A Retrospective Study of Coagulation Abnormalities in Patients Receiving Cefoperazone Sodium and Sulbactam Sodium

Objective: The study was to investigate the risk factors for coagulopathy and countermeasures during cefoperazone sodium and sulbactam sodium (CPZ-SBT) injection, which could provide scientific reference for the safety of clinical rational drug use. Methods: In our study, 79 patients that have been diagnosed with pneumonia were treated with CPZ-SBT and retrospectively investigated for duration of one year. Records of these patients were reviewed for age, sex, underlying disease, albumin, alanine transaminase, total bilirubin, prothrombin time (PT), nutritional approach, prognosis, hospitalization duration, additional antibiotics and hemorrhage. Results: PT prolongation occurred in 30 out of 79 patients (38.0%). The rate of PT prolongation was significantly higher in the patients with total parenteral nutrition than enteral nutrition (62% vs. 38%, P = 0.009). It was more common in patients receiving antibiotics combinations than single CPZ-SBT (44.3% vs. 16.7%, P = 0.034). In addition, synergistic effect appeared in patients with total parenteral nutrition and combined with antibiotics (P = 0.003). Positive stool occult test and positive gastric juice occult test were significantly different (25.3% vs. 12.1%, P = 0.001; 29.1% vs. 8.9%, P = 0.002, respectively). PT was prolonged for 6.6 +/- 3.6 days after initiation of CPZ-SBT injection, and rapidly returned to normal in all patients treated with vitamin K-1, after 1.4 +/- 0.9 days. Conclusion: PT prolongation was susceptible to parenteral nutrition and share antibiotics for the patients treated with CPZ-SBT. The coagulopathy could be reversed by an intramuscular injection of 10 mg/d vitamin K-1. We recommend daily intramuscular injection vitamin K-1 for these patients.