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Correlation between severity of myelosuppression caused by piperacillin-tazobactam and factors: Analysis through a
Meng-Ting Li1, Ri-Xing Mo2, Jian-Ke Guan2
1Department of Pharmacy, The First People's Hospital of Foshan (Foshan Hospital Affiliated to Southern University of Science and Technology), School of Medicine, Southern University of Science and Technology, Foshan, Guangdong, China.
Aims:
To explore the factors influencing the severity of piperacillin-tazobactam-associated myelosuppression and the time of symptom onset and to provide a basis for clinical risk prevention and control.
Methods:
Based on the electronic database and data from a city's adverse drug reaction monitoring system in the past 10 years, 115 patients with piperacillin-tazobactam-induced myelosuppression were included. Multivariate ordered logistic regression models were used to analyse the factors affecting severity and time to symptom onset.
Results:
Concomitant medication significantly increased the risk of myelosuppression severity (OR = 3.95, p < 0.001). Male (OR = 4.03, p = 0.02), past medical history (OR = 4.25, p < 0.01) and prolonged duration of medication (OR = 1.60, p < 0.0001) accelerated symptom onset. Laboratory indices showed a significant decrease in leucocytes (2.2 × 109/L vs. 9.1 × 109/L) and platelets (25.5 × 109/L vs. 222.5 × 109/L) after medication (p < 0.001). Symptomatic improvement was observed after discontinuation of the medication in 80.0% of the patients, but prolongation of the original course of the disease due to myelosuppression was observed in 24.3% of the patients.
Conclusion:
Concomitant medication, especially multiple medication, is a key risk factor for the severity of myelosuppression, and early monitoring needs to be strengthened in males, those with past medical history and long-term medication users. This study provides data support for individualized medication regimens and risk warnings.
Insights
Piperacillin-tazobactam can cause myelosuppression, increasing severity with concomitant medications. Early monitoring is crucial for males, those with medical history, and long-term users to prevent adverse drug reactions.
Area of Science:
- Pharmacology
- Hematology
- Clinical Medicine
Background:
- Piperacillin-tazobactam is a widely used antibiotic.
- Myelosuppression is a potential adverse drug reaction.
- Understanding risk factors is crucial for patient safety.
Purpose of the Study:
- To identify factors influencing piperacillin-tazobactam-associated myelosuppression severity.
- To determine factors affecting the onset time of myelosuppression symptoms.
- To inform clinical risk management strategies.
Main Methods:
- Retrospective analysis of 115 patients with piperacillin-tazobactam-induced myelosuppression.
- Data sourced from electronic health records and adverse drug reaction monitoring systems over 10 years.
- Multivariate ordered logistic regression models applied to analyze influencing factors.
Main Results:
- Concomitant medication use significantly increased myelosuppression severity (OR=3.95).
- Male sex (OR=4.03), past medical history (OR=4.25), and prolonged medication duration (OR=1.60) accelerated symptom onset.
- Significant decreases in leucocytes and platelets were observed post-medication; 80% improved after discontinuation.
Conclusions:
- Concomitant and polypharmacy are key risk factors for severe myelosuppression.
- Targeted monitoring is recommended for males, individuals with prior medical history, and those on long-term piperacillin-tazobactam.
- Findings support individualized treatment regimens and enhanced risk warnings for piperacillin-tazobactam therapy.