What is a significant side effect associated with Cefotetan due to its NMTT side chain?

Cefotetan, a cephalosporin antibiotic, has a unique side chain known as the NMTT (N-methylthiotetrazole) side chain, which is responsible for a specific set of side effects. The significant side effect associated with this side chain is bleeding due to a vitamin K antagonistic effect, leading to an increased risk of bleeding disorders. This occurs because the NMTT side chain interferes with the metabolism of vitamin K, which is crucial for the synthesis of clotting factors in the liver.

Additionally, the NMTT side chain can cause a disulfiram-like reaction when alcohol is consumed. This reaction can lead to unpleasant symptoms such as flushing, nausea, vomiting, and palpitations, which discourage patients from drinking alcohol while on this medication. This combination of bleeding risk and the potential for disulfiram-like reactions makes option B the most significant concern associated with cefotetan.

The other options, while they may represent concerns with other medications or conditions, do not specifically relate to the NMTT side chain of cefotetan. Thus, the focus remains on the bleeding and disulfiram reaction as the prominent side effect linked to this antibiotic.