible by platelet washing. Biostatistical comparison of inhibition of platelet aggregation demonstrated nafcillin to cause significantly ...Continue Reading

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