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Enhanced Bleeding With Cefoxitin or Moxalactam: Statistical Analysis Within a Defined Population of 1493 Patients-Reply

Richard B. Brown, MD; Daniel Teres, MD; Michael Sands, MD; Janelle Klar, MD; Stanley Lemeshow, PhD; Harris Pastides
Arch Intern Med. 1987;147(10):1859. doi:10.1001/archinte.1987.00370100173046.
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Our recent study demonstrates enhanced rates of clinical bleeding associated with the use of either cefoxitin or moxalactam, and we believe that our results are valid. The total number of patients studied was large enough to utilize multiple logistic regression modeling. This allowed us to examine associations between patient treatments and conditions, antibiotic usage, and clinical bleeding episodes. It should again be noted that we only studied patients who received antibiotic monotherapy, and that we defined bleeding as a clinical episode that was temporally related to the administration of a targeted antibiotic. Studies such as ours, which employ standard statistical methods, investigate patients in the aggregate, rather than seeking impressions from individual case studies.

Dr McGregor is concerned about the relatively small number of patients in our study who received moxalactam and the conclusions that were drawn. Of the 18 persons who received this product, four (22%) bled. This


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