Key result
Vitamin K1 prophylaxis prevents hypoprothrombinemia and bleeding associated with cefoperazone therapy.
Why the study?
Hypoprothrombinemia and hemorrhage associated with cefoperazone therapy have been reported infrequently, and its true incidence and prevention are unclear.
Does cefoperazone therapy cause hypoprothrombinemia and hemorrhage?
Cohort (n=80)
Does cefoperazone therapy cause hypoprothrombinemia and hemorrhage?
Hypoprothrombinemia is a common and preventable complication of cefoperazone therapy, suggesting the need for routine phytonadione prophylaxis.
Cefoperazone without prophylaxis was associated with hypoprothrombinemia and hemorrhage; leaves open whether routine vitamin K1 prevents events.
Cefoperazone, a beta-lactam antibiotic with a methylthiotetrazole side chain, has been reported infrequently to cause hypoprothrombinemia and hemorrhage. We retrospectively analyzed the records of 80 patients who had been given this drug for more than 72 hours. Nine patients received vitamin K1 (phytonadione) prophylaxis and had no evidence of hemorrhage. Of the remaining 71 patients, 32 had prothrombin times measured; 14 of them had hypoprothrombinemia. Prothrombin times ranged from 14.8 to 97.3 seconds at a mean of 6.2 days after initiation of therapy. Seven of the 14 patients had clinically significant hemorrhage and five required transfusions. Two patients with clinically evident hemorrhage died during or immediately after cefoperazone therapy. Prothrombin times rapidly returned to normal in all patients treated with phytonadione. We believe hypoprothrombinemia is a more common complication of cefoperazone therapy than is generally acknowledged, and is preventable. Unless clinically contraindicated, we recommend that all patients treated with cefoperazone receive phytonadione prophylaxis.
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MUELLER et al. (1987) conducted a cohort in Patients receiving cefoperazone therapy (n=80). Cefoperazone without vitamin K1 prophylaxis vs. Cefoperazone with vitamin K1 prophylaxis was evaluated on Hypoprothrombinemia and hemorrhage. Cefoperazone therapy without vitamin K1 prophylaxis was associated with hypoprothrombinemia in 14 of 32 tested patients, whereas 9 patients receiving prophylaxis had no evidence of hemorrhage.
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