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Meropenem-induced thrombocytopenia: a paediatric case

Joanna Cachia1, Paul Torpiano2, David Pace2

  • 1Department of Paediatrics, Mater Dei Hospital, Msida, Malta joanna.cachia@gmail.com.

BMJ Case Reports
|September 4, 2021
PubMed

Insights

Meropenem, a broad-spectrum antibiotic, can cause severe thrombocytopenia and rash in children. This drug-induced reaction necessitates considering meropenem cessation when these symptoms appear.

Area of Science:

  • Pharmacology
  • Pediatric Medicine
  • Infectious Diseases

Background:

  • Meropenem is a critical carbapenem antibiotic for severe Gram-positive and Gram-negative bacterial infections.
  • It is frequently used for infections caused by extended-spectrum beta-lactamase (ESBL)-producing organisms.

Observation:

  • A case report details a pediatric patient with intra-abdominal sepsis treated with intravenous meropenem.
  • The patient developed a pruritic maculopapular rash with petechiae and severe thrombocytopenia after seven days of treatment.

Findings:

  • Investigations ruled out other common causes of thrombocytopenia, such as line sepsis.
  • Thrombocytopenia resolved only after discontinuing meropenem, strongly suggesting a drug-induced adverse reaction.

Implications:

  • Clinicians should consider meropenem-induced hypersensitivity and thrombocytopenia in pediatric patients presenting with rash and low platelet counts.
  • Early recognition and cessation of meropenem may be crucial for managing this adverse event.
Keywords:
contraindications and precautionsdrugs: infectious diseaseshaematology (drugs and medicines)paediatrics (drugs and medicines)

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