疑似Tazocin®引起嗜中性白血球低下之案例報告

A Case Report about the Suspect of Tazocin-Induced Neutropenia

10.6168/FJCP.2013.2104.06

張雅嵐(Ya-Lan Chang)；賴永融(Yun-Rung Lai)；李建瑩(Chien-Ying Li)

Neutropenia ； Piperacillin ； Tazobactam

臺灣臨床藥學雜誌

21卷4期（2013 / 12 / 31）

335 - 341

繁體中文

Piperacillin/tazobactam（Tazocin®，PTZ）為一廣效性複方抗生素，廣泛用於院內感染的經驗性抗生素。本案例為54歲男性因醫療照護相關肺炎而入院，長期使用PTZ出現嗜中性白血球低下（WBC：2,440/mm^3；絕對嗜中性球：440/mm^3）。停藥後一週白血球上升至14,480/mm^3，第9 天白血球攀升至54,500/mm^3，停藥後第17天降至16,860/mm^3。依據文獻查證，PTZ造成骨髓抑制與劑量累積有相關性。藉由此案例提醒醫療人員，長期使用PTZ須小心監測病人血球變化。若發生不良反應時應立即停藥，防止對病人造成更進一步的嚴重傷害。

Piperacillin/tazobactam (Tazocin®, PTZ) is a combination antibiotic with a broad spectrum of activity, and used in nosocomial infections. This case is a 54-year-old male with health-care associated pneumonia (HCAP), which was prolonged use of piperacillin/tazobactam with induced neutropenia (WBC: 2,440/mm^3; absolute neutrophil count [ANC]: 440/mm^3). Approximately one week after cessation of PTZ, laboratory data revealed that elevated WBC 14,480/mm^3, ANC 4,923/mm^3, WBC increased to 54,500/mm^3 at day-9 after cessation, and recovered to 16,860/mm^3 at day-17 after discontinued PTZ. From a literature review, PTZ causes bone marrow suppression correlated with cumulative dose. The purpose of this study was to recall the monitoring of blood counts carefully after long-term use of PTZ. PTZ should be discontinued immediately to prevent further serious injury when adverse reactions occurred as well.