Impact of Probiotics on Coagulation Function in Older Adults Aged ≥60 years Patients Receiving Cefoperazone-Sulbactam: A Retrospective Study.

BACKGROUND: Coagulation abnormalities are frequently observed in elderly patients, especially in those with antibiotic therapy like cefoperazone-sulbactam. Probiotics are suggested to modify coagulation via their influence on gut microbiota and systemic inflammation, however the studies focusing on probiotics in the management of coagulation disturbances in older adults aged ≥60 years patients during antibiotic therapy are limited. Our study aimed to observe the effect of probiotics on coagulation function in older adults aged ≥60 years patients treated with cefoperazone-sulbactam, through comprehensive coagulation parameters including prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT), and platelet count (PLT).

METHODS: This retrospective study included patients who had received cefoperazone-sulbactam monotherapy or combined with probiotic therapy. Probiotic exposure was defined as oral administration of probiotic preparations prescribed during cefoperazone-sulbactam therapy, initiated concurrently with or during the course of antibiotic treatment according to routine inpatient clinical practice. Baseline characteristics were collected, and coagulation function was assessed before and after treatment.

RESULTS: This study included 247 patients aged ≥60 years. Coagulation parameters of the probiotic group were significantly affected by probiotics, TT was decreased while PLT was slightly decreased. Compared with the nonprobiotic group, patients receiving probiotics showed significantly different posttreatment TT and PLT values (both P < 0.01), whereas no significant between-group differences were observed in PT, APTT, or fibrinogen levels (all P > 0.01). The nonprobiotic group showed no significant variations. In subgroup analysis, more profound changes in coagulation parameters were evident in patients with baseline coagulation abnormalities.

CONCLUSIONS: Probiotics may play a beneficial role in coagulation function modulation in patients aged ≥60 years treated with cefoperazone-sulbactam. The findings propose probiotics as an adjunctive therapy that should be explored in terms of improving coagulation outcomes and reducing bleeding or thrombosis risk in this population. Intervention studies will be needed to confirm these findings and identify the underlying mechanisms.