Neutropenia in primary care

Hay, Deborah; Hill, Matilda; Littlewood, Tim

doi:10.1136/bmj.g5340

Cited by 9 publications

(13 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

Section: Definition Of Antimicrobial-related Adverse Eventsmentioning

confidence: 99%

“…The pharmacists assessed causality according to the criteria of the WHO-Uppsala Monitoring Center, and causality considered 'possible' or stronger was considered to indicate an ADE. Severity was assessed using criteria suggested in previous studies (Table 5) [32][33][34]. A two-step approach was adopted for identifying antimicrobial-related ADEs: first, potential ADE cases were screened using a computerized program with specific criteria such as laboratory results and the use of specific agents for management of ADEs; second, cases that met the criteria and those with voluntary reports of adverse events were reviewed by pharmacists, based on full individual electronic medical records.…”

Section: Exclusion Criteriamentioning

confidence: 99%

See 1 more Smart Citation

Potential Impact of the Involvement of Clinical Pharmacists in Antimicrobial Stewardship Programs on the Incidence of Antimicrobial-Related Adverse Events in Hospitalized Patients: A Multicenter Retrospective Study

Suh

Chun

et al. 2021

Antibiotics

View full text Add to dashboard Cite

Although specialized pharmacists have been suggested to be essential members of antimicrobial stewardship programs (ASPs), not all hospitals in Korea operate ASPs with pharmacists involved. We aimed to evaluate the association of involvement of clinical pharmacists as team members of multidisciplinary ASPs with the incidence of antimicrobial-related adverse drug events (ADEs). Five tertiary teaching hospitals participated in this retrospective cohort study. At each participating hospital, we randomly selected 1000 participants among patients who had received systemic antimicrobial agents for more than one day during the first quarter of 2017. We investigated five categories of antimicrobial-related ADEs: allergic reactions, hematologic toxicity, nephrotoxicity, hepatotoxicity, and antimicrobial-related diarrhea. Multivariate logistic regression analysis was used to evaluate the potential impact of pharmacist involvement in ASPs on the incidence of ADEs. A total of 1195 antimicrobial-related ADEs occurred in 618 (12.4%) of the 4995 patients included in the analysis. The overall rate of ADE occurrence was 17.4 per 1000 patient days. Hospitals operating ASPs with pharmacists showed significantly lower AE incidence proportions than other hospitals (8.9% vs. 14.7%; p < 0.001). Multidisciplinary ASPs that included clinical pharmacists reduced the risk of antimicrobial-related ADEs by 38% (adjusted odds ratio 0.62; 95% confidence interval 0.50–0.77). Our results suggest that the active involvement of clinical pharmacists in multidisciplinary ASPs may contribute to reduce the incidence of antimicrobial-related ADEs in hospitalized patients.

show abstract

Section: Definition Of Antimicrobial-related Adverse Eventsmentioning

confidence: 99%

Section: Exclusion Criteriamentioning

confidence: 99%

Potential Impact of the Involvement of Clinical Pharmacists in Antimicrobial Stewardship Programs on the Incidence of Antimicrobial-Related Adverse Events in Hospitalized Patients: A Multicenter Retrospective Study

Suh

Chun

et al. 2021

Antibiotics

View full text Add to dashboard Cite

show abstract

“…5,6 In susceptible ethnicities, a variable benign ethnic neutropenia prevalence of 25-50% has generally been reported. 1 Arab ethnicity is among those who constitutionally harbor this ethnic neutropenia. 7 In Saudi Arabia, the prevalence of benign ethnic neutropenia is not definitely known.…”

Section: Introductionmentioning

confidence: 99%

“…Isolated neutropenia, in the absence of other hematological abnormalities, is a common problem in the primary care and consultation settings of the hematology practice. 1 , 2 There are many causes of neutropenia, whether congenital or acquired. 3 Work-up of neutropenia is usually dictated by the associated clinical scenario but when chronic, stable, and mild or moderate in nature, isolated neutropenia is usually a benign condition with no increased risk of infection or progression to hematological malignancies.…”

Section: Introductionmentioning

confidence: 99%

<p>The Prevalence of Isolated Neutropenia at High Altitude in Southern Saudi Arabia: Does Altitude Affect Leucocyte Count?</p>

Alkhaldy¹,

Awan²,

Abouzaid³

et al. 2020

IJGM

View full text Add to dashboard Cite

Introduction: Isolated neutropenia is a common problem in hematology practice. Benign ethnic neutropenia (BEN) is the common form of neutropenia worldwide and it affects mainly African and Middle Eastern ethnicities. Most cases of isolated mild and moderate neutropenia are benign and associated with no clinical significance. The aim of this study was to estimate the prevalence of isolated neutropenia at high-altitude southern Saudi Arabia. Methods: A large dataset of complete blood counts (CBCs) was analyzed for walk-in patients of both genders, of age ranges from 12 to 60 years doing blood tests at a commercial lab for high altitude − 2,270 meters above sea level-(HA) group, and from sea level SL group. Abnormal biochemical or CBC results were excluded before analysis. Results: For HA group, 3123 CBCs were analyzed and for SL group 18,427 CBCs were analyzed. The prevalence of mild neutropenia, defined as absolute neutrophil count (ANC) in the range of 1.0−.5× 10 9 /L, was 12.4% (n=399) versus 5.6% (n=1025), while moderate neutropenia, defined as ANC of 0.5-1 × 10 9 /L, was present 6% (n=191) versus 1.45% (n=269) in the high altitude and sea level groups, respectively. Severe neutropenia, defined as neutrophil count less than 0.5-1 × 10 9 /L, was rare in both groups. Conclusion: Isolated neutropenia is common in Saudis living at high altitude. While benign ethnic neutropenia (BEN) is thought to be the major contributing factor to this high prevalence, other factors including environmental factors and altitude are possible contributing factors along with underlying ethnic neutropenia.

show abstract

“…Benign ethnic neutropenia (BEN) is a relatively common condition throughout the Middle East, especially among those of African descent [ 19 ]. It is a clinical diagnosis based on persistent neutropenia with normal levels of other white blood cell lines, as well as the absence of secondary causes of neutropenia or hematological disorders [ 20 – 23 ]. There are many reports of the prevalence of BEN in Arab populations.…”

Section: Introductionmentioning

confidence: 99%

White blood cell subpopulation changes and prevalence of neutropenia among Arab diabetic patients attending Dasman Diabetes Institute in Kuwait

et al. 2018

View full text Add to dashboard Cite

BackgroundThe effects of diabetes mellitus on the differential white blood cell count are not widely studied in the Arab populations. The objective of this cross-sectional, retrospective study is to assess the influence of chronic diabetes mellitus on white blood cell counts, absolute neutrophil (ANC) and lymphocyte counts (ALC) as well as the prevalence of benign ethnic neutropenia among Arabs attending the Dasman Diabetes Institute (DDI) in Kuwait.Methods and findings1,580 out of 5,200 patients registered in the DDI database qualified for our study. Age, gender, HbA1c and creatinine levels, estimated glomerular filtration rate as well as average WBC, ANC and ALC levels, presence of diabetes-associated complications and anti-diabetic medications were analyzed. Our results showed the mean value of the WBC was 7.6 ± 1.93 x 109/L (95% CI: 2.95–17.15). The mean ANC was 4.3 x 109/L (95% CI: 0.97–10.40) and mean ALC was 2.5 x 109/L (95% CI: 0.29–10.80). Neutropenia (ANC: <1.5 x 109/L) was detected in fifteen patients (0.94%). Six patients (0.4%) fulfilled the definition of lymphopenia (ALC < 1 x109/L). Patients with an HbA1c ≥ 7% and those taking at least 3 anti-diabetic medications showed higher values for ANC and ALC. Patients with diabetes-associated neuropathy or nephropathy displayed higher mean ANC values. Our study was limited by overrepresentation of patients over 50 years old compared to those under 50 as well as selection bias given its retrospective nature.ConclusionsOur study showed that patients with poorly controlled diabetes displayed higher ANC and ALC levels. In addition, patients with DM-associated complications showed higher ANC levels. This finding would suggest that DM exerts a pro-inflammatory influence on differential WBC counts. Our study also showed that the prevalence of benign ethnic neutropenia was lower than previously reported in other studies.

show abstract

Neutropenia in primary care

Cited by 9 publications

References 26 publications

Potential Impact of the Involvement of Clinical Pharmacists in Antimicrobial Stewardship Programs on the Incidence of Antimicrobial-Related Adverse Events in Hospitalized Patients: A Multicenter Retrospective Study

Potential Impact of the Involvement of Clinical Pharmacists in Antimicrobial Stewardship Programs on the Incidence of Antimicrobial-Related Adverse Events in Hospitalized Patients: A Multicenter Retrospective Study

<p>The Prevalence of Isolated Neutropenia at High Altitude in Southern Saudi Arabia: Does Altitude Affect Leucocyte Count?</p>

White blood cell subpopulation changes and prevalence of neutropenia among Arab diabetic patients attending Dasman Diabetes Institute in Kuwait

Contact Info

Product

Resources

About