Hemoglobin reduction due to cefoperazone sodium and sulbactam sodium

Abstract

A 36-year-old male patient undergoing renal transplantation had postoperative fever and painful urination. Laboratory tests showed the white blood cell count (WBC) 17.1×109/L, neutrophils 0.92, hemoglobin (Hb) 113 g/L, and calcitonin (PCT) 3.04 μg/L. Urinary tract infection was considered and an IV infusion of cefoperazone sodium and sulbactam sodium 1.5 g every 8 hours was given. On day 4 of medication, painful urination was relieved and his body temperature returned to normal. Laboratory tests showed PCT 0.43 μg/L, WBC 8.5×109/L, neutrophils 0.90, and Hb 81 g/L. Anti-infective treatment was continued and subcutaneous injection of recombinant human erythropoietin injection (CHO cell) 4 000 IU every 48 hours was given. On day 7, laboratory tests showed his WBC 9.7×109/L, neutrophils 0.88, PCT 0.15 μg/L, and Hb 74 g/L. The reduction of hemoglobin was considered to be associated with cefoperazone sodium and sulbactam sodium. Cefoperazone sodium and sulbactam sodium was replace by sequential therapy of oral cefuroxime. On day 2 of drug replacement, his Hb was 80 g/L and recombinant human erythropoietin injection (CHO cell) was discontinued. On day 7, his Hb was 90 g/L and on day 12, 97 g/L. Key words: Cefoperazone; Sulbactam; Anemia, hypochromic