Benli Aysun, Şimşek-Yavuz Serap, Başaran Seniha, Çağatay Atahan, Özsüt Halit, Eraksoy Haluk
Muş State Hospital, Clinic of Infectious Diseases and Clinical Microbiology, Muş, Turkey
İstanbul University İstanbul Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, İstanbul, Turkey
Turk J Haematol. 2018 Nov 13;35(4):290-295. doi: 10.4274/tjh.2018.0127. Epub 2018 Jun 1.
We aimed to find the incidence and risk factors of hematologic adverse effects of piperacillin-tazobactam (TZP).
Adult patients who used TZP for more than 10 days were included in the study.
The incidence of leukopenia, neutropenia, and eosinophilia in 110 TZP therapy episodes was found to be 16.3%, 10%, and 10%, respectively. Lower Charlson Comorbidity Index score, lower initial leukocyte count, combination of TZP with another antibiotic, and total duration of TZP therapy were found to be independent risk factors for leukopenia, while initial higher eosinophil count (IHEC) and usage of TZP for >20 days were independent risk factors for neutropenia and IHEC and total duration of TZP therapy were independent risk factors for eosinophilia.
Longer duration of therapy, combination with other antibiotics, younger age with fewer comorbidities, and IHEC could result in hematologic adverse effects in patients treated with TZP. Patients with IHEC may be more prone to allergic reactions, so immunological mechanisms may facilitate the development of hematological adverse effects of TZP.
我们旨在找出哌拉西林-他唑巴坦（TZP）血液学不良反应的发生率及危险因素。
纳入使用TZP超过10天的成年患者进行研究。
在110例TZP治疗疗程中，白细胞减少、中性粒细胞减少和嗜酸性粒细胞增多的发生率分别为16.3%、10%和10%。较低的查尔森合并症指数评分、较低的初始白细胞计数、TZP与另一种抗生素联用以及TZP治疗的总疗程被发现是白细胞减少的独立危险因素，而初始较高的嗜酸性粒细胞计数（IHEC）和使用TZP超过20天是中性粒细胞减少的独立危险因素，IHEC和TZP治疗的总疗程是嗜酸性粒细胞增多的独立危险因素。
治疗疗程较长、与其他抗生素联用、合并症较少的年轻患者以及IHEC可能导致接受TZP治疗的患者出现血液学不良反应。IHEC患者可能更容易发生过敏反应，因此免疫机制可能促进TZP血液学不良反应的发生。
