Cefoperazone-sulbactam and risk of coagulation disorders or bleeding: a retrospective cohort study. Issue 3 (3rd March 2020)

• Record Type: Journal Article
• Authors: Wang, Wen; Liu, Yanmei; Yu, Chuan; Tan, Jing; Xiong, Weiyi; Dong, Duo; Li, Sheyu; Zhang, Rui; Li, Jijie; Wu, Yu; Zong, Zhiyong; Su, Na; Zou, Kang; Wu, Guizhi; Sun, Xin
• Is Part Of: Expert opinion on drug safety. Volume 19:Issue 3(2020)
• Page Start: 339
• Page End: 347
• Publication Date: 2020-03-03
• Subjects: Cefoperazone-sulbactam -- coagulation disorders -- bleeding -- PT prolongation; Drugs -- Side effects -- Periodicals; Drugs -- Toxicology -- Periodicals; Chemotherapy -- Periodicals; 615.704
• DOI: 10.1080/14740338.2020.1713090
• Languages: English
• ISSNs: 1474-0338

Abstract

ABSTRACT: Objectives : Limited evidence has suggested that cefoperazone-sulbactam causes coagulation disorders and bleeding. Methods : The authors conducted a retrospective study to compare patients receiving cefoperazone-sulbactam versus those treated with cefoperazone-tazobactam or ceftazidime. Propensity-score matching was used to explore whether treatment with cefoperazone-sulbactam increased the risk of prothrombin time (PT) prolongation, coagulation disorders, and bleeding, or decreased platelets (PLT). Results : The cohort included 23, 242 patients. Among patients receiving cefoperazone-sulbactam, the risk of PT prolongation, coagulation disorders, decreased PLT, and bleeding was 5.3%, 9.2%, 15.7%, and 4.2%, respectively. Propensity-score matching analyses suggested that cefoperazone-sulbactam increased the risk of PT prolongation (aOR 2.26, 95% CI 1.61–3.18), coagulation disorders (aOR 1.81, 95% CI 1.43–2.30), and decreased PLT (aOR 1.46, 95% CI 1.25–1.72), but not increase bleeding (aOR 1.05, 95% CI 0.79–1.40) compared with ceftazidime. Patients receiving cefoperazone-sulbactam had higher risk of PT prolongation (aOR 1.53, 95% CI 1.11–2.10), coagulation disorders (aOR 1.53, 95% CI 1.21–1.95), but not decreased PLT (aOR 0.93, 95% CI 0.81–1.07) or bleeding (aOR 1.11, 95% CI 0.87–1.42), compared with those receiving cefoperazone-tazobactam. Conclusion : Cefoperazone-sulbactam may be associated with a higher risk of PT prolongation and coagulation disorders compared with cefoperazone-tazobactam and ceftazidime.