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Antimicrobial Stewardship & Healthcare Epidemiology
By Dakota Sicignano and Julie Gray.
Abstract
We report a case of cefazolin-induced coagulopathy in a patient with a methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia.
Medical intensive care unit at a 1,500-bed, tertiary medical center.
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A 74-year-old male presented to the medical intensive care unit with septic shock secondary to a left skin and soft tissue infection. Blood cultures resulted positive for and the patient was initiated on cefazolin therapy. Shortly after initiation of therapy, patient lab work showed an increased INR to a max of >9.67. Hematology was consulted, and further work-up revealed a clotting deficiency consistent with a vitamin K-mediated coagulopathy. Intravenous vitamin K was administered, and the patient had rapid correction of their INR. Therapy was switched to oxacillin for the completion of treatment with no further cases of coagulopathy.
Cefazolin-associated coagulopathy, though rare, should be considered in patients with unexplained INR elevation during therapy. Early recognition is critical, as discontinuation of the offending agent and administration of vitamin K can rapidly reverse coagulopathy. Clinicians should maintain heightened awareness in critically ill patients, particularly when additional risk factors for coagulopathy are present.
Published in Antimicrobial Stewardship & Healthcare Epidemiology. The abstract is shown as published and remains the work of its authors; read the full article at the source.
cambridge.org/core/product/identifier/S2732494X26108936/type/journal_article
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