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Beta-lactam-induced severe neutropaenia: a descriptive study.
Vial, Thierry; Bailly, Henry; Perault-Pochat, Marie-Christine; Default, Anne; Boulay, Charlène; Chouchana, Laurent; Kassai, Behrouz.
Afiliación
  • Vial T; Centre Régional de Pharmacovigilance, Hospices Civils de Lyon, Service Hospitalo-Universitaire de Pharmacotoxicologie, 162 avenue Lacassagne, Lyon, 69424, France.
  • Bailly H; Centre Régional de Pharmacovigilance, Hospices Civils de Lyon, Service Hospitalo-Universitaire de Pharmacotoxicologie, 162 avenue Lacassagne, Lyon, 69424, France.
  • Perault-Pochat MC; Centre Régional de Pharmacovigilance, Centre Hospitalier Régional et Universitaire, 86021, Poitiers Cedex, France.
  • Default A; Centre Régional de Pharmacovigilance Marseille - Provence - Corse, Hôpital Sainte-Marguerite AP-HM, 270 boulevard de Saint-Marguerite, 13274, Marseille Cedex 9, France.
  • Boulay C; Centre Régional de Pharmacovigilance, Institut de Biologie Clinique, Hôpital Charles Nicolle, CHU de Rouen, 76031, Rouen cedex, France.
  • Chouchana L; Centre Régional de Pharmacovigilance, Hôpitaux Universitaires Paris Centre, Site Hôpital Cochin, 27 rue du faubourg Saint Jacques, 75014, Paris, France.
  • Kassai B; Centre Régional de Pharmacovigilance, Hospices Civils de Lyon, Service Hospitalo-Universitaire de Pharmacotoxicologie, 162 avenue Lacassagne, Lyon, 69424, France.
Fundam Clin Pharmacol ; 33(2): 225-231, 2019 Apr.
Article en En | MEDLINE | ID: mdl-30289173
ABSTRACT
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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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Beta-Lactamas / Antibacterianos / Neutropenia Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Aged80 / Child / Child, preschool / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Fundam Clin Pharmacol Asunto de la revista: FARMACOLOGIA Año: 2019 Tipo del documento: Article País de afiliación: Francia

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Beta-Lactamas / Antibacterianos / Neutropenia Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Aged80 / Child / Child, preschool / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Fundam Clin Pharmacol Asunto de la revista: FARMACOLOGIA Año: 2019 Tipo del documento: Article País de afiliación: Francia