HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Chung, A. H. Articles by Watson, K. Search for Related Content PubMed PubMed Citation Articles by Chung, A. H. Articles by Watson, K.

AMY H. CHUNG, PHARMD., is Post-Graduate Year-1 Resident, Veterans Affairs Maryland Health Care System—Baltimore Division, Baltimore. KRISTIN WATSON, PHARMD., BCPS, is Assistant Professor,. Department of Pharmacy Practice and Sciences, School of Pharmacy, University of Maryland, Baltimore.

Address correspondence to Dr. Watson at the School of Pharmacy, University of Maryland, 20 North Pine Street, Room 430, Baltimore, MD 21201 (kwatson{at}rx.umaryland.edu).

Purpose. A case of cefazolin-induced hypoprothrombinemia in a patient with renal failure is reported. Summary. 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. Conclusion. A patient with a postsurgery wound infection and acute renal failure developed hypoprothrombinemia after receiving cefazolin for seven days. Index terms: Cefazolin sodium; Cephalosporins; Hypoprothrombinemias; International normalized ratio; Kidney failure; Toxicity; Vitamin K; Vitamins