{Reference Type}: Case Reports
{Title}: Cefazolin-Associated INR Elevation: A Case Report.
{Author}: Barnes JL;Pabian IE;Bonjour AK;Mosbacher KA;Mortrude GC;Beasley KA;
{Journal}: J Pharm Pract
{Volume}: 37
{Issue}: 1
{Year}: Feb 2024 7
暂无{DOI}: 10.1177/08971900221132680
{Abstract}: Purpose: To describe a case of significantly elevated international normalized ratio (INR) in a patient on apixaban receiving treatment with intravenous cefazolin in the setting of coronavirus disease 2019 (COVID-19) infection and malnutrition. Summary: A 74-year-old male patient on apixaban receiving cefazolin for osteomyelitis in the setting of COVID-19 and poor nutritional intake presented with internal jugular tunneled catheter site bleeding and an INR of greater than 22.5. Laboratory abnormalities and bleeding concerns were successfully managed with vitamin K and changing antimicrobial therapy from cefazolin to daptomycin. Follow-up labs one week later demonstrated a sustained improvement in coagulopathy. Conclusion: INR prolongation believed to be secondary to cefazolin can be effectively managed with administration of vitamin K and conversion of antimicrobial therapy to an alternative agent.