dcubed Posted January 19, 2011 Share Posted January 19, 2011 How many have seen antibody to Cefatetan causing hemolysis in a patient? To what lengths must a transfusion service go to demonstrate the presence or absence of Cefotatan antibody? Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted January 19, 2011 Share Posted January 19, 2011 How many have seen antibody to Cefatetan causing hemolysis in a patient? To what lengths must a transfusion service go to demonstrate the presence or absence of Cefotatan antibody?I ahve never seen a case myself (indeed, I have only ever seen one case of drug-induced IHA, and even then it wasn't that convincing), but I would urge you to read Petz and Garratty, Immune Hemolytic Anemias, 2nd edition, 2004, Elsevier Inc, on the subject, with particular reference to pages 295-297, where you will find cited many papers on the subject.:nod::nod: Link to comment Share on other sites More sharing options...
David Saikin Posted January 20, 2011 Share Posted January 20, 2011 Apparently the cephalosporins are used prohylactically post-op in some cases. The literature discusses some Drug-Induced HA associated with their use. Never seen one. The only Drug Induced HA I have ever seen was to acetaminophen - young child of a fellow blood banker; rbc on admission was < one million. Link to comment Share on other sites More sharing options...
Jives Posted January 20, 2011 Share Posted January 20, 2011 we saw probably 3-4 in about a 2 year span from 1999-2001 (i'm guessing here...i would have to pull archived work-ups to be more accurate!) but it was enough of a problem that we got cefatetan taken out of our pharmacy! most were mom's that presented a few weeks after c-section and were anemic (drug was given prophalactically before surgery) and one happened to be some type of GI surgery and the doc's wife was an OB who suggested to him that the anemia after surgery might be do to cefatetan!!! they really do listen at "grand rounds"! Link to comment Share on other sites More sharing options...
rrcc1974 Posted January 20, 2011 Share Posted January 20, 2011 http://www.microbugs.org/showabstract.php?pmid=15373671 Link to comment Share on other sites More sharing options...
Frances Haas Posted January 20, 2011 Share Posted January 20, 2011 http://www.microbugs.org/showabstract.php?pmid=15373671We had a case like this here a few years ago. I don't remember all of the details, but it was scary because we had transfused her and at first thought it was a transfusion reaction. Link to comment Share on other sites More sharing options...
L106 Posted January 21, 2011 Share Posted January 21, 2011 Thanks for the link to the article, rrcc1974. We haven't seen this problem, but I will put the article in my "Drug-Induced Problems" file folder in case I ever need it.Donna Link to comment Share on other sites More sharing options...
dcubed Posted January 21, 2011 Author Share Posted January 21, 2011 How many have seen antibody to Cefatetan causing hemolysis in a patient? To what lengths must a transfusion service go to demonstrate the presence or absence of Cefotatan antibody?A brief synopsis of what happened here: Lady was given three dose of Cefatetan post op as prophalaxis. Released from hospital with 13.6 gram hemoglobin. Three weeks post op patient presented with a 5.6 gram hemoglobin with a 4+ pos DAT by IgG, 2+ pos DAT with anti c3b-c3d. The pre op speciment had a negative DAT. The patient's IAT has been negative on both admissions. To me this is enough evidence to implicate Cefatetan as the culprit, but the patient's doc insisted that we send samples to our reference lab to look for antibody to Cefatetan, which we did. The reference lab did find antibody to Cefatetan.We have had one other case about a year ago that we also believe was anemia due to antibody to Cefatetan.I for one, would not like to receive this drug! Link to comment Share on other sites More sharing options...
Mabel Adams Posted January 23, 2011 Share Posted January 23, 2011 We had a case a couple of years ago--I think it was cefotetan, although it might have been another cephalosporin. The critical thing is to make sure they don't give more of the drug. Our case was post-op gyn and she came back in with a fever I think and they were thinking infection so almost put her back on it! Astute BB tech suspected drug induced HA and gave the doc a head's up. It was a pretty fulminant hemolysis but she came through. We did end up sending it to Garraty's lab in CA (our Red Cross reference lab doesn't do that test) and it came back positive. By the time you get the answer, the crisis is past but I suppose it might be useful for the patient in future. This lady was already allergic to another class of antibiotics so it seemed useful for her to have a firmer idea of the cause. Our ARC medical director urged the dr. to report the case to the FDA; she feels that these drugs require a stronger warning or to be recalled due to the hemolysis risk so she wants the FDA to have the data. Link to comment Share on other sites More sharing options...
galvania Posted January 25, 2011 Share Posted January 25, 2011 I thought that Cefotetan had been banned - at least in Europe??? Link to comment Share on other sites More sharing options...
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