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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
Summary
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.
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