title: Moxifloxacin-Induced Immune-Mediated Thrombocytopenia in a Chronic Kidney Disease Patient Receiving Hemodialysis.
abstract: To alert clinicians to a serious complication from a commonly prescribed medication, moxifloxacin.
  
  
  
  A 65-year-old male, septic, hemodialysis patient developed thrombocytopenia following exposure to vancomycin, ceftazidime, and moxifloxacin. Drug-specific immunoglobulin testing showed positive autoantibodies against only moxifloxacin, and the probability stratification proposed by Naranjo et al would give this case a score of 7-a probable association between moxifloxacin and the adverse event.
  
  
  
  Idiopathic thrombocytopenic purpura (ITP) results in immune-mediated platelet destruction, with bleeding risk frequently manifested by purpuric skin and mucosal lesions. Although many drugs are associated with ITP, moxifloxacin has only been characterized in 2 previous case reports. This is the first case report where specific immunoglobulin antibody testing showed a positive association between ITP and moxifloxacin.
  
  
  
  Moxifloxacin is a commonly prescribed medication because of its wide spectrum of activity, high bioavailability, and convenient dose schedule. Clinicians need to be aware of this little-known side effect of this commonly prescribed antibiotic.
authors.affiliation: Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Jonathan F
authors.initials: JF
authors.lastname: Mailman
authors.affiliation: Royal Jubilee Hospital-Vancouver Island Health Authority, Victoria, BC, Canada.
authors.forename: Caroline
authors.initials: C
authors.lastname: Stigant
authors.affiliation: Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada Royal Jubilee Hospital-Vancouver Island Health Authority, Victoria, BC, Canada dan.martinusen@viha.ca.
authors.forename: Dan
authors.initials: D
authors.lastname: Martinusen
keywords: antibiotics; blood dyscrasias; dialysis; drug safety; hemodialysis; moxifloxacin; quinolone; thrombocytopenia