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Related Experiment Video

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Cefoperazone-treated Mouse Model of Clinically-relevant Clostridium difficile Strain R20291

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Cefazolin-Associated INR Elevation: A Case Report.

Jeremiah L Barnes¹, Inez E Pabian¹, Abigail K Bonjour¹

¹Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin, USA.

Journal of Pharmacy Practice

|October 7, 2022

Summary

This summary is machine-generated.

This case study highlights how cefazolin can significantly elevate a patient's international normalized ratio (INR), especially during COVID-19 infection. Management involved vitamin K and switching antibiotics to resolve the bleeding risk.

Keywords:

COVID-19 apixaban cefazolin international normalized ratio vitamin K

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Published on: January 22, 2021

Area of Science:

Pharmacology
Infectious Diseases
Hematology

Background:

Apixaban is a common anticoagulant.
Coronavirus disease 2019 (COVID-19) can affect various bodily systems.
Malnutrition can impact drug metabolism and patient outcomes.

Observation:

A patient on apixaban developed severe bleeding due to an elevated international normalized ratio (INR > 22.5).
This occurred while receiving intravenous cefazolin for osteomyelitis during COVID-19 infection and malnutrition.
The patient presented with bleeding at the internal jugular tunneled catheter site.

Findings:

Treatment with vitamin K and switching antimicrobial therapy from cefazolin to daptomycin successfully managed the coagulopathy and bleeding.
Follow-up laboratory tests confirmed sustained improvement in the patient's INR levels.

Implications:

Cefazolin may contribute to significant INR prolongation in patients taking apixaban.
Vitamin K administration and changing antibiotic therapy are effective strategies for managing this drug interaction.
This case underscores the importance of monitoring coagulation parameters in patients with complex medical conditions receiving multiple medications.