Cross-reactivity of beta-lactam antibiotics in a patient with
drug-induced immune thrombocytopenia
Abstract
Beta-lactam antibiotics are a relatively common cause of immune
thrombocytopenia. Cross-reactivity of them in patient with drug-induced
immune thrombocytopenia is rarely reported. Here, we describe the case
of a 79-year-old male patient experienced thrombocytopenia after
receiving piperacillin-tazobactam for acute exacerbation of chronic
obstructive pulmonary disease (AECOPD). Fortunately, the patient was
able to successfully challenge with meropenem and cefotiam. However,
after the cefoperazone-sulbactam was administered, the patient
experienced thrombocytopenia again. Therefore, there are cross-reactions
of platelet-relative antibodies between piperacillin-tazobactam and
cefoperazone-sulbactam. Although the exact responsible antibodies remain
unknown and need further investigation, attention should be paid to the
role of chemical structure similarities in determining the risk of
immune thrombocytopenia among beta-lactams in the clinical setting.