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Assessing the Effect of Piperacillin/Tazobactam on Hematological Parameters in Patients Admitted with Moderate or
Will Fry1, Sean McCafferty1, Catherine Gooday1,2
1Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK.
Introduction:
Piperacillin/tazobactam is a commonly used antibiotic for the empirical treatment of severe diabetic foot infections. One of the most feared complications of this drug is the development of pancytopenia. The aim of this study was to determine whether the use of piperacillin/tazobactam caused any hematological changes in patients admitted with severe diabetes-related foot infections from a specialist multidisciplinary foot clinic. Specifically, looking at whether it caused anemia, leukopenia, neutropenia, or thrombocytopenia.
Methods:
A 1-year retrospective analysis of patients admitted to a tertiary care center for treatment of diabetes-related foot infection using piperacillin/tazobactam. Hematological indices, urea and electrolytes, and C-reactive protein (CRP) were recorded pretreatment, during treatment, and posttreatment. HbA1c, vitamin B12, folate, thyroid-stimulating hormone, and free thyroxin were also analyzed to exclude any potential confounders as a cause of pancytopenia.
Results:
A total of 154 patients were admitted between 1 January 2016 and 31 December 2016 who received piperacillin/tazobactam for severe diabetes-related foot infection. On admission, white cell count and CRP were raised and fell significantly within the first 48 h. Other hematological factors did not change. Five patients developed a mild pancytopenia, of which three were unexplained.
Conclusion:
In this relatively small cohort, pancytopenia did not occur. As such, piperacillin/tazobactam appeared to have a low risk of adverse hematological outcomes and remains the treatment of choice for severe diabetes-related foot infections.
Insights
Piperacillin/tazobactam use in severe diabetic foot infections showed a low risk of pancytopenia. This antibiotic remains a preferred choice for treating these serious infections.
Area of Science:
- Infectious Diseases
- Hematology
- Pharmacology
Background:
- Severe diabetic foot infections often require broad-spectrum antibiotics like piperacillin/tazobactam.
- Pancytopenia is a potential, albeit feared, adverse effect of piperacillin/tazobactam.
- Understanding hematological impacts is crucial for patient safety in diabetes care.
Purpose of the Study:
- To investigate hematological changes associated with piperacillin/tazobactam in severe diabetic foot infections.
- To assess the incidence of anemia, leukopenia, neutropenia, and thrombocytopenia.
- To evaluate the overall risk of pancytopenia from this antibiotic treatment.
Main Methods:
- Retrospective analysis of 154 patients treated with piperacillin/tazobactam.
- Hematological indices, CRP, urea, and electrolytes monitored pre-, during, and post-treatment.
- Analysis of HbA1c, vitamin B12, folate, and thyroid function to rule out confounders.
Main Results:
- White cell count and CRP levels decreased significantly within 48 hours of treatment initiation.
- No significant changes were observed in other hematological parameters.
- Five patients experienced mild pancytopenia, with three cases of unknown etiology.
Conclusions:
- Piperacillin/tazobactam demonstrated a low risk of adverse hematological outcomes in this patient cohort.
- The antibiotic is considered a safe and effective treatment option for severe diabetic foot infections.
- Further research may be warranted to investigate unexplained pancytopenia cases.
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