Related Experiment Video
Updated: Jun 16, 2026
11:17
Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Haemolytic anaemia caused by piperacillin-tazobactam
I Dapper1, M Nauwynck, D Selleslag
1Intensive Care Unit, AZ Monica, Antwerpen, Belgium. drDapper@azmonica.be
Acta Clinica Belgica
|January 28, 2010
Summary
Piperacillin-tazobactam can cause drug-induced hemolytic anemia, a rare but serious side effect. Discontinuing the antibiotic resolves the condition, highlighting the need for physician awareness in critical care settings.
Area of Science:
- Pharmacology
- Hematology
- Critical Care Medicine
Background:
- Piperacillin-tazobactam is a commonly prescribed broad-spectrum antibiotic, particularly in critical care settings.
- Drug-induced hemolytic anemia (DIHA) is a rare but potentially severe adverse drug reaction.
- Identifying causative agents is crucial for effective patient management and preventing recurrence.
Observation:
- A case of hemolytic anemia was observed in a 50-year-old female patient following the administration of piperacillin-tazobactam.
- Four additional cases of piperacillin-tazobactam-induced hemolysis have been reported since 2002.
- Both piperacillin and tazobactam components of the antibiotic combination have been implicated as potential triggers for hemolysis.
Findings:
- Discontinuation of piperacillin-tazobactam led to the resolution of hemolytic anemia in all reported cases.
- The mechanism by which piperacillin-tazobactam induces hemolysis appears to be immune-mediated or direct toxicity.
- The rarity of DIHA associated with piperacillin-tazobactam should not overshadow its potential clinical significance.
Implications:
- Physicians, especially in critical care, should maintain a high index of suspicion for piperacillin-tazobactam-induced hemolytic anemia in patients presenting with unexplained hemolysis.
- Prompt recognition and cessation of the offending antibiotic are essential for favorable outcomes.
- Further pharmacovigilance studies are warranted to better understand the incidence and risk factors associated with piperacillin-tazobactam-induced DIHA.
Related Concept Videos
01:29Pneumonia I: Introduction
Pneumonia is an infection of the lower respiratory tract that leads to inflammation of the lung parenchyma, often resulting in the accumulation of inflammatory exudate in the alveoli and airways. Unlike the watery, low-protein fluid exudate in pulmonary edema, the exudate in this case is a thick fluid rich in immune cells, proteins, and debris produced during infection and inflammation.This impairs gas exchange and can lead to consolidation of lung tissue. The infection may be caused by a...
01:30Pneumonia I: Introduction
Pneumonia is an acute respiratory infection that targets the lungs, specifically the alveoli. These tiny air sacs, essential for oxygen exchange, become engorged with pus and fluid, severely hindering breathing, decreasing oxygen absorption, and causing significant pain and discomfort during respiration.
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:01Hypersensitivity Reactions: Cytolytic Reactions
Type II hypersensitivity involves IgG and IgM antibodies targeting cell surface antigens, leading to cell destruction. This can occur through complement activation, antibody-dependent cell-mediated cytotoxicity (ADCC), or acting as opsonins for phagocytosis. When excessive, these reactions cause significant tissue damage.Drug-induced hemolytic anemia is a common example, where drugs like penicillin or cephalosporins bind to red blood cells, forming drug-protein complexes. These complexes...
01:14Atypical Pneumonia
Atypical pneumonia, often caused by Mycoplasma pneumoniae, is a form of pulmonary infection that differs from the classical presentation of bacterial pneumonia in both its cause and clinical symptoms. Mycoplasma pneumoniae is a pleomorphic bacterium notable for its lack of a rigid cell wall. This structural characteristic imparts resistance to beta-lactam antibiotics and significantly influences the bacterium’s behavior within the human host.Other pathogens responsible for the disease include...
01:28Pneumonia IV: Management
The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:23Inhibitors of Gram-positive Cell Wall Synthesis
Bacterial cell walls are typically rigid structures composed mainly of peptidoglycan, a mesh-like polymer that provides mechanical strength and maintains cell shape. The synthesis of peptidoglycan is a crucial process in bacterial growth and serves as a primary target for many antibiotics.Mechanism of Action of Beta-Lactam AntibioticsBeta-lactam antibiotics, such as penicillin, inhibit peptidoglycan synthesis in actively growing cells. These antibiotics share a characteristic four-membered...