Cefotetan and Hypoprothrombinemia
Authors: ANN CONJURA
Journal: Annals of Internal Medicine (1988)

Letters and Corrections1 April 1988Cefotetan and HypoprothrombinemiaANN CONJURA, M.D., WILLIAM BELL, M.D., JAMES J. LIPSKY, M.D.ANN CONJURA, M.D.Search for more papers by this author, WILLIAM BELL, M.D.Search for more papers by this author, JAMES J. LIPSKY, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-108-4-643_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Antibiotics containing the methyl-tetrazolethiol-leaving group have been associated with reductions in the levels of vitamin K-dependent coagulation factors, manifested by prolongation of the prothrombin time and bleeding. Previous reports have noted this complication in patients receiving cefamandole, moxalactam, and cefoperazone (1). Hypoprothrombinemia, without bleeding, has also been reported with the use of cefotetan, another recently available compound containing the methyl-tetrazolethiol-leaving group (2). We report a case of hypoprothrombinemia involving the use of cefotetan that required transfusion.A 30-year-old woman was hospitalized with pneumonia. Therapy with intravenous gentamicin and cefotetan was begun. Baseline serum urea nitrogen level, serum...References1. LIPSKY J. Antibiotic-associated hypoprothrombinemia. J Antimicrob Chemother. 1988. (In press.) CrossrefMedlineGoogle Scholar2. MACKIEWALSHECOHEN IKH. Effects of N-methyl-thiotetrazole cephalosporin on haemostasis in patients with reduced serum vitamin K1 concentrations. J Clin Pathol. 1986;39:1245-9. CrossrefMedlineGoogle Scholar3. LIPSKY J. N-Methyl-thiotetrazole inhibition of gamma carboxylation of glutamic acid: possible mechanism for antibiotic associated hypoprothrombinemia. Lancet. 1983;1:192-3. CrossrefGoogle Scholar4. LIPSKY J. Mechanism of the inhibition of the γ-carboxylation of glutamic acid by N-methyl-thiotetrazole-containing antibiotics. Proc Natl Acad Sci. 1984;81:2893-7. CrossrefMedlineGoogle Scholar5. BECHTOLDANDRASSYJAHNCHEN HKE. Evidence for impaired hepatic vitamin K1 metabolism in patients treated with N-methyl-thiotetrazole cephalosporins. Thromb Haemostas. 1984;51:358-61. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: The Johns Hopkins Medical Institutions Baltimore, MD 21205 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByDrug Interactions Between Antibiotics and Select Maintenance Medications: Seeing More Clearly Through the Narrow Therapeutic Window of OpportunityCephalosporin-Associated Hypoprothrombinemia: Case and Review of the LiteratureCurrent antimicrobial therapy of anaerobic infectionsRandomized, double-blind study of cefotetan and cefoxitin in post-cesarean section endometritis 1 April 1988Volume 108, Issue 4Page: 643-643KeywordsAntibioticsCoagulation factorsHemorrhagePneumoniaProthrombin timeSerum urea nitrogen Issue Published: 1 April 1988 PDF DownloadLoading ...