Meropenem-induced thrombocytopenia: a paediatric case

Abstract

Meropenem is a broad-spectrum carbapenem widely used to treat both Gram-positive and negative bacterial infections, including extended-spectrum beta-lactamase-producing microbes. We describe the occurrence of thrombocytopenia and hypersensitivity in a boy receiving intravenous meropenem for intra-abdominal sepsis secondary to perforated appendicitis. The patient developed a pruritic maculopapular rash with occasional petechiae, associated with severe thrombocytopenia, after 7 days of meropenem administration. Investigations for other causes of thrombocytopenia, including possible line sepsis, were unfruitful, and the thrombocytopenia did not resolve until cessation of meropenem. Drug-induced reactions should be considered in children receiving meropenem who present with a rash and thrombocytopenia.

Prevalence and risk factors for severe linezolid-associated thrombocytopenia in pediatric patients: An analysis of a public database

“…There is limited literature on thrombocytopenia induced by carbapenem or piperacillin/tazobactam. [19][20][21] The mechanism by which the combination therapy increases the risk is unclear. The possible explanations include the additional myelosuppression effect that inhibits the production of platelets and the accelerated activation of the complement system to promote the destruction of platelets.…”