Incidence of Neutropenia during Treatment of Bone-Related Infections with Piperacillin-Tazobactam

Abstract

Of 41 patients with bone-related infections who were treated for > or =10 days with piperacillin-tazobactam, 14 (34%) developed neutropenia. Cumulative doses of piperacillin administered to neutropenic patients were higher than those administered to nonneutropenic ones (330 vs. 237 g; P=.008), and an inverse correlation was detected between the absolute neutrophil count at the end of treatment and the cumulative dose of piperacillin (r=-0.47, P=.002). Moreover, the incidence of piperacillin-tazobactam-induced neutropenia increased with an increase in the cumulative dose of piperacillin: 0% of patients in the first quartile of cumulative piperacillin doses, 33.3% in the second quartile, 40% in the third quartile, and 66.7% in the fourth quartile.

Deferiprone‐induced agranulocytosis: 20 years of clinical observations

“…This is consistent with the lack of dependence of clozapine‐associated agranulocytosis and neutropenia on dose 30, but in contrast with the dose dependency of beta‐lactam antibiotic‐mediated agranulocytosis 31. …”

A Randomized, Open-Label, Multicenter Comparative Study of the Efficacy and Safety of Piperacillin-Tazobactam and Cefepime for the Empirical Treatment of Febrile Neutropenic Episodes in Patients with Hematologic Malignancies

“…Consistent with previous studies [61][62][63], we noted a reduced risk for C. difficile-associated diarrhea among piperacillin-tazobactam recipients (OR, 0.32; 95% CI, 0.12-0.81), an observation with important economic implications [64]. Although piperacillin-related myelosuppression has been reported previously [65,66], the prolonged neutropenia observed among piperacillin-tazobactam recipients in our study was associated with other factors, including underlying disease and use of other potentially myelosuppressive agents, such as glycopeptides [54][55][56][57][58]. The all-cause mortality among cefepime recipients was nonsignificantly higher in our study (3% in the piperacillin-tazobactam group vs. 5.7% in the cefepime group), a finding that is in keeping with a recent systematic review [46].…”

Fever and Reversible Laboratory Abnormalities Associated with Prolonged Use of Piperacillin–Tazobactam in Children

“…5 Large cohort studies in adult patients also have suggested that the myelotoxicity may be related to large cumulative doses of piperacillin, and that the effect is infrequent with treatment duration less than 10 days. 3 A recent retrospective cohort study of pediatric patients documented a 4-fold increase in the risk of developing neutropenia in patients receiving piperacillin-tazobactam compared with those treated with ticarcillin-clavulanate. 7 The development of neutropenia was more common in patients <13 years and in those treated with piperacillin-tazobactam for >2 weeks.…”