Piperacillin/tazobactam-induced immune-mediated thrombocytopenia in the intensive care unit.
OBJECTIVE
Drug-induced immune-mediated thrombocytopenia is a rare adverse event that remains a diagnostic challenge, especially in the critically ill population. There are only two previously reported cases of rapid and profound thrombocytopenia after administration of piperacillin/tazobactam.


METHODS
A 64-year-old man experienced several episodes of isolated thrombocytopenia after receiving piperacillin/tazobactam. Interestingly, the degree of thrombocytopenia varied with the amount of corticosteroid therapy the patient was receiving. Due to the complexity of thrombocytopenia in critically ill patients, other potential causes were extensively worked up and ruled out.


CONCLUSIONS
We describe the first case of piperacillin/tazobactam-induced immune-mediated thrombocytopenia that was mitigated by the administration of corticosteroid therapy. This case highlights the importance of identifying potential drug-related causes of isolated thrombocytopenia.
Department of Critical Care and Department of Pharmacy Services, Surrey Memorial Hospital, Surrey, BC, Canada.
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K
Boyce
Department of Critical Care and Department of Pharmacy Services, Surrey Memorial Hospital, Surrey, BC, Canada.
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H
Brar
Department of Critical Care and Department of Pharmacy Services, Surrey Memorial Hospital, Surrey, BC, Canada. Sarah.Stabler@fraserhealth.ca.
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http://orcid.org/0000-0001-5296-3261
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Stabler
D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010397:Penicillanic Acid / Q000009:adverse effects / Q000031:analogs & derivatives*; D010878:Piperacillin / Q000009:adverse effects; D000077725:Piperacillin, Tazobactam Drug Combination; D013921:Thrombocytopenia / Q000139:chemically induced*
D000900:Anti-Bacterial Agents; D000077725:Piperacillin, Tazobactam Drug Combination; D010397:Penicillanic Acid; D010878:Piperacillin
immune; piperacillin/tazobactam; thrombocytopenia