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Apparently raised serum creatinine levels due to cephalosporins.

To the Editor.— We wish to call attention to the clinical implications of cephalosporins falsely elevating serum creatinine measurements in patients receiving concomitant nephrotoxic agents. Although documented in the literature, creatinine assay interference by cephalosporins is not well recognized in the general medical community. We report a case that illustrates how erroneous creatinine levels secondary to cefoxitin resulted in discontinuation of administration of an aminoglycoside. Report of a Case.— A 63-year-old man was admitted for management of obstructive jaundice. A myocardial infarction he experienced two weeks before admission prompted use of percutaneous transhepatic cholangiography for obstruction evaluation. Three days after this procedure, the patient became febrile (with a temperature of 38 °C) and had abdominal rebound tenderness. Cholecystitis with subacute bacterial peritonitis was suspected, and intravenous antibiotic therapy was initiated with ampicillin, 2 g every four hours; cefoxitin, 2 g every six hours; and amikacin, 325 mg every eight hours.