piperacillin--tazobactam-drug-combination and Hypokalemia

Piperacillin/tazobactam is a commonly prescribed antimicrobial agent. Tenofovir alafenamide (TAF) is increasingly being used in antiretroviral therapy (ART) of HIV. Herein we report a case of a 57-year-old male with AIDS receiving TAF-containing ART in whom severe refractory hypokalaemia developed after coadministration of piperacillin/tazobactam for suspected hospital-acquired infection. Upon withdrawal of piperacillin/tazobactam, serum potassium concentrations returned to normal within 2 days. Hypokalaemia is a rare adverse effect of piperacillin/tazobactam and may be aggravated with the underlying use of TAF. We also reviewed past reported cases of hypokalaemia after piperacillin/tazobactam administration. We want to highlight that a more cautious approach should be considered when combining piperacillin/tazobactam and TAF in clinical practice.

Topics: Acquired Immunodeficiency Syndrome; Alanine; Antiviral Agents; Humans; Hypokalemia; Male; Middle Aged; Piperacillin, Tazobactam Drug Combination; Tenofovir

Topics: Adult; Age Factors; Aged; Aged, 80 and over; Anti-Bacterial Agents; Biomarkers; Body Mass Index; Cohort Studies; Female; Humans; Hypokalemia; Incidence; Male; Middle Aged; Piperacillin, Tazobactam Drug Combination; Potassium; Retrospective Studies; Risk Factors; Severity of Illness Index

Topics: Acetamides; Amikacin; Anti-Bacterial Agents; Antifungal Agents; Candidiasis, Invasive; Drug Therapy, Combination; Humans; Hypokalemia; Linezolid; Lung Diseases, Fungal; Male; Middle Aged; Oxazolidinones; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Potassium Chloride; Pyrimidines; Triazoles; Voriconazole

Electrolytes imbalance has been reported with the use of several antimicrobials. We report a case of severe hypokalemia secondary to piperacillin/tazobactam in a patient with normal renal function and normal serum potassium level who had presented with a fractured neck of femur. The electrolytes abnormality was corrected once piperacillin/tazobactam was stopped. To our knowledge, this is the first case to describe an early severe hypokalemia induced by piperacillin/ tazobactam therapy in an otherwise healthy individual.

Topics: Aged; Anti-Bacterial Agents; Female; Femoral Neck Fractures; Humans; Hypokalemia; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Respiratory Tract Infections