Myelosuppression in Patients with Prolonged use of Piperacillin/Tazobactam

Abstract

Objectives: The use of piperacillin-tazobactam in hospital acquired infections requiring long treatment periods maycause adverse effects including myelosuppression. Myelosuppression results in rare, but potentially serious clinic manifestations such as neutropenia, thrombocytopenia, leukemia and anemia. The objective of this study was to investigatethe incidence and characteristics of myelosuppression in patients with prolonged use of piperacillin-tazobactam.Methods: Inpatients followed-up and treated in Kahramanmaras Sutcu Imam University Medical Faculty Hospital andMMT Gaziantep American Hospital between April 1, 2017 and December 31, 2018 were included in the study. Patients’demographic data, biochemical laboratory outcome, duration and dose of antibiotic treatment, comorbidities, sideeffects of antibiotic therapy were recorded and analyzed.Results: A total of 34 inpatients who received antibiotic therapy with piperacillin-tazobactam due to various diagnoseswere included in the study. The mean duration of PTZ use was found as 11.9±6.31 days. Of all patients, 19 (55.9%) usedantibiotics for longer than 10 days, while 15 (44.1%) used PTZ for 10 days or shorter. The mean duration of antibioticuse was found as 12.2 days in patients aged 65 years and over, while this duration was 11.5 days in patients aged under65 years. Five patients (14.7%) developed neutropenia. Neutropenia was developed in 14.8 days of PTZ treatment onaverage. The mean duration of returning to normal values was found as 1.8 days in these patients. Neutropenia wasdeveloped at the 4th week of the treatment in 60% of these patients.Conclusion: It should be kept in mind that myelosuppression may be encountered especially during prolonged PTZtherapy, and full blood count monitoring should be performed carefully and closely in these patients.