Reactions 571 - 7 Oct 1995

★ SCefonicid

First report of haemorrhagic diathesis in an elderlypatient: case report

Haemorrhagic diathesis occurred in a 68 year-old womanafter she received cefonicid for a suspected urinary tractinfection. Her concomitant medications included enalapril andacenocoumarol.

The woman was prescribed cefonicid 1g/day and 2 dayslater she developed multiple haematomas, haematuria andmelena and her condition deteriorated rapidly. On admissionshe was hypotensive and jaundiced. Her partialthromboplastin time was 129 sec (normal 27 sec) and herprothrombin index was < 5%; 2 weeks prior to admission herprothrombin index had been 28%.

The woman was given IV crystalloids, ranitidine,ciprofloxacin, phytomenadione [vitamin K1], plasma andpacked red blood cells. The following day her partialthromboplastin time and prothrombin index had returned tonormal and there was no evidence of haemorrhage. Anultrasound scan revealed kidney stones and urinalysis showedevidence of Escherichia coli infection.

Author comment: ‘A MEDLINE search of articles publishedfrom 1986 to 1994 found no other reports of hemorrhagicdiathesis associated with cefonicid use . . . it seems likely thatanticoagulant therapy and urinary tract infection predisposedthis patient to hemorrhage.’Riancho JA, et al. Life-threatening bleeding in a patient treated with cefonicid.Annals of Internal Medicine 123: 472-473, 15 Sep 1995 - Spain 800390295

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Reactions 7 Oct 1995 No. 5710114-9954/10/0571-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved