Department of Pharmacy, Chongqing University Jiangjin Hospital, 725 Jiangzhou Avenue, Jiangjin District, Chongqing, 402260, China.
Department of Pharmacy, Central Hospital of Jiangjin District, Chongqing, 725 Jiangzhou Avenue, Jiangjin District, Chongqing, 402260, China.
J Int Med Res. 2023 Mar;51(3):3000605231162434. doi: 10.1177/03000605231162434.
Beta-lactam antibiotics commonly cause immune thrombocytopenia. Cross-reactivity in patients with drug-induced immune thrombocytopenia has rarely been reported. In this study, we describe the case of a 79-year-old man who developed thrombocytopenia after receiving piperacillin-tazobactam for an acute exacerbation of chronic obstructive pulmonary disease, and he was successfully treated with meropenem and cefotiam. However, thrombocytopenia recurred after cefoperazone-sulbactam administration. This indicated that cross-reactivity of platelet-specific antibodies occurred between piperacillin-tazobactam and cefoperazone-sulbactam. However, the responsible drug structures remain unknown, requiring further investigation. Likewise, chemical structure similarities among beta-lactam antibiotics must be examined to determine the risk of immune thrombocytopenia in the clinical setting.
β-内酰胺类抗生素通常会引起免疫性血小板减少症。药物诱导的免疫性血小板减少症患者的交叉反应很少有报道。在本研究中，我们描述了一位 79 岁男性的病例，他在因慢性阻塞性肺疾病急性加重而接受哌拉西林他唑巴坦治疗后出现血小板减少症，并用美罗培南和头孢噻肟治疗后病情得到缓解。然而，在给予头孢哌酮舒巴坦后，血小板减少症再次发作。这表明血小板特异性抗体在哌拉西林他唑巴坦和头孢哌酮舒巴坦之间发生了交叉反应。然而，导致这种反应的药物结构仍不清楚，需要进一步研究。同样，必须检查β-内酰胺类抗生素的化学结构相似性，以确定在临床环境中发生免疫性血小板减少症的风险。
