Key result
Broad-spectrum antibiotics caused vitamin K deficiency and macrohaematuria in a patient on a direct oral factor Xa inhibitor, which resolved after vitamin K supplementation.
Case Report (n=1)
Broad spectrum antibiotics can cause vitamin K deficiency, which may present as macrohaematuria and abnormal coagulation assays in patients on direct oral factor Xa inhibitors.
May prompt vitamin K assessment in bleeding DOAC patients on antibiotics; hypothesis-generating case report requiring confirmation.
A 61-year old woman with atrial fibrillation developed macrohaematuria during anticoagulant treatment with a direct oral factor Xa inhibitor for stroke prevention. Abnormal results of coagulation assays were first interpreted as an effect of the anticoagulant. However, upon further testing diagnosis of vitamin K deficiency was established. After vitamin K supplementation, coagulation tests normalized and macrohaematuria disappeared. Treatment with broad spectrum antibiotics for urinary tract infection was finally established as a rare cause for vitamin K deficiency in the patient.
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Sabine Eichinger (2014) conducted a case report in Atrial fibrillation and vitamin K deficiency (n=1). Broad spectrum antibiotics and direct oral factor Xa inhibitor was evaluated on Development of macrohaematuria and vitamin K deficiency. Broad-spectrum antibiotics caused vitamin K deficiency and macrohaematuria in a patient on a direct oral factor Xa inhibitor, which resolved after vitamin K supplementation.
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