Life-Threatening Bleeding in a Patient Treated with Cefonicid
Authors: Jose A. Riancho
Journal: Annals of Internal Medicine (1995)

Letters15 September 1995Life-Threatening Bleeding in a Patient Treated with CefonicidJose A. Riancho, MD, Jose M. Olmos, MD, and Carmen Sedano, MDJose A. Riancho, MDHospital M. Valdecilla; University of Cantabtia; 39008 Santander; SpainSearch for more papers by this author, Jose M. Olmos, MDHospital M. Valdecilla; University of Cantabtia; 39008 Santander; SpainSearch for more papers by this author, and Carmen Sedano, MDHospital M. Valdecilla; University of Cantabtia; 39008 Santander; SpainSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-123-6-199509150-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Although cephalosporins are generally considered to be safe and well-tolerated antimicrobial agents, they may have several adverse hematologic effects, including hemolytic anemia, neutropenia, thrombocytopenia, and coagulation defects. Compounds with an N-methyl-thiotetrazole (NMTT) side chain (such as moxalactam, cefotetan, or cefamandole) have been associated with a higher incidence of bleeding [1]. Free NMTT inhibits vitamin K epoxide reductase, thus interfering with the carboxylation of several factors in the coagulation cascade [2]. Cefonicid is a second-generation cephalosporin that does not contain an NMTT chain and that is usually considered free of hemorrhagic adverse effects. We describe a patient who ...References1. Brown RB, Klar J, Lemeshow S, Teres D, Pastides H, Sands M. Enhanced bleeding with cefoxitin or moxalactam. Statistical analysis within a defined population of 1493 patients. Arch Intern Med. 1986; 146:2159-64. Google Scholar2. Creedon KA, Suttie JW. Effect of N-methyl thiotetrazole on vitamin K epoxide reductase. Thrombosis Res. 1986; 44:147-53. Google Scholar3. Andrade RJ, Lucena MI, Medina C, Lazo D, Gonz lez-Correa JA, Sanchez F. Evaluaci&162;n de la coagulaci&162;n sangu&161;nea en pacientes cirr&162;ticos en tratamiento con cefonicida. Rev Clin Esp. 1992;190:160-1. Google Scholar4. Monerris H, Horga JF, P&130;rez-Mateo M. Hipoprotrombinemia asociada a cefonicid. Med Clin (Barcelona) 1995;104:237-8. Google Scholar5. Cohen H, Scott SD, Mackie IJ, Shearer M, Bax R, Karran SJ, et al. The development of hypoprothrombinaemia following antibiotic therapy in malnourished patients with low serum vitamin K1 levels. Br J Haematol. 1988; 68:63-6. Google Scholar Author, Article, and Disclosure InformationAffiliations: Hospital M. Valdecilla; University of Cantabtia; 39008 Santander; Spain PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byEosinophilic Hepatitis Associated with Cefonicid TherapyCefonicid 15 September 1995Volume 123, Issue 6Page: 472-473KeywordsAnticoagulant therapyCoagulation factorsHemorrhageInternational normalized ratioKidney stonesPartial thromboplastin timeUrinary tract infectionsUrineVitamin K Issue Published: 15 September 1995 Copyright & PermissionsCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...