27 July 2022
: Case report 
Hypoprothrombinemia During Cefmetazole Treatment: A Case Report
Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Adverse events of drug therapy, Educational Purpose (only if useful for a systematic review or synthesis)
Yuichiro Haba1ABCDEF*, Hikaru Akizuki2ABCDEF, Naoyuki Hashiguchi2ADEF, Toshio Naito
1ADEF
DOI: 10.12659/AJCR.936712
Am J Case Rep 2022; 23:e936712
Table 2. Summary of the previous reported cases of CMZ-induced hypoprothrombinemia on MEDLINE.
| Year | Country | Age | Sex | Purpose of use of CMZ | PT(s) [control (s)] |
|---|---|---|---|---|---|
| 1984 | JPN | 86 | F | Pneumonia | >45 [NA] |
| 1984 | JPN | 70 | F | Sepsis | 22.9 [NA] |
| 1984 | JPN | 81 | F | Urinary tract infection, bronchitis | 36.9 [NA] |
| 1984 | JPN | 71 | F | Prophylaxis for blood access construction surgery | >45 [–]11 |
| 1984 | JPN | 72 | F | NA | 87.1 [–]11 |
| 1989 | US | 57 | M | Appendicitis and appendectomy | 17 []11 |
| 1997 | US | 63 | M | Prophylaxis for leg amputation | 91.2 [11.5] |
| 2017 | JPN | 93 | F | Urinary tract infection | NA |
| 2019 | JPN | 84 | M | Urinary tract infection | NA |
| 2020 | JPN | 70 | M | Prophylaxis for laparoscopic rectal cancer surgery | NA |
| 2022 | JPN | 76 | F | Diverticulitis | 37.1 [13.8] |
| CMZ – cefmetazole; JPN – Japan; US – United States; PT – prothrombin time; INR – international normalized ratio; NA – not available. | |||||
| Year | PT-INR | Dose of CMZ | Duration from the start of CMZ to the onset of the events (days) | Bleeding | Reference |
| 1984 | NA | 2–4 g/day | 5 | Melena | []4 |
| 1984 | NA | 2 g/day | 15 | Melena | |
| 1984 | NA | 3 g/day | 20 | Hematemesis | |
| 1984 | NA | 2 g/day | 4 | Melena, Bleeding on lips, Purpura on extremities | []18 |
| 1984 | NA | 4 g/day | 10 | Melena | |
| 1989 | NA | 2 g q8h | 4.5 | Epistaxis | []13 |
| 1997 | 8.3 | 1 g q24h | 4 | No | []19 |
| 2017 | 2.51 | 1 g q12h | 7 | Melena | []20 |
| 2019 | >7.5 | 1 g q12h | 14 | Alveolar bleeding | []8 |
| 2020 | 3.33 | 2 g/day | 4 | Intraperitoneal bleeding | []9 |
| 2022 | 2.46 | 2 g q8h | 4 | Melena | Our study |
| CMZ – cefmetazole; JPN – Japan; US – United States; PT – prothrombin time; INR – international normalized ratio; NA – not available. | |||||