Coagulopathy induced by treatment with cefazolin and rifampin: A case report

Current guidelines recommend treatment of MSSA prosthetic valve endocarditis with combination therapy consisting of cefazolin or an antistaphylococcal penicillin and rifampin, with the addition of gentamicin for the first 2 weeks of therapy. Rifampin-induced coagulopathy and cefazolin-induced coagulopathy due to hypoprothrombinemia have been rarely reported. Concomitant therapy with rifampin and cefazolin may exacerbate coagulopathy, particularly in the setting of renal dysfunction, thus coagulation studies should be closely monitored if combination therapy is indicated.