piperacillin--tazobactam-drug-combination and Eosinophilia

Piperacillin-tazobactam is a broad-spectrum antimicrobial agent that is commonly used in clinical practice. The development of delayed drug hypersensitivity reaction (DHR) has been reported in several cases previously. Here we describe an unusual case of non-immediate DHR due to a prolonged course of piperacillin-tazobactam. We report a 22-year-old man who developed fever, eosinophilia, thrombocytopenia and elevated hepatic enzymes following 17 days of piperacillin-tazobactam for methicillin-sensitive

Topics: Adult; Eosinophilia; Humans; Liver; Male; Piperacillin; Piperacillin, Tazobactam Drug Combination; Thrombocytopenia; Young Adult

Topics: Anti-Bacterial Agents; Antifungal Agents; beta-Lactamase Inhibitors; Candida albicans; Drug Hypersensitivity Syndrome; Eosinophilia; Fluconazole; Humans; Lymphohistiocytosis, Hemophagocytic; Osteomyelitis; Piperacillin, Tazobactam Drug Combination; Pseudomonas aeruginosa; Staphylococcus aureus

We aimed to find the incidence and risk factors of hematologic adverse effects of piperacillin-tazobactam (TZP).. Adult patients who used TZP for more than 10 days were included in the study.. The incidence of leukopenia, neutropenia, and eosinophilia in 110 TZP therapy episodes was found to be 16.3%, 10%, and 10%, respectively. Lower Charlson Comorbidity Index score, lower initial leukocyte count, combination of TZP with another antibiotic, and total duration of TZP therapy were found to be independent risk factors for leukopenia, while initial higher eosinophil count (IHEC) and usage of TZP for >20 days were independent risk factors for neutropenia and IHEC and total duration of TZP therapy were independent risk factors for eosinophilia.. Longer duration of therapy, combination with other antibiotics, younger age with fewer comorbidities, and IHEC could result in hematologic adverse effects in patients treated with TZP. Patients with IHEC may be more prone to allergic reactions, so immunological mechanisms may facilitate the development of hematological adverse effects of TZP.. Piperasilin-tazobaktamın (TZP) hematolojik istenmeyen etki insidansını ve risk faktörlerini bulmayı amaçladık.. On günden uzun süre TZP kullanan erişkin hastalar çalışmaya dahil edildi.. Yüz on tedavi epizodunda lökopeni, nötropeni ve eozinofili insidansları sırasıyla %16,3, %10 ve %10 olarak bulundu. Charlson’ın Komorbidite İndeksi’nin düşük olması, başlangıç lökosit sayısının düşük olması, TZP ile başka antibiyotiğin kombine kullanılması ve TZP’nin toplam tedavi süresi; başlangıç eozinofil sayısının yüksek olması (BESYO) ve 20 günden uzun süreli TZP kullanımı; BESYO ve TZP’nin toplam tedavi süresi sırasıyla lökopeni, nötropeni ve eozinofili için bağımsız risk faktörleri olarak bulundu.. TZP ile tedavi edilen hastaların tedavi süresinin uzun olması, kombine antibiyotik tedavisi almaları, daha genç yaşta daha az komorbiditelerinin olması ve BESYO hematolojik istenmeyen etkilerin gelişmesine neden olabilir. BESYO olması hastaların alerjik reaksiyonlara daha yatkın olmasına neden olabilir, bu nedenle immünolojik mekanizmalar TZP kullanımıyla hematolojik istenmeyen etkilerin gelişmesini kolaylaştırabilir.

Topics: Eosinophilia; Female; Humans; Leukopenia; Male; Middle Aged; Neutropenia; Piperacillin, Tazobactam Drug Combination; Risk Factors

Drug-related rash with eosinophilia and systemic symptoms (DRESS) syndrome, or drug-induced hypersensitivity syndrome (DIHS), is a life-threatening multiorgan systemic reaction characterized by rash, fever, lymphadenopathy, hepatitis, and leukocytosis with eosinophilia. Aromatic anticonvulsant drugs and allopurinol have been reported to be the most frequent eliciting agents. Our search of the literature revealed only 2 cases induced by piperacillin and 1 case by ceftriaxone.We present 2 cases of DRESS syndrome induced by the beta-lactam drugs ceftriaxone and piperacillin-tazobactam. An allergological workup including skin prick test, intradermal tests, patch tests, and lymphocyte transformation test (LTT) was performed. LTT was shown to be a useful technique in both cases to help to identify the drugs involved.

Topics: Adrenal Cortex Hormones; Adult; Anticonvulsants; beta-Lactams; Ceftriaxone; Cell Proliferation; Cells, Cultured; Colitis, Ulcerative; Drug Hypersensitivity; Eosinophilia; Epilepsy; Exanthema; Female; Histamine Antagonists; Humans; Lymphocyte Activation; Male; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination