Cefoperazone/sulbactam-induced coagulopathy following pancreatic surgery

Cefoperazone/sulbactam is widely prescribed for the treatment of moderate-to-severe infections caused by β-lactamase-producing organisms. It is one of most common antibiotics for hospitalized patients with complicated intra-abdominal infections. However, multiple reports on adverse events raised significant concerns among clinicians regarding safety profile. Data from the China National ADR Monitoring Network revealed that cefoperazone/sulbactam ranked among the top three drugs associated with reported adverse events. In addition to allergic reactions and gastrointestinal disturbances, coagulopathy has emerged as one of the most significant complications. Cefoperazone/sulbactam-induced coagulopathy may lead to serious bleeding episodes and pose a substantial risk to postoperative patients. International literature describes severe hematuria, abdominal wall hematomas, and upper gastrointestinal bleeding in patients treated with cefoperazone/sulbactam. Moreover, a recent study involving 6.191 patients demonstrated a higher risk of bleeding associated with cefoperazone/sulbactam compared to other antibiotics. Considering the lack of Russian data on this adverse effect, we present patients who developed significant coagulation disorders following pancreatic resections associated with cefoperazone/sulbactam administration in early postoperative period.