Cefazolin-induced hypoprothrombinemia

Area of Science:

• Pharmacology
• Internal Medicine
• Nephrology

Background:

• Long-term antibiotic therapy, particularly cephalosporins, is linked to diverse side effects.
• Common cephalosporin adverse events include dermatologic reactions and gastrointestinal disturbances.
• Antibiotic-induced coagulopathy, often due to hypoprothrombinemia, is a recognized but infrequent complication.

Observation:

• A rare case of spontaneous retroperitoneal hematoma is presented.
• This event occurred during cefazolin administration for vertebral osteomyelitis.
• The patient exhibited normal renal function at the time of the adverse event.

Findings:

• Cefazolin, a cephalosporin antibiotic, was implicated in causing coagulopathy.
• This contrasts with most reported cases of cefazolin-induced coagulopathy, which typically involve patients with renal impairment.
• The presented case expands the understanding of cefazolin's potential to induce bleeding complications even in patients with preserved kidney function.

Implications:

• Clinicians should be vigilant for rare bleeding complications associated with cefazolin, even in patients with normal renal function.
• This case underscores the importance of monitoring coagulation parameters in patients on long-term cefazolin therapy.
• Further research may be warranted to elucidate the precise mechanisms of cefazolin-induced coagulopathy in non-renal failure settings.