Wen Wang1, Yanmei Liu1, Chuan Yu1, Jing Tan1, Weiyi Xiong2, Duo Dong3, Sheyu Li4, Rui Zhang5, Jijie Li6, Yu Wu7, Zhiyong Zong8, Na Su9, Kang Zou1, Guizhi Wu10, Xin Sun1. 1. Chinese Evidence-based Medicine Center and CREAT Group, West China Hospital, Sichuan University, Chengdu, China. 2. Department II of Pharmaceuticals Surveillance and Evaluation, National Center for ADR monitoring, Beijing, China. 3. Department of Technical Coordination, National Center for ADR monitoring, Beijing, China. 4. Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China. 5. Information Center, West China Hospital, Sichuan University, Chengdu, China. 6. Department of Medical Record, West China Second University Hospital, Chengdu, China. 7. Department of Hematology, West China Hospital, Sichuan University, Chengdu, China. 8. Department of Infection Control, West China Hospital of Sichuan University, Chengdu, China. 9. Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China. 10. Department I of Pharmaceuticals Surveillance and Evaluation, National Center for ADR monitoring, Beijing, China.
Abstract
Objectives: Limited evidence has suggested that cefoperazone-sulbactam causes coagulation disorders and bleeding. Methods: The authors conducted a retrospective study to compare patients receiving cefoperazone-sulbactam versus those treated with cefoperazone-tazobactam or ceftazidime. Propensity-score matching was used to explore whether treatment with cefoperazone-sulbactam increased the risk of prothrombin time (PT) prolongation, coagulation disorders, and bleeding, or decreased platelets (PLT). Results: The cohort included 23,242 patients. Among patients receiving cefoperazone-sulbactam, the risk of PT prolongation, coagulation disorders, decreased PLT, and bleeding was 5.3%, 9.2%, 15.7%, and 4.2%, respectively. Propensity-score matching analyses suggested that cefoperazone-sulbactam increased the risk of PT prolongation (aOR 2.26, 95% CI 1.61-3.18), coagulation disorders (aOR 1.81, 95% CI 1.43-2.30), and decreased PLT (aOR 1.46, 95% CI 1.25-1.72), but not increase bleeding (aOR 1.05, 95% CI 0.79-1.40) compared with ceftazidime. Patients receiving cefoperazone-sulbactam had higher risk of PT prolongation (aOR 1.53, 95% CI 1.11-2.10), coagulation disorders (aOR 1.53, 95% CI 1.21-1.95), but not decreased PLT (aOR 0.93, 95% CI 0.81-1.07) or bleeding (aOR 1.11, 95% CI 0.87-1.42), compared with those receiving cefoperazone-tazobactam. Conclusion: Cefoperazone-sulbactam may be associated with a higher risk of PT prolongation and coagulation disorders compared with cefoperazone-tazobactam and ceftazidime.
Objectives: Limited evidence has suggested that cefoperazone-sulbactam causes coagulation disorders and bleeding. Methods: The authors conducted a retrospective study to compare patients receiving cefoperazone-sulbactam versus those treated with cefoperazone-tazobactam or ceftazidime. Propensity-score matching was used to explore whether treatment with cefoperazone-sulbactam increased the risk of prothrombin time (PT) prolongation, coagulation disorders, and bleeding, or decreased platelets (PLT). Results: The cohort included 23,242 patients. Among patients receiving cefoperazone-sulbactam, the risk of PT prolongation, coagulation disorders, decreased PLT, and bleeding was 5.3%, 9.2%, 15.7%, and 4.2%, respectively. Propensity-score matching analyses suggested that cefoperazone-sulbactam increased the risk of PT prolongation (aOR 2.26, 95% CI 1.61-3.18), coagulation disorders (aOR 1.81, 95% CI 1.43-2.30), and decreased PLT (aOR 1.46, 95% CI 1.25-1.72), but not increase bleeding (aOR 1.05, 95% CI 0.79-1.40) compared with ceftazidime. Patients receiving cefoperazone-sulbactam had higher risk of PT prolongation (aOR 1.53, 95% CI 1.11-2.10), coagulation disorders (aOR 1.53, 95% CI 1.21-1.95), but not decreased PLT (aOR 0.93, 95% CI 0.81-1.07) or bleeding (aOR 1.11, 95% CI 0.87-1.42), compared with those receiving cefoperazone-tazobactam. Conclusion:Cefoperazone-sulbactam may be associated with a higher risk of PT prolongation and coagulation disorders compared with cefoperazone-tazobactam and ceftazidime.