Nakamura Shunsuke, Shinohara Natsuyo
Department of Emergency Medicine, Okayama Rosai Hospital, Okayama, JPN.
Cureus. 2025 Feb 24;17(2):e79540. doi: 10.7759/cureus.79540. eCollection 2025 Feb.
Cefmetazole (CMZ), a cephamycin antibiotic containing an N-methyltetrazolethiol (NMTT) group, is known to interfere with vitamin K metabolism, potentially causing coagulation disorders. We present the case of a 78-year-old man with chronic kidney disease who developed a coagulation disorder during CMZ administration, exacerbated by chronic vitamin K deficiency from prolonged enteral nutrition. In the context of chronic vitamin K deficiency precipitated by prolonged enteral nutrition for renal disease, the administration of CMZ-a medication that disrupts vitamin K metabolism and reduces coagulation factor activity through a mechanism similar to that of warfarin-led to abnormal blood coagulation test results. Clinical improvement followed the discontinuation of CMZ and vitamin K supplementation. This report highlights the importance of monitoring vitamin K status in patients receiving CMZ, particularly those with risk factors for deficiency, and reviews the relevant literature to highlight the mechanisms and management strategies for such complications.
头孢美唑（CMZ）是一种含有N-甲基四氮唑硫醇（NMTT）基团的头孢霉素类抗生素，已知其会干扰维生素K代谢，有可能导致凝血障碍。我们报告一例78岁患有慢性肾脏病的男性患者，在使用CMZ期间出现了凝血障碍，因长期肠内营养导致慢性维生素K缺乏而加重。在因肾脏疾病长期肠内营养引发慢性维生素K缺乏的情况下，使用CMZ（一种通过类似于华法林的机制破坏维生素K代谢并降低凝血因子活性的药物）导致凝血试验结果异常。停用CMZ并补充维生素K后临床症状改善。本报告强调了监测接受CMZ治疗患者的维生素K状态的重要性，特别是那些有缺乏风险因素的患者，并回顾相关文献以突出此类并发症的机制和管理策略。
