Abstract
A coagulation disorder was seen after penicillin-G administration (10 million units/day) in uræmic patients and after high-dose penicillin G (40 million units/day) in patients with a normal glomerular filtration-rate (5 patients after cardiac surgery). This disorder was characterised by: prolongation of bleeding-time, appearing immediately after penicillin-G administration and persisting until 4 days after withdrawal of therapy; disturbance of collagen-induced and ristocetin-induced platelet aggregation; increase of antithrombin-III activity; and inhibition of factor-xa activity. The inhibition of factor-xa activity corres- ponded to that seen after low-dose —heparin prophylaxis. The clinically latent coagulation disorder, when super- imposed upon pre-existing coagulation abnormalities (uræmia, treatment with anti-coagulants) may cause severe bleeding, as observed in 1 patient with acute renal failure on hæmodialysis.
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