Influence of antibiotics on posttransfusion platelet increment

Fever has been identified as a major cause of platelet refractoriness. However, it is regularly attended by the administration of antibiotics, and thus it cannot be determined whether fever, the administration of antibiotics, or both are responsible for the reduced platelet increment. The present study was undertaken to discern the effect of body temperature and antibiotics on transfusion success.

Single-donor platelet transfusions (n = 400) were monitored retrospectively. Besides other influencing factors (e.g., spleen size, number of previous transfusions, diagnosis, bone marrow transplantation), body temperature and the administration of antibiotics were documented from the patients' records. To distinguish the effects of fever and antibiotics, a general mixed model of variance was used for analysis.

Besides the well-known factors of splenomegaly, hepatomegaly, bone marrow transplantation, and pretransfusion storage time, both body temperature and antibiotics independently reduced the corrected count increment. Among the various antibiotics, amphotericin B, ciprofloxacin, and vancomycin had the greatest influence.

The administration of antibiotics has a negative effect on the corrected count increment, independent of the presence of fever. Besides amphotericin B, which has previously been shown to influence the corrected count increment, vancomycin and ciprofloxacin reduce it significantly. Because these antibiotics are widely used in patients with bone marrow failure, these observations should be proven by further prospective in vivo and in vitro studies.