Hypersensitivity to antibiotics in patients with cystic fibrosis

Roehmel, Jobst; Schwarz, C.; Mehl, Anne; Stock, Philippe; Staab, Doris

doi:10.1016/j.jcf.2013.10.002

Cited by 46 publications

(48 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Reports of DIHA attributed to piperacillin are increasing, especially in patients with CF 4–12 16. Whether this unequal distribution is due to the frequent usage of piperacillin for pulmonary exacerbation in patients with CF or due to CF-related promoting cofactors, such as hyperinflammation, still need to be clarified 7 13 14 16…”

Section: Discussionmentioning

confidence: 99%

“…However, piperacillin also is a commonly used drug for the treatment of pulmonary and urinary tract infections in different patient groups where immune haemolytic anaemia has not been reported as frequently 7. In general, in patients with CF the prevalence of adverse reactions to antibiotics is high 13. This hypersensitivity is of yet unclear aetiology and of variably reported prevalence,14 possibly due to unequal study cohorts.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Piperacillin-induced mild haemolytic anaemia in a 44-year-old patient with cystic fibrosis

Meinus¹,

Schwarz

Mayer

et al. 2016

BMJ Case Reports

Self Cite

View full text Add to dashboard Cite

Piperacillin-tazobactam is an antipseudomonal antibiotic frequently used in patients with cystic fibrosis (CF) to treat pulmonary exacerbations. Drug-induced immune haemolytic anaemia is a rare complication during treatment with piperacillin. So far, piperacillin-induced immune haemolytic anaemia (PIHA) is regarded as an acute and severe haemolytic anaemia resulting into life-threatening events. Here we report on a patient with mild PIHA, which did not result in any clinical symptoms or necessity for treatment. To the best of our knowledge, this is the first case report of PIHA without an acute severe haemolytic anaemia. Further research is needed to clarify if this case is a solitary clinical manifestation of PIHA or if mild clinical courses of PIHA might be under-reported. Cases of PIHA have been largely reported in patients with CF. This unequal distribution maybe due to the frequent administration of piperacillin for pulmonary exacerbation in patients with CF or due to CF-related cofactors of yet unknown aetiology.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Piperacillin-induced mild haemolytic anaemia in a 44-year-old patient with cystic fibrosis

Meinus¹,

Schwarz

Mayer

et al. 2016

BMJ Case Reports

Self Cite

View full text Add to dashboard Cite

show abstract

“…This prospective observational study was conducted at the Charité Universitätsmedizin Berlin. Patients at the CF center of the Charité (Pediatric Pneumology Department) were selected to represent patients with extremely high exposure to parenteral antibiotics . From this cohort of currently treated 450 patients with CF (320 adults, 130 children), pediatric (minimum age of 12 years) and adult patients were recruited prospectively at the beginning of in‐hospital IV antibiotic treatment courses between October 2015 and June 2016.…”

Section: Methodsmentioning

confidence: 99%

“…Patients with cystic fibrosis (CF) suffer from chronic bronchial infections with multi‐resistant, primarily gram‐negative bacteria and require repeated treatment with high‐dose antibiotics . Previous case reports and case series suggest a higher incidence of DIIHA due to piperacillin in patients with CF compared to the general patient population.…”

mentioning

confidence: 99%

Risk of piperacillin‐induced hemolytic anemia in patients with cystic fibrosis and antipseudomonal treatment: a prospective observational study

et al. 2019

Self Cite

View full text Add to dashboard Cite

BACKGROUND Drug‐induced immune hemolytic anemia (DIIHA) is a rare but severe side effect caused by numerous drugs. Case reports and case series suggest that piperacillin‐related DIIHA may be more common among patients with cystic fibrosis (CF). However, the prevalence is speculative. The aim of this prospective, observational study was determine the prevalence of DIIHA in such affected patients. METHODS AND MATERIALS Patients with CF hospitalized for parenteral antibiotic therapy at Charité Universitätsmedizin Berlin, who had previously been exposed to IV antibiotics, were enrolled. Blood samples were collected on Days 3 and 12 of antibiotic treatment courses. Serological studies were performed using standard techniques with gel cards. Screening for drug‐dependent antibodies (ddab) was performed in the presence of the drugs and their urinary metabolites. RESULTS A total of 52 parenteral antibiotic cycles in 43 patients were investigated. Ddab against piperacillin were detected in two patients (4.7%). The direct AHG was positive with anti‐IgG only in both patients. However only one of these patients developed mild immune hemolytic anemia. Both patients had been repeatedly treated with piperacillin without any evident hemolysis. There was no correlation between the exposure to piperacillin and the prevalence of ddab. CONCLUSION Our prospective study indicates that piperacillin‐induced ddab occur more frequently in patients with CF than previously suggested. The question related to the significance of piperacillin‐dependent antibodies may reflect new aspects in this field.

show abstract

“…Well-established complications (e.g. CF-related diabetes, massive haemoptysis, pneumothorax) are more common in adult patients and the treatment of infections caused by multi-resistant micro-organisms is made more complex by frequent adverse reactions to drugs, toxicity (including renal insufficiency and vestibular/ototoxicity) [15,16] and problems associated with vascular access. Other less well-defined but emerging complications may well become common in the future care for adults living into their fourth decade and beyond.…”

Section: Complexity Of Adult Cf Carementioning

confidence: 99%

Report of the European Respiratory Society/European Cystic Fibrosis Society task force on the care of adults with cystic fibrosis

et al. 2015

View full text Add to dashboard Cite

The improved survival in people with cystic fibrosis has led to an increasing number of patients reaching adulthood. This trend is likely to be maintained over the next decades, suggesting a need to increase the number of centres with expertise in the management of adult patients with cystic fibrosis. These centres should be capable of delivering multidisciplinary care addressing the complexity of the disease, in addition to addressing the psychological burden on patients and their families. Further issues that require attention are organ transplantation and end of life management.Lung disease in adults with cystic fibrosis drives most of the clinical care requirements, and major lifethreatening complications, such as respiratory infection, respiratory failure, pneumothorax and haemoptysis, and the management of lung transplantation require expertise from trained respiratory physicians. The taskforce therefore strongly reccommends that medical leadership in multidisciplinary adult teams should be attributed to a respiratory physician adequately trained in cystic fibrosis management.The task force suggests the implementation of a core curriculum for trainees in adult respiratory medicine and the selection and accreditation of training centres that deliver postgraduate training to the standards of the HERMES programme. @ERSpublications Respiratory physicians, trained in adult CF management, should lead multidisciplinary teams taking care of patients http://ow.ly/SgRgj

show abstract

Hypersensitivity to antibiotics in patients with cystic fibrosis

Abstract: During days 1-4 of antibiotic treatment patients are at elevated risk for HRPA. HRPA are drug-specific and dependent on cumulative annual exposure. Elucidation of HRPA's immunological mechanisms and development of diagnostic algorithms for clinical use are required.

Cited by 46 publications

References 28 publications

Piperacillin-induced mild haemolytic anaemia in a 44-year-old patient with cystic fibrosis

Piperacillin-induced mild haemolytic anaemia in a 44-year-old patient with cystic fibrosis

Risk of piperacillin‐induced hemolytic anemia in patients with cystic fibrosis and antipseudomonal treatment: a prospective observational study

Report of the European Respiratory Society/European Cystic Fibrosis Society task force on the care of adults with cystic fibrosis

Contact Info

Product

Resources

About