Zidovudine-induced neutropenia: are we too cautious?
30 patients with recurrent zidovudine-induced neutropenia were followed up for a total of 493 months of treatment to evaluate their risk of bacterial infection. Zidovudine was temporarily discontinued only when the polymorphonuclear (PMN) cell count fell to less than 500/microliters. The incidence of bacterial infection during periods of severe neutropenia (PMN less than 500/microliters) was 230% higher than when the PMN count was 500-1000/microliters, and 600% higher than when the count was greater than 1000/microliters. The difference between periods when the PMU count was 500-1000/microliters and non-neutropenic periods was not significant. The findings suggest that zidovudine therapy can be continued despite neutropenia without a major increase in the incidence of bacterial infection provided the PMN count does not fall to less than 500/microliters.
Shaunak
S
S
Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina 27710.
Bartlett
J A
JA
D000163:Acquired Immunodeficiency Syndrome / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D000380:Agranulocytosis / Q000139:chemically induced*; D001424:Bacterial Infections / Q000209:etiology*; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D009503:Neutropenia / Q000139:chemically induced* / Q000150:complications; D009894:Opportunistic Infections / Q000209:etiology*; D011446:Prospective Studies; D015215:Zidovudine / Q000009:adverse effects*
D015215:Zidovudine