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Indian Pediatr 2019;56: 1068 |
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Preventive Role of Vitamin K in Antibiotic-induced Vitamin K
Deficiency Bleeding in Neonates: Author's Reply
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Ramesh Aggarwal
Department of Pediatrics, AIIMS, New Delhi, India.
Email: [email protected]
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We acknowledge and express thanks to the authors for
reviewing our study and bringing out relevant points for discussion. We
totally agree that the prevalence of 100% vitamin K deficiency at the
time of enrollment (i.e. at 7th day of antibiotic therapy) can be
attributed to prematurity and co-existing sepsis for which the neonates
required antibiotic therapy. We collected data on type of antibiotics in
the study population as shown in Table I.
TABLE I Distribution of Antibiotic Therapy Between the Two Groups of Neonates with Sepsis
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Antibiotic |
Vitamin K group |
Control group |
|
(n=41) |
(n=39) |
|
Ciprofloxacin |
20
(48.7) |
15
(36.5) |
|
Amikacin |
41
(100) |
39
(100) |
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Piperacillin-Tazobactam* |
20
(48.7) |
28
(71.2) |
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Vancomycin |
7
(17.1) |
6
(15.4) |
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Cefoperazone- Sulbactam |
2
(4.8) |
5
(12.8) |
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Metronidazole |
0 |
1
(2.5) |
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Amoxycillin-clavulanate |
3
(7.3) |
2
(5.1) |
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Ampicillin |
2
(4.8) |
0 |
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Netilmicin |
2
(4.8) |
1
(2.5) |
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Cefazolin |
1
(2.4) |
0 |
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Meropenem |
1
(2.4) |
1
(2.5) |
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Cefotaxime |
0 |
1
(2.5) |
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Data presented as n
(%); all P>0.05 except *P=0.02. |
We did not find any specific class of antibiotics,
which led to the vitamin K deficiency as evident by PIVKA levels >2 ng/mL.
All the babies who had any episode of clinical bleed before enrollment
were excluded. Regarding the postnatal age of 10.5 and 10 days in both
the groups, we enrolled babies at 7th day of antibiotic therapy and
babies with both early and late onset sepsis were enrolled. Neonatal
cholestasis was one of the exclusion criteria at the time of enrollment.
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