Clinical Pharmacology and Therapeutics
Clinical Pharmacology and Therapeutics
5 years ago

Elevated PT, APPT and PT/INR possibly associated with doxycycline and cefoperazone co-administration: A case report

Elevated PT, APPT and PT/INR possibly associated with doxycycline and cefoperazone co-administration: A case report
C. Qiu, Y. Tan, J. Q. Hu, X. Q. Zhu, S. H. Deng, C. F. Guo, Y. G. Wen, D. W. Shang
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. 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.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1111/jcpt.12600

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