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急性抗生素诱导性中性粒细胞减少症:病例报告的系统评价。

Acute antibiotically induced neutropenia: A systematic review of case reports.

机构信息

Faculty of Medicine, Riga Stradins University, Riga, Latvia.

Department of Pharmacology, Paul Stradins Clinical University Hospital, Riga Stradins University, Riga, Latvia.

出版信息

Br J Clin Pharmacol. 2022 May;88(5):1978-1984. doi: 10.1111/bcp.15170. Epub 2021 Dec 28.

Abstract

AIMS

Acute neutropenia induced by antibiotics is a rare side effect of this frequently prescribed class of drugs. We aim to find similarities and differences between reported cases.

METHODS

Through a database search (PubMed, 1968-2020), we identified published case reports and extracted, among other data, patient demographics, duration of treatment with the respective agent, and duration of recovery.

RESULTS

Overall, 83 cases were included. Neutropenia developed after a median (min-max) of 21 (17.5-28.5) days of treatment and was resolved after a median (min-max) of 6 (3.0-8.75) days. Vancomycin and ceftaroline emerged as the two most commonly described antibiotics. In 51.8% of cases, the suspected antibiotic was discontinued; in 37.4% of cases, it was substituted by another agent. Only three case reports mentioned death as a result of neutropenia. The use of granulocyte colony-stimulating growth factors (CSFs) shortened the duration of neutropenia and improved outcome for patients' health.

CONCLUSION

Neutropenia induced by antibiotics remains a rare or rarely reported side effect. Long-term and high-dose treatment regimens expose a higher risk of development. Thus, regular full blood counts are advised during therapy.

摘要

目的

抗生素引起的中性粒细胞减少症是此类常用药物类别的罕见副作用。我们旨在寻找已报道病例之间的相似点和不同点。

方法

通过数据库搜索(PubMed,1968-2020),我们确定了已发表的病例报告,并提取了其他数据,包括患者人口统计学、各自药物的治疗持续时间和恢复时间。

结果

共纳入 83 例。中性粒细胞减少症在治疗后中位数(最小-最大)21 天(17.5-28.5)后出现,在中位数(最小-最大)6 天(3.0-8.75)后得到解决。万古霉素和头孢洛林是描述最常见的两种抗生素。在 51.8%的情况下,停用了可疑抗生素;在 37.4%的情况下,用另一种药物替代了它。只有 3 份病例报告提到中性粒细胞减少症导致死亡。使用粒细胞集落刺激因子(CSF)缩短了中性粒细胞减少症的持续时间并改善了患者的健康结局。

结论

抗生素引起的中性粒细胞减少症仍然是一种罕见或很少报道的副作用。长期和高剂量的治疗方案增加了发病风险。因此,建议在治疗期间定期进行全血细胞计数。

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