Evaluation of cefoperazone/sulbactam and vitamin k use in patients with bacterial infections

Abstract

Objective: The objectives of this study were to evaluate the effects of Vitamin K use for bleeding or coagulopathies prevention and to assess the occurrence of drug-related problems in patients receiving cefoperazone/sulbactam. Methods: The prospective study was conducted between January and April 2018 at 5 general medicine wards in Mahasarakham Hospital, Thailand. Patients above 18 years of age with bacterial infections who received cefoperazone/sulbactam concurrent with Vitamin K were included. Rate of bleeding, coagulopathies, and drug-related problems were evaluated. Results: Forty-three eligible patients enrolled in this study. Most were women (72.1%), average ages were 64.7 years old and 93.0% had comorbidities (most were diabetes, hypertension, and chronic kidney disease). High doses of cefoperazone/sulbactam have been used in 35 patients (81.4%). Gastrointestinal bleeding occurred in one patient (8.3%), 24 patients had prolonged prothrombin time (55.8%), and 8 patients had prolonged activated partial thromboplastin time (18.6%). Anticipated risk factors were not associated with bleeding. Drug-related problems were missing of dose adjustment for cefoperazone/sulbactam in patients with renal impairment (4.7%), drug interactions between warfarin and Vitamin K (4.7%), and drug allergy (2.3%). Conclusion: This study found that cefoperazone/sulbactam aggravated bleeding and coagulopathies despite using Vitamin K for prevention. We support the use of Vitamin K for the prevention of bleeding in high-risk patient such as elderly who receive cefoperazone/sulbactam.