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Updated: Aug 5, 2025

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Cross-reactivity between piperacillin-tazobactam and cefoperazone-sulbactam in drug-induced immune thrombocytopenia

Xiaoyan He1,2, Wanting Huang1,2, Xiong Wan3,4

  • 1Department of Pharmacy, Chongqing University Jiangjin Hospital, 725 Jiangzhou Avenue, Jiangjin District, Chongqing, 402260, China.

The Journal of International Medical Research
|March 27, 2023
PubMed

Insights

Beta-lactam antibiotics can cause immune thrombocytopenia. This study highlights cross-reactivity between piperacillin-tazobactam and cefoperazone-sulbactam, indicating a need to examine beta-lactam structures for cross-reactivity risks.

Area of Science:

  • Pharmacology
  • Immunology
  • Hematology

Background:

  • Beta-lactam antibiotics are a common cause of drug-induced immune thrombocytopenia.
  • Cross-reactivity between different beta-lactam antibiotics in patients with drug-induced immune thrombocytopenia is rarely documented.

Observation:

  • A 79-year-old male patient developed thrombocytopenia following administration of piperacillin-tazobactam.
  • Thrombocytopenia recurred upon subsequent administration of cefoperazone-sulbactam, despite initial successful treatment with meropenem and cefotiam.

Findings:

  • The recurrent thrombocytopenia suggests cross-reactivity of platelet-specific antibodies between piperacillin-tazobactam and cefoperazone-sulbactam.
  • The specific drug structures responsible for this cross-reactivity remain unidentified.

Implications:

  • Further investigation into the chemical structures of beta-lactam antibiotics is necessary.
  • Understanding structural similarities can help assess and mitigate the risk of immune thrombocytopenia in clinical practice.
Keywords:
Piperacillincefoperazonecross-reactionsulbactamtazobactamthrombocytopenia

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