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Neutropenia associated with cloxacillin and other semisynthetic penicillins in children

F Al-Fadley1

  • 1Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Annals of Saudi Medicine
|March 1, 1992
PubMed

Insights

High-dose penicillin therapy in children can lead to neutropenia, a dangerous drop in white blood cells. Monitoring complete blood counts is crucial during treatment with these antibiotics.

Area of Science:

  • Pediatric Hematology
  • Infectious Diseases
  • Pharmacology

Background:

  • Neutropenia is a significant risk factor for serious infections.
  • Semisynthetic penicillins are widely used antibiotics in pediatric care.
  • High-dose antibiotic therapy requires careful monitoring for adverse effects.

Purpose of the Study:

  • To report on the occurrence of neutropenia in children treated with high-dose semisynthetic penicillin.
  • To investigate the clinical course and resolution of neutropenia associated with penicillin therapy.
  • To highlight potential complications and recommend monitoring guidelines.

Main Methods:

  • Case series of five pediatric patients treated with high-dose semisynthetic penicillin (cloxacillin, ampicillin, piperacillin).
  • Clinical data collection including duration of therapy, onset and resolution of neutropenia, and complications.
  • Bone marrow aspiration performed in two patients to assess granulocyte precursor maturation.

Main Results:

  • All five children developed neutropenia (ANC <1.5 x 10(9)/L) 15-23 days after initiating high-dose penicillin therapy.
  • Neutropenia resolved between 8-95 days after drug discontinuation.
  • One patient experienced perianal necrotizing fasciitis secondary to neutropenia; bone marrow revealed granulocyte precursor maturation arrest in two patients.

Conclusions:

  • High-dose penicillin therapy can induce neutropenia in children.
  • Close monitoring of complete blood counts, including differentials, is recommended during prolonged high-dose penicillin treatment.
  • Early detection and management of neutropenia are essential to prevent severe complications.

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