Chung Amy H, Watson Kristin
Veterans Affairs Maryland Health Care System-Baltimore Division, Baltimore, MD, USA.
Am J Health Syst Pharm. 2008 May 1;65(9):823-6. doi: 10.2146/ajhp070243.
A case of cefazolin-induced hypoprothrombinemia in a patient with renal failure is reported.
A 50-year-old African-American woman was transferred from the orthopedics service to the internal medicine service for management of acute renal failure. Before her transfer, she had spinal surgery and subsequently developed a wound infection complicated by Escherichia coli bacteremia. After trials of multiple antibiotics, she developed acute interstitial nephritis and renal failure. On the day of her transfer to the internal medicine service, i.v. cefazolin sodium 1 g was administered every 24 hours to eradicate the E. coli detected in blood cultures. Her baseline International Normalized Ratio (INR) was 1.3. On day 7 of cefazolin therapy, her INR increased to 4.0. Because of her recent history of bleeding and hypotension, vitamin K 10 mg i.v. was administered, followed by 5 mg orally for the next two days. Her INR decreased and normalized at 1.1. The patient had no changes to other drug therapies and had no medical conditions known to independently affect prothrombin time during this episode. The score on the Naranjo et al. adverse-event probability scale revealed a probable relationship between cefazolin and hypoprothrombinemia in this patient.
A patient with a postsurgery wound infection and acute renal failure developed hypoprothrombinemia after receiving cefazolin for seven days.
报告1例肾衰竭患者头孢唑林引起的低凝血酶原血症。
一名50岁非裔美国女性因急性肾衰竭的治疗从骨科转入内科。转科前，她接受了脊柱手术，随后发生伤口感染并并发大肠杆菌菌血症。在试用多种抗生素后，她出现了急性间质性肾炎和肾衰竭。转入内科当天，每24小时静脉注射1g头孢唑林钠以清除血培养中检测到的大肠杆菌。她的基线国际标准化比值（INR）为1.3。在头孢唑林治疗的第7天，她的INR升至4.0。鉴于她近期有出血和低血压史，静脉注射了10mg维生素K，随后两天口服5mg。她的INR下降并恢复正常至1.1。在此期间，患者的其他药物治疗无变化，也没有已知会独立影响凝血酶原时间的疾病。Naranjo等人的不良事件概率量表评分显示，该患者的头孢唑林与低凝血酶原血症之间可能存在关联。
一名术后伤口感染并伴有急性肾衰竭的患者在接受头孢唑林治疗7天后发生了低凝血酶原血症。
