Deranged Coagulation Profile Secondary to Cefazolin Use: Case Report.

Area of Science:

• Pharmacology
• Nephrology
• Hematology

Background:

• Cefazolin, a first-generation cephalosporin, is frequently used for infections.
• While generally safe, intravenous cefazolin has been linked to coagulopathy in case reports.
• Impaired renal function complicates antibiotic selection and dosing, potentially increasing toxicity.

Observation:

• A 72-year-old male with methicillin-sensitive staphylococcus aureus infective endocarditis received IV cefazolin.
• The patient developed a significantly elevated international normalised ratio (INR) during cefazolin therapy.
• Coagulopathy resolved within 48 hours after cefazolin discontinuation and vitamin K administration.

Findings:

• Cefazolin can induce significant coagulopathy, indicated by elevated INR.
• Renal impairment may alter cefazolin metabolism and excretion, potentiating side effects.
• Malnourished patients with kidney injury face an increased risk of cefazolin-induced coagulopathy.

Implications:

• Clinicians should monitor INR in patients receiving cefazolin, particularly those with renal impairment.
• Dose adjustments and careful monitoring are crucial for cefazolin in patients with kidney disease.
• Awareness of cefazolin-related coagulopathy is essential for patient safety, especially in vulnerable populations.