Fatal Vitamin K-Dependent Coagulopathy Associated with Cefoperazone/Sulbactam: A Case Report
Huan-Rong Hu, Huan-Rong Hu
Abstract
This case report describes a suspected and fatal adverse reaction involving vitamin K-dependent coagulopathy that might be associated with cefoperazone/sulbactam (CPZ/SAM), a combined antimicrobial formulation. We reported a patient diagnosed with acute cerebral infarction and secondary pulmonary infection who was treated with an intravenous infusion of CPZ/SAM at 3 g twice daily. After receiving treatment with CPZ/SAM, the patient developed a fatal adverse reaction of CPZ-induced hemorrhage. The Naranjo assessment score in this report was 5, suggesting that the patient's coagulation function disorder was potentially associated with the use of CPZ/SAM. To prevent vitamin K-dependent coagulopathy caused by CPZ/SAM, it is suggested to avoid cephalosporins in patients with a high risk of bleeding unless the need for cephalosporins is compelling.
Conflict of interest statement
Huan-rong Hu has no conflicts of interest that are directly relevant to the content of this case report.
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References
- Wang CP, Yaki K, Lin PJ, Jin DY, Makabe KW, Stafford DW. Identification of a gene encoding a typical γ-carboxyglutamic acid domain in the tunicate Halocynthia roretzi. J Thromb Haemost. 2010;1(1):118–123. doi: 10.1046/j.1538-7836.2003.00069.x.
- Prorok M, Geng JP, Warder SE, Castellino FJ. The entire γ-carboxyglutamic acid- and helical stack-domains of human coagulation factor IX are required for optimal binding to its endothelial cell receptor. Chem Biol Drug Des. 2010;48(3):281–285.
- Durante E. Management of Gram-negative and fungal endocarditis. Int J Antimicrob Agents. 2010;36(Suppl. 2):S40–S45. doi: 10.1016/j.ijantimicag.2010.11.012.
- Shearer MJ, Bechtold H, Andrassy K, et al. Mechanism of cephalosporin-induced hypoprothrombinemia: relation to cephalosporin side chain, vitamin K metabolism, and vitamin K status. J Clin Pharmacol. 2013;28(1):88–95. doi: 10.1002/j.1552-4604.1988.tb03106.x.
- Agnelli G, Del FA, Parise P, et al. Cephalosporin-induced hypoprothrombinemia: is the N-methylthiotetrazole side chain the culprit? Antimicrob Agents Chemother. 1986;29(6):1108–1109. doi: 10.1128/AAC.29.6.1108.
- Cristiano P. Hypoprothrombinemia associated with cefoperazone treatment. Drug Intell Pharm. 1984;18(4):314–316.
- Shenkenberg TD, Mackowiak PA, Smith JW. Coagulopathy and hemorrhage associated with cefoperazone therapy in a patient with renal failure. South Med J. 1985;78(4):488–489. doi: 10.1097/00007611-198504000-00035.
- Ozen IO, Moralioğlu S, Karabulut R, et al. Cefoperazone induced gastro-intestinal haemorrhage: a case report. Acta Chir Belg. 2008;108(6):777–778. doi: 10.1080/00015458.2008.11680339.
- Jr FH, Cetnarowski AB, Lumish RM, Schafer FJ. Cefoperazone-induced coagulopathy. Drug Intell Clin Pharm. 1986;20(4):281–283. doi: 10.1177/106002808602000413.
- Ge T, Shen Q, Wang N, et al. Diagnostic values of alpha-fetoprotein, dickkopf-1, and osteopontin for hepatocellular carcinoma. Med Oncol. 2015;32(3):59. doi: 10.1007/s12032-014-0367-z.
- Katukuri GR, Maddala RN, Ramamoorthi K, Hande M. Cefoperazone induced gastrointestinal bleeding. J Clin Diagn Res. 2016;10(8):OD10-1.
- Schentag JJ, Welage LS, Grasela TH, Adelman MH. Determinants of antibiotic-associated hypoprothrombinemia. Pharmacotherapy. 2012;7(3):80–86. doi: 10.1002/j.1875-9114.1987.tb03522.x.
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