Cefazolin and coagulation disorder : a case report and review of literature

Abstract EN

A 63-year old Yemeni male, known case of end- stage renal disease (ESRD), hypertension and diabe¬tes mellitus, underwent craniotomy and endoscopic removal of an intraventricular mass.

Peri-operatively he was started on cefazolin, a normal diet and regular hemodialysis without heparin.

The international normal¬ising ratio (INR) increased rapidly, reaching 4.2 on day five but responded equally rapidly to parenteral Vitamin K and withdrawal of cefazolin.

Cefazolin is an antibiotic commonly used in clinical practice because of its long half-life, narrow spectrum and its ability for dose adjustment in renal failure pa¬tients.

We review the literature, discuss the risk factors of its use and suggest possible mechanisms causing the prolonged coagulation.