Piperacillin-Tazobactam–Induced Neutropenia and Fever: A Report of 11 Cases

Background This study aims to describe our experience with 11 cases of piperacillin-tazobactam–related neutropenia and fever that were observed over a 6-year period and detail some of their clinical findings, risk factors, management, and outcome. Method Review of the records of all cases of piperacillin-tazobactam–related neutropenia and fever reported to the adverse drug reaction reporting system of the Department of Pharmacy at Hamad General Hospital in the period between 2010 and 2015 was performed. Results During the study period, 11 cases of piperacillin-tazobactam–related neutropenia and fever were identified. Nine were males, and 2 were females, with a mean age of 36 years. All patients had neutropenia, and 10 had fever at the same time. The mean duration of piperacillin-tazobactam use before the development of neutropenia and fever was 17.3 days. Concomitant anemia and thrombocytopenia were observed in 82% and 55%, respectively. Recovery was fast with resolution of fever and neutropenia in 1.5 days and 2.9 days, respectively. All patients survived. Conclusion Piperacillin-tazobactam is a commonly used antibiotic in Qatar. Neutropenia and fever related to piperacillin-tazobactam does occur, however, very rarely. The most important risk factor for its occurrence is prolonged use of more than 17 days. Discontinuation of the drug results in rapid resolution with no sequelae. We report these cases to alert physicians to this uncommon adverse effect of piperacillin-tazobactam and to encourage reporting. Correspondence to: Hussam Al Soub, MD, CABM, FACP, Department of Internal Medicine, Hamad Medical Corporation, PO Box 3050, Doha, Qatar. E-mail: hussamalsoub@yahoo.com. The authors have no funding or conflicts of interest to disclose. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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