Hypoprothrombinemia Associated with Cefamandole

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Abstract
Seven patients developed hypoprothrombinemia during the course of cefamandole therapy. In three cases, overt hemorrhaging resulted. After the administration of vitamin K, bleeding stopped and the prothrombin time returned to normal. A significant contributing factor was poor dietary intake, with a mean of 7.3 days with no oral intake. Prior to the development of hypoprothrombinemia, cefamandole was administered for four to six days with a mean dosage of 88.9 mg/kg/d. It is suggested that hypoprothrombinemia secondary to cefamandole may be a result of its high biliary excretion, which suppresses bacterial vitamin K synthesis in the intestine.