Elevated PT, APPT and PT/INR possibly associated with doxycycline and cefoperazone co‐administration: A case report. (28th August 2017)

• Record Type: Journal Article
• Authors: Zhu, X. Q.; Guo, C. F.; Wen, Y. G.; Shang, D. W.; Hu, J. Q.; Deng, S. H.; Tan, Y.; Qiu, C.
• Is Part Of: Journal of clinical pharmacy and therapeutics. Volume 43:Number 1(2018)
• Page Start: 141
• Page End: 144
• Publication Date: 2017-08-28
• Subjects: case report -- cefoperazone -- coagulation parameters -- doxycycline -- drug–drug interaction; Clinical pharmacology -- Periodicals; Chemotherapy -- Periodicals; 615
• DOI: 10.1111/jcpt.12600
• Languages: English
• ISSNs: 0269-4727

Abstract

Summary: What is known and objective: Little is known regarding changes in blood coagulation parameters associated with tetracycline antibiotics. We report a possible case of elevated PT, APPT and PT/INR associated with doxycycline and cefoperazone co‐administration. Case summary: An 83‐year‐old Chinese male inpatient with severe pneumonia, chronic renal insufficiency and malnutrition experienced elevated PT, APPT and PT/INR which occurred within a few days of doxycycline added to his cefoperazone treatment and returned to normal after removal of it. What is new and conclusion: Very close monitoring of coagulation parameters might be advisable in those subjects when administering doxycycline and cefoperazone concomitantly. Abstract : Little is known regarding changes in blood coagulation parameters associated with tetracycline antibiotics. We report a possible case of elevated PT, APPT and PT/INR associated with doxycycline and cefoperazone co‐administration. His PT, APTT and PT/INR were within normal limits during his initial cefoperazone‐tazobactam treatment period. Doxycycline was empirically added to treat his more severe pneumonia on day 12. The PT, APTT and PT/INR levels began to increased gradually within a few days of doxycycline treatment, of which his PT and PT/INR levels reached critical values on day 18 (his PT and PT/INR values on that day were 33.1 seconds and 3.10, respectively). Doxycycline was discontinued on that day, whereas his cefoperazone‐tazobactam was still held. His elevation of PT, APTT and PT/INR levels resolved significantly following withdrawal of doxycycline.