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Published on: December 26, 2017
Piperacillin induced bone marrow suppression: a case report
Ashish Kumar1, Gourdas Choudhuri, Rakesh Aggarwal
1Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India. ashishk@sgpgi.ac.in
Background:
Piperacillin (and piperacillin/tazobactam) is a commonly prescribed antibiotic and is generally considered safe. We report a case of piperacillin induced bone marrow suppression.
Case Presentation:
A 19-year-old boy was being treated with piperacillin followed by piperacillin/tazobactam for infected pancreatic pseudocyst. After 21 days of treatment, he developed neutropenia and thrombocytopenia. These reversed promptly after stopping piperacillin/tazobactam. The time course of events suggested that piperacillin was the cause of bone marrow suppression in this patient.
Conclusion:
Bone marrow suppression is a serious adverse effect of piperacillin, which should be kept in mind while treating patients with this drug.
Insights
Piperacillin, a common antibiotic, can cause serious bone marrow suppression, including neutropenia and thrombocytopenia. This adverse effect necessitates careful patient monitoring during treatment with piperacillin or piperacillin/tazobactam.
Area of Science:
- Pharmacology
- Hematology
- Infectious Diseases
Background:
- Piperacillin and piperacillin/tazobactam are widely used antibiotics.
- These antibiotics are generally considered safe for clinical use.
Observation:
- A case study involving a 19-year-old male patient treated for an infected pancreatic pseudocyst.
- The patient received piperacillin followed by piperacillin/tazobactam for 21 days.
Findings:
- The patient developed neutropenia and thrombocytopenia after 21 days of antibiotic treatment.
- Bone marrow suppression symptoms resolved rapidly upon discontinuation of piperacillin/tazobactam.
- The clinical timeline strongly suggested piperacillin as the causative agent for bone marrow suppression.
Implications:
- Bone marrow suppression is a significant, albeit rare, adverse effect of piperacillin.
- Clinicians should maintain a high index of suspicion for piperacillin-induced bone marrow suppression.
- Awareness of this potential toxicity is crucial for safe patient management.
