Ceftriaxone-induced Agranulocytosis

Area of Science:

• Pharmacology
• Hematology
• Infectious Diseases

Background:

• Ceftriaxone is a frequently prescribed antibiotic known for its safety and efficacy.
• Drug-induced agranulocytosis is a severe adverse reaction with limited reported cases linked to ceftriaxone.

Purpose of the Study:

• To report a rare case of ceftriaxone-induced agranulocytosis.
• To highlight the importance of recognizing this adverse reaction in patients receiving prolonged ceftriaxone therapy.

Main Methods:

• Case presentation of a patient diagnosed with a brain abscess and treated with ceftriaxone.
• Monitoring of neutrophil count and clinical response to ceftriaxone withdrawal and filgrastim administration.

Main Results:

• The patient developed neutropenic fever on day 29 of ceftriaxone therapy (cumulative dose 116 g), with a neutrophil nadir of 0.1×10^9/l.
• Ceftriaxone withdrawal and 3 days of filgrastim administration led to neutrophil normalization.

Conclusions:

• Ceftriaxone-induced agranulocytosis, though rare, can occur with high cumulative doses.
• Early identification, cessation of ceftriaxone, and administration of recombinant human granulocyte colony-stimulating factor (rhG-CSF) are essential management strategies.