Medicine: Handle with Care

Doctors are keenly aware that the antibiotics (sulfa drugs, penicillin, streptomycin, etc.) have two great dangers: 1) sometimes the drug has a poisonous effect on the patient, and 2) the bacteria under attack may develop a tolerance for the drug. Last week doctors at the 13th Congress of the International Society of Surgery in New Orleans were reminded of another danger: antibiotics speed up the clotting time of the blood, thus subject the patient to the risk of death from blood clots forming, breaking loose, and being carried through the heart into the lungs.

Now that shock and infection have been brought under control by science, thromboembolism* has replaced them as the principal cause of death after operations, reported Dr. Alton Ochsner of Tulane. Because of the clotting speedup, he said, the “almost routine administration of antibiotics to all hospital patients” has become a major factor in the increase in cases of thromboembolism.

In cases where the blood clots quickly, an anti-clotting agent to slow the process might be the answer. But Ochsner warned that such agents are “too dangerous.” His suggestion: alpha tocopherol phosphate, “a normal antithrombin found within the blood [which] appears to represent a satisfactory substance to correct an antithrombin deficiency.”

Ochsner was not, he said, speaking against antibiotics, “the greatest thing in medicine”: their good points dramatically offset their bad. The main thing, he said, is that doctors must know the bad points, and deal with them so as to take full advantage of the good ones.

* From the Greek thrombos (clot) and embolos (stopper).