Int J Clin Pharmacol Ther. 2022 Aug;60(8):358-363. doi: 10.5414/CP204215.
Imipenem cilastatin sodium, as a member of a new generation of β-lactam antibiotics, has a broad spectrum of antibacterial activity and a very wide range of application. Thrombocytopenia has been reported as a rare adverse event in several studies of patients treated with imipenem cilastatin sodium. In this study, we present a case of thrombocytopenia associated with imipenem cilastatin sodium in an older patient. The 78-year-old male patient with pulmonary infection was initiated on anti-infection therapy with imipenem cilastatin sodium. On the 9 day after imipenem cilastatin sodium administration, the patient experienced a sudden and dramatic decrease in platelet count. Similarly, on the 4 day after the re-administration of imipenem cilastatin sodium for anti-infection therapy, the patient's platelet count showed a remarkable downward trend again. A time correlation between the drug therapy and the occurrence of platelet reaction was found. The patient's platelet count gradually returned to the normal level on the 6 day after the first drug withdrawal and the 13 day after the second drug withdrawal, respectively. Considering the widespread use of imipenem cilastatin sodium, healthcare providers should improve the notification of thrombocytopenia associated with imipenem cilastatin sodium.
亚胺培南西司他丁钠作为新一代β-内酰胺类抗生素的成员，具有广谱抗菌活性和广泛的应用范围。在几项接受亚胺培南西司他丁钠治疗的患者的研究中，已报道血小板减少症是一种罕见的不良事件。在本研究中，我们报告了一例老年患者与亚胺培南西司他丁钠相关的血小板减少症。这名 78 岁的男性患者患有肺部感染，开始接受亚胺培南西司他丁钠的抗感染治疗。在开始使用亚胺培南西司他丁钠治疗的第 9 天，患者血小板计数突然显著下降。同样，在重新开始使用亚胺培南西司他丁钠进行抗感染治疗的第 4 天，患者的血小板计数再次呈现显著下降趋势。发现药物治疗与血小板反应发生之间存在时间相关性。患者的血小板计数分别在首次停药后的第 6 天和第二次停药后的第 13 天逐渐恢复到正常水平。考虑到亚胺培南西司他丁钠的广泛使用，医护人员应提高对与亚胺培南西司他丁钠相关的血小板减少症的通知意识。
