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Microfluidics in Assessing Platelet Function
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Severe bleeding caused by piperacillin/tazobactam-induced platelet dysfunction
.

Bosko Skoric, Antonio Agic, Marijan Pasalic

    International Journal of Clinical Pharmacology and Therapeutics
    |April 24, 2020
    PubMed
    Summary

    Piperacillin/tazobactam can cause bleeding through platelet dysfunction, not just low platelets. This rare complication requires specific platelet function tests for diagnosis.

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    Area of Science:

    • Pharmacology
    • Hematology
    • Infectious Diseases

    Background:

    • Piperacillin/tazobactam (TZP) is a critical antibiotic for nosocomial infections caused by multidrug-resistant Pseudomonas.
    • Thrombocytopenia is a recognized complication of TZP therapy.
    • Bleeding complications associated with TZP are typically linked to thrombocytopenia.

    Observation:

    • A 73-year-old male developed severe pulmonary hemorrhage and bloody diarrhea while on TZP for Pseudomonas aeruginosa ventilator-associated pneumonia.
    • Routine platelet counts and coagulation tests were within normal limits.
    • Platelet functional assays revealed impaired ADP-dependent aggregation.

    Findings:

    • This case highlights platelet dysfunction as a rare mechanism for TZP-induced bleeding.
    • This is the second reported instance of TZP-related bleeding due to platelet dysfunction.
    • Unlike thrombocytopenia, platelet dysfunction requires specialized functional tests for detection.

    Implications:

    • Clinicians should consider platelet dysfunction in patients experiencing unexplained bleeding during TZP treatment, even with normal platelet counts.
    • Platelet functional testing is crucial for diagnosing this specific TZP adverse effect.
    • This finding expands the understanding of piperacillin/tazobactam's potential adverse effects beyond thrombocytopenia.