en
Scientific article
English

Prevention of vitamin K deficiency bleeding with three oral mixed micellar phylloquinone doses: results of a 6-year (2005-2011) surveillance in Switzerland

ContributorsLaubscher, Bernard; Bänziger, Oskar; Schubiger, Gregor; the Swiss Paediatric Surveillance Unit (SPSU)
Published inEuropean journal of pediatrics, vol. 172, no. 3, p. 357-360
Publication date2013
Abstract

In 2003, the Swiss guidelines to prevent vitamin K deficiency bleeding (VKDB) were adapted. As two oral doses (2 mg, hour/day 4) of mixed micellar VK preparation had failed to abolish late VKDB, a third dose (week 4) was introduced. This report summarizes the new guidelines acceptance by Swiss pediatricians and the results of a prospective 6-year surveillance to study their influence on the incidence of VKDB. The new guidelines acceptance by Swiss pediatricians was evaluated by a questionnaire sent to all pediatricians of the Swiss Society of Paediatrics. With the help of the Swiss Paediatric Surveillance Unit, the incidence of VKDB was monitored prospectively from July 1, 2005 until June 30, 2011. Over a 6-year period (458,184 live births), there was one case of early and four cases of late VKDB. Overall incidence was 1.09/10(5) (95 % confidence intervals (CI) 0.4-2.6). Late VKDB incidence was 0.87/10(5) (95 % CI 0.24-2.24). All four infants with late VKDB had an undiagnosed cholestasis at the time of bleeding; parents of 3/4 had refused VK prophylaxis, and in 1/4, the third VK dose had been forgotten. Compared with historical control who had received only two oral doses of mixed micellar VK (18 cases for 475,372 live births), the incidence of late VKDB was significantly lower with three oral doses (Chi(2),Yates correction, P = 0.007).

Keywords
  • Administration, Oral
  • Antifibrinolytic Agents/administration & dosage/therapeutic use
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Guideline Adherence/statistics & numerical data
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Micelles
  • Physician's Practice Patterns/statistics & numerical data
  • Population Surveillance
  • Practice Guidelines as Topic
  • Prospective Studies
  • Questionnaires
  • Switzerland/epidemiology
  • Treatment Outcome
  • Vitamin K 1/administration & dosage/therapeutic use
  • Vitamin K Deficiency Bleeding/epidemiology/prevention & control
Citation (ISO format)
LAUBSCHER, Bernard, BÄNZIGER, Oskar, SCHUBIGER, Gregor. Prevention of vitamin K deficiency bleeding with three oral mixed micellar phylloquinone doses: results of a 6-year (2005-2011) surveillance in Switzerland. In: European journal of pediatrics, 2013, vol. 172, n° 3, p. 357–360. doi: 10.1007/s00431-012-1895-1
Main files (1)
Article (Published version)
accessLevelRestricted
Identifiers
ISSN of the journal0340-6199
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