Cephalosporin‐induced immune neutropenia

Murphy, Michael; Metcalfe, Paul; Grint, P.; Green, A. R.; Knowles, Sue; Amess, J. A. L.; Waters, A. H.

doi:10.1111/j.1365-2141.1985.tb02957.x

Cited by 58 publications

(28 citation statements)

References 22 publications

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“…prolonged treatment or high dose, progressive decrease in neutrophil counts…), the usual absence of clinical signs of hypersensitivity and the inconsistent detection of specific beta‐lactam‐induced antineutrophil antibodies. By contrast, an immune‐mediated reaction was considered in patients positively tested for the presence of drug‐dependent antibodies such as cefotaxime and cefuroxime . Also in keeping with an immune mechanism, one study involving 13 patients with beta‐lactam induced neutropaenia found a positive leucocyte microagglutination test in 8 of the 9 tested patients .…”

Section: Discussionmentioning

confidence: 99%

Beta‐lactam‐induced severe neutropaenia: a descriptive study

Vial

Bailly

Pérault‐Pochat

et al. 2018

Fundamemntal Clinical Pharma

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The objectives of this study were to describe the characteristics and natural history of beta‐lactam‐induced severe neutropaenia and to evaluate the risk of recurrences after another beta‐lactam readministration. Reports of pure agranulocytosis associated with a beta‐lactam exposure within the 10 days preceding the neutropaenia were extracted from the French Pharmacovigilance Database over the year 2010. Cases with another evident cause or more likely attributable to another drug were excluded. Data were analyzed for demographics, clinical and biological features, prognosis factors, granulocyte colony stimulating factors administration and outcome. Sixty‐two cases were included (median age: 65 years). The median duration of treatment before neutropaenia was 16 days. In 47% of cases, the diagnosis was made on a systematic blood cell count. The median neutrophil count at nadir was 0.125 × 109/L, and bone marrow examination evidenced features of neutrophilic maturation arrest or aplasia in 21 patients, hyperplasia of granulopoietic cells in three and normal findings in five. Three patients developed severe sepsis. All but one recovered a normal blood cell count within 2–56 days after beta‐lactam discontinuation. The last patient died from recurrent severe septic shock. No significant effect of granulocyte colony stimulating factor on the mean duration of haematological recovery was found. Among the 21 patients who later received another beta‐lactam, two experienced recurrence of the neutropaenia after receiving a beta‐lactam from another subfamily. Beta‐lactam‐induced agranulocytosis was usually observed after prolonged treatment, and severe complications are uncommon. In most patients, a subsequent treatment with another beta‐lactam was well tolerated.

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Section: Discussionmentioning

confidence: 99%

Beta‐lactam‐induced severe neutropaenia: a descriptive study

Vial

Bailly

Pérault‐Pochat

et al. 2018

Fundamemntal Clinical Pharma

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“…The combination of rash and agranulocytosis/neutropenia is intriguing for being an immune reaction. Antibodies to b-lactams have been demonstrated in DIAG patients as well as inhibition of colony growth in vitro by b-lactams [66][67][68].…”

Section: Immunologicalmentioning

confidence: 99%

Idiosyncratic drug‐induced agranulocytosis: Possible mechanisms and management

2009

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The incidence of drug‐induced neutropenia has not changed in the western hemisphere over the last 30 years. Yet, the drug panorama has changed considerably. This implies that host factors may play an intriguing role for this idiosyncratic reaction. The knowledge as to mechanisms for the reaction has advanced with emerging understanding of neutropoiesis and immune regulation. Nonetheless, it is still remarkably difficult to pinpoint why and how a drug causes this unexpected, severe adverse event in a patient. Patient characteristics, e.g. genetics, appear to be keys for better understanding, predictions and prevention. Am. J. Hematol. 2009. © 2009 Wiley‐Liss, Inc.

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“…The mechanism of the disorder, that is, toxic [5][6][7] or immune [8,9] mediated or both [10], is not fully understood. Our data do not afford to any conclusion regarding this question.…”

Section: Discussionmentioning

confidence: 99%

Cephapirin-Induced Neutropenia

Pan

Gonzalez-Quintela²,

García³

et al. 1989

Chemotherapy

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Five cases (3.5%) of reversible cephapirin-induced neutropenia were observed in 132 patients receiving this antibiotic. The disorder was severe (agranulocytosis) in 3 cases. Simultaneous maculopapular rash was observed in all of them and in 4 cases fever occured. All the cases observed were female (p not significant). Neutropenia developed only after administration of high doses of the antibiotic for a prolonged period of time. In contrast to another 127 patients treated with cephapirin who did not develop neutropenia, neutropenic patients had received a mean daily dose, total dose, mean daily dose per kilogram and total dose per kilogram of body weight significantly larger (p = 0.05, 0.02, 0.001 and 0.001, respectively). The duration of therapy was significantly longer in the neutropenic group (p = 0.001). Neutropenia did not occur below 90 g of total dose, but when this amount was exceeded, the incidence of the disorder reached 26.3% (p < 0.001). We conclude that when this drug must be used either for long periods of time or at high doses, a hematologic vigilance is recommendable.

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Cephalosporin‐induced immune neutropenia

Cited by 58 publications

References 22 publications

Beta‐lactam‐induced severe neutropaenia: a descriptive study

Beta‐lactam‐induced severe neutropaenia: a descriptive study

Idiosyncratic drug‐induced agranulocytosis: Possible mechanisms and management

Cephapirin-Induced Neutropenia

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