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Bleeding associated with cephalosporins is because of the side chains interfering with prothrombin synthesis

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Some cephalosporins have been associated with bleeding complications.
It may be due to hypoprothrombinaemia and/or platelet dysfunction occurring with cephalosporins and cephamycins having an N-methylthiotetrazole side-chain, including
• cefamandole
• cefbuperazone
• cefmenoxime
• cefmetazole
• cefonicid
• cefoperazone
• ceforanide
• cefotetan
• cefpiramide
• latamoxef.
The presence of a methylthiadiazolethiol side-chain in cefazolin, or an N-methylthiotriazine ring in ceftriaxone, might also be associated with such bleeding disorders.
Hypoprothrombinaemia is usually reversible with vitamin K.
It was previously thought to be due to an alteration in intestinal flora but interference with prothrombin synthesis now seems more likely.
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