Department of Pharmacy, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China
Dongyang People's Hospital, Dongyang, Zhejiang, China.
Eur J Hosp Pharm. 2021 Jul;28(4):237-238. doi: 10.1136/ejhpharm-2019-002182. Epub 2020 Jun 17.
Haematologic side effects associated with piperacillin/tazobactam (PTZ) treatment are rare but can be fatal. The exact mechanism by which PTZ causes haemorrhages has not been determined. We report the case of a patient who received PTZ treatment and developed a coagulopathy through a vitamin K-dependent mechanism. A 70-year-old female patient was admitted to the intensive care unit because she had a severe case of pneumonia and a pulmonary thromboembolism. Empirical antibiotic treatment using PTZ was started. Her international normalised ratio (INR) was already increased and became elevated again when PTZ was restarted. Her coagulopathy was reversed by supplementation with vitamin K. We conclude that PTZ can induce coagulopathy through a vitamin K-dependent mechanism and, to our knowledge, this is the first case report to suggest that mechanism. We suggest that patients at risk for a vitamin K deficiency should be monitored for coagulopathy when piperacillin or any other board spectrum antibiotic is administered.
哌拉西林/他唑巴坦（PTZ）治疗相关的血液学副作用较为罕见，但可能是致命的。PTZ 导致出血的确切机制尚未确定。我们报告了一例患者在接受 PTZ 治疗后通过维生素 K 依赖机制发生凝血功能障碍的病例。一名 70 岁女性患者因患有严重肺炎和肺血栓栓塞症而被收入重症监护病房。使用 PTZ 开始经验性抗生素治疗。她的国际标准化比值（INR）已经升高，当重新开始使用 PTZ 时再次升高。她的凝血功能障碍通过补充维生素 K 得到逆转。我们得出结论，PTZ 可以通过维生素 K 依赖机制诱导凝血功能障碍，据我们所知，这是首例提示该机制的病例报告。我们建议，当给予哌拉西林或任何其他广谱抗生素时，应监测有维生素 K 缺乏风险的患者是否发生凝血功能障碍。
