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.

Figures

Fig. 1
Fig. 1
Changes in coagulation functional parameters with time after admission. APTT activated partial thromboplastin time, bid twice daily, CPZ cefoperazone, PT prothrombin time, qd once daily, s seconds, SAM sulbactam
Fig. 2
Fig. 2
Changes in platelet count with time after admission. bid twice daily, CPZ cefoperazone, qd once daily, SAM sulbactam

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