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Related Experiment Videos

Hypoprothrombinemia associated with cefoperazone therapy.

R J Mueller1, D Green, J P Phair

  • 1Department of Medicine, Rehabilitation Institute of Chicago, Ill.

Southern Medical Journal
|November 1, 1987
PubMed
Summary

Cefoperazone antibiotic use can cause bleeding due to low prothrombin levels. Vitamin K1 (phytonadione) prophylaxis effectively prevents this serious complication in patients receiving cefoperazone.

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Area of Science:

  • Pharmacology
  • Internal Medicine
  • Infectious Diseases

Background:

  • Cefoperazone, a beta-lactam antibiotic, is associated with rare reports of hypoprothrombinemia and hemorrhage.
  • The methylthiotetrazole side chain of cefoperazone is implicated in these adverse effects.

Purpose of the Study:

  • To retrospectively analyze the incidence of hypoprothrombinemia and hemorrhage in patients treated with cefoperazone.
  • To evaluate the efficacy of vitamin K1 (phytonadione) in preventing these complications.

Main Methods:

  • Retrospective analysis of 80 patients receiving cefoperazone for over 72 hours.
  • Comparison of outcomes between patients receiving vitamin K1 prophylaxis and those who did not.
  • Measurement of prothrombin times in a subset of patients.

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Main Results:

  • Fourteen of 32 patients (43.8%) not receiving prophylaxis developed hypoprothrombinemia.
  • Seven of these 14 patients experienced clinically significant hemorrhage, with two fatalities.
  • No hemorrhage was observed in the nine patients who received vitamin K1 prophylaxis.

Conclusions:

  • Hypoprothrombinemia and hemorrhage are more common complications of cefoperazone therapy than previously acknowledged.
  • Vitamin K1 (phytonadione) prophylaxis is effective in preventing cefoperazone-induced hypoprothrombinemia and hemorrhage.
  • Routine phytonadione prophylaxis is recommended for patients receiving cefoperazone unless contraindicated.