Prevention of vitamin K deficiency bleeding: efficacy of different multiple oral dose schedules of vitamin K

Abstract

There is consensus that late vitamin K defi ciency bleeding (VKDB) should be prevented by vitamin K prophylaxis, One single dose of 1 mg vitamin Ki is effective if given i.m. or s.c., but not if given orally. Repeated oral doses might be as effective as the par enteral dose but the optimal dose regimen remains to be established. Different oral dose schedules are presently used in different countries. In Australia, Germany, The Netherlands and Switzerland active surveillance data on late VKDB were collected in a similar manner and failure rates compared. Identical case definitions were used. There were three basic strategies for oral and one for parenteral vitamin K prophylaxis for healthy new borns in the four countries: (1) daily supplementation of low dose vitamin K (25 pig) for breast-fed infants (The Netherlands); (2) 3 x

Prophylactic Dosing of Vitamin K to Prevent Bleeding

“…10,12,23 Our present data confirm this observation, even upon analysis of a group of infants with an inherently higher risk of VKDB. A great benefit of this type of prophylaxis is that the prophylaxis does not depend on daily or weekly adherence to the advised administration or the still rather uncharacterized intestinal absorption of vitamin K in infants.…”

“…11 This regimen significantly decreased the incidence of late VKDB. 12 Previously, however, we and others reported several cases of VKDB based on surveillance studies and studies in high-risk populations, despite strong indications of adherence to the recommendations. In fact, in >80% of infants with biliary atresia (BA), severe late VKDB was the presenting symptom.…”

Vitamin K-Deficient Intracranial Hemorrhage as the First Symptom of Cytomegalovirus Hepatitis with Cholestasis

“…The oral VitK prophylactic failure rates per 100,000 live births (including cases given all recommended doses and those given incomplete prophylaxis) were 2.3 (95% CI 1.6-3.4) in Germany (December 1992-December 1994) and 2.5 (1.1-4.8) in Australia (January 1993-March 1994) (Cornelissen et al 1997). In Japan, VitK prophylaxis has dramatically reduced the incidence of VitK-D ICH and a similar failure rate of 2.5 was seen in 1990 (Shirahata et al 2002).…”

Vitamin K and childhood cancer: analysis of individual patient data from six case–control studies

“…vitamin K is known to be effective in the prevention of both haemorrhagic disease in neonates and late onset vitamin K deficiency bleeding (McNinch and Tripp, 1991;Sutor et al, 1999;Zipursky, 1999). The efficacy of oral vitamin K is less certain and there have been reports that late bleeding may occur in some healthy breast-fed babies in whom no additional risk factors are identified (McNinch and Tripp, 1991;Cornelissen et al, 1997;Sutor et al, 1999;Zipursky, 1999;Wariyar et al, 2000). Controversy concerning prophylactic I.M.…”