title: Reversible bone marrow depression by high-dose piperacillin/tazobactam.
abstract: Bone marrow toxicity, mainly neutropenia, has been described as an uncommon secondary effect of most beta-lactams, and it is usually related to large cumulative doses. Although previously described for piperacillin, no cases of marrow depression caused by piperacillin/tazobactam have been reported to date. We report a case of reversible pancytopenia, with evidence of bone marrow depression, which occurred after a 17 d course of piperacillin/tazobactam. The drug was given to an underweight 18-year-old woman, at the usual dosage of 4/0.5 g three times a day. We stress the need for reducing the recommended dosage when treating underweight adult patients, and also of monitoring haematological parameters during prolonged treatments.
authors.affiliation: Service of Internal Medicine, Hospital de Cruces, Bizkaia, Basque Country, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Ruiz-Irastorza
authors.forename: G
authors.initials: G
authors.lastname: Barreiro
authors.forename: C
authors.initials: C
authors.lastname: Aguirre
mesh_terms: D000293:Adolescent; D001835:Body Weight; D001855:Bone Marrow Diseases / Q000139:chemically induced*; D004359:Drug Therapy, Combination / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005334:Fever / Q000139:chemically induced; D006801:Humans; D009503:Neutropenia / Q000139:chemically induced*; D010198:Pancytopenia / Q000139:chemically induced*; D010397:Penicillanic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D010878:Piperacillin / Q000008:administration & dosage / Q000009:adverse effects*; D000078142:Tazobactam; D015431:Weight Loss
chemical_list: D010397:Penicillanic Acid; D000078142:Tazobactam; D010878:Piperacillin