Cefoperzone - Sulbactum induced hypoprothrombinemia

An elderly man who presented to the hospital with UTI and renal failure was given cefoperazone-sulbactum, subsequently developed hemetemesis and hematuria. Cefoperazone, a parenteral third generation cephalosporin is effective against many Gram positive and Gram negative organisms. Cefoperazone, similar to other cephalosporins such as cefamandole, contains the methyltiotetrazole (NMTT) side chain, which can cause hypoprothrombinaemia and consequently bleeding manifestations. This type of coagulation disorder usually responds to Vitamin K administration.