Arch Dis Child 1998;79:295-297 ( October )

Annotation

The vitamin K debacle: cut the Gordian knot but first do no harm

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	Introduction

As clinicians who have contributed to the data and the discussions about vitamin K prophylaxis to prevent vitamin K deficiency bleeding (VKDB) in infancy, we are acutely aware that the debate about the advantages and disadvantages of various forms of prophylaxis may undermine public confidence and so put at risk potential health benefit. Echoing Von Kries¹ we suggest in this annotation that a radical solution is urgently required and could be introduced. Sadly, the history of vitamin K prophylaxis is replete with examples of medical practice driven by fashion and controversy. For example, over enthusiastic dosing with synthetic vitamin K₂ (Synkavit, Roche, Herts, UK) during the 1960s led to complications of haemolysis, hyperbilirubinaemia, and kernicterus, which brought the practice of vitamin K prophylaxis into some disrepute. The most dramatic controversy, still current, originates from reports by Golding and colleagues that intramuscular prophylaxis with vitamin K₁ may be associated with an . . . [Full text of this article]

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