An elderly patient′s dysfunction of blood coagulation due to cefoperazone sulbactam sodium

Abstract

A 71-year-old woman with acute kidney injury complicated with acute left heart failure received IV infusion of cefoperazone sulbactam sodium (cefoperazone 1000 mg plus sulbactam 500 mg dissolved in 0.9% sodium chloride injection 100 ml, once per 12 hours) because of pulmonary infection. The laboratory tests before taking the medicine revealed the following results: activated partial thromboplastin time (APTT) 43.7 s, prothrombin time (PT) 14.8 s, international normalized ratio (INR) 1.16, fibrinogen (FIB) 5.86 g/L. The results of reexamining in the morning of day 6 of drug administration showed APTT 84.3 s, PT 54.9 s, INR 6.00, FIB 3.38 g/L. She was diagnosed as dysfunction of blood coagulation due to cefoperazone sulbactam sodium. Cefoperazone sulbactam sodium was stopped the same day, change with IV infusion of imipenem and cilastatin and intravenous injection of vitamin K1. The results of reexamining in the afternoon of day of change medical prescription showed APTT 42.6 s, PT 15.1 s, INR 1.19, FIB 3.55 g/L. On day 6 of cefoperazone sulbactam sodium withdrawal, the results of reexamining showed APTT 34.9 s, PT 13.6 s, INR 1.05, FIB 3.56 g/L. Key words: Cefoperazone; Sulbactam; Blood coagulation disorders