Bobajob

There is no effective proactive measures you can take other than standard hemolysis checks ie LDH, haptoglobins if the Hb falls unexpectedly. Positive DAT's are common in patients with infections Piperacillin induced AIH is rare considering how commonly the drug is used. As with other penicillins the patient usually has to be on intravenous doses of the drug for at least a week before the DAT becomes positive (usually IgG). Even then the majority of patients do not hemolyse. The investigation of an hemolysing patient is relatively straightfoward as the drug (10mg/mL solution in PBS) readily coats red cells at 37C though raising the pH increases the uptake. Testing the patients serum and an eluate from the patients red cells with the drug treated cells by IAT usually gives convincing results. You would expect the eluate to be negative by IAT with untreated red cells.