Piperacillin thrombocytopenia with

Thrombocytopenia with penicillins has very rarely been reported (57-61). In two cases with mezlocillin (62) and piperacillin + azobactam (63) antibodies became attached to the platelets in the presence of the incriminated drug. The second of these cases is of particular interest, since drug-dependent antibodies were found in the presence of piperacillin but not tazobactam. 

Reports of drug-induced thrombocytopenia have been systematically reviewed (1). Among the 98 different drugs described in 561 articles the following antibiotics were found with level I (definite) evidence co-trimoxa-zole, rifampicin, vancomycin, sulfisoxazole, cefalothin, piperacillin, methicillin, novobiocin. Drugs with level II (probable) evidence were oxytetracycline and ampicillin. 

Reichardt P, Handrick W, Linke A, Schille R, BQess W. Leukocytopenia, thrombocytopenia and fever related to piperacillin/tazobactam treatment—a retrospective analysis in 38 children with cystic fibrosis. Infection 1999 27(6) 355-6. 

Yan MT, Chu HY, Chau T, Lin SH. Profound thrombocytopenia associated with piperacillin in a hemodialysis patient. Clin Nephrol 2009 72(3) 240-3. 

Piperacillin/tazobactam has been associated with thrombocytopenia. A 74-year-old woman on continuous renal replacement therapy developed severe thrombocytopenia (19,000/mm ) a week after the initiation of piperacillin/ tazobactam. After discontinuation of piperacillin/fazobacfam, the platelet coxmt recovered within 3 days. Piperacillin/tazobactam should be considered as a causative agent for thrombocytopenia in this type of patient [39 ]. 

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