Flucloxacillin associated neutropenia in children treated for bone and joint infections.
OBJECTIVE
This report describes episodes of acute neutropenia associated with flucloxacillin use in children treated for bone and joint infections.


METHODS
A retrospective chart audit was performed on eight children who developed neutropenia when treated with flucloxacillin.


RESULTS
Eight children (aged 1 month to 13 years) had a diagnosis of neutropenia attributed to treatment with flucloxacillin, seven of whom received parenteral therapy. The time to onset of neutropenia averaged 27 days, with neutrophil counts returning to normal limits in all patients after 2 to 9 days. Two children were asymptomatic when the neutropenia was detected. The average flucloxacillin dose used was 65% (range 20-100%) of the recommended maximum dose.


CONCLUSIONS
These cases suggest that flucloxacillin should be used with greater caution and guidelines for dosing and clinical monitoring (regular neutrophil counts) need to be reassessed, despite none of these patients experiencing serious sequelae.
van den Boom
J
J
Starship Children's Health, Auckland City Hospital, Auckland District Health Board, Auckland, New Zealand.
Kristiansen
J B
JB
Voss
L M
LM
Stott
N S
NS
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001170:Arthritis, Infectious / Q000188:drug therapy*; D001850:Bone Diseases, Infectious / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005436:Floxacillin / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D008297:Male; D009503:Neutropenia / Q000139:chemically induced*; D012189:Retrospective Studies
D000900:Anti-Bacterial Agents; D005436:Floxacillin