Severe thrombocytopenia in cirrhotic patients treated with Piperacillin-Tazobactam - 10/08/23

Doi : 10.1016/j.liver.2023.100170

Lívia Guimarães ^a, Juliana Piedade ^a, Tamires Rocha ^a, Caroline Baldin ^a, Lívia Victor ^a, Gustavo Pereira ^a,^b,^⁎
^a Gastroenterology and Hepatology Unit, Bonsucesso Federal Hospital (Ministry of Health), 3rd floor, Bonsucesso, Rio de Janeiro 616 (21041-030), Brazil
^b Estácio de Sá University, School of Medicine (IDOMED), Rio de Janeiro, Brazil

^⁎Corresponding author at: Gastroenterology and Hepatology Unit, Bonsucesso Federal Hospital (Ministry of Health), 3rd floor, Bonsucesso, Rio de Janeiro 616 (21041-030), Brazil.Gastroenterology and Hepatology UnitBonsucesso Federal Hospital (Ministry of Health)3rd floor, BonsucessoRio de Janeiro616 (21041-030)Brazil

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Abstract

portal hypertension and bacterial infections are frequent in cirrhosis and their coexistence may render this population susceptible to severe drug-induced thrombocytopenia. We describe frequency, clinical characteristics and prognosis of Piperacillin/Tazobactan associated thrombocytopenia. 84 patients [Child 10±1, MELD 18±8; SIRS and ACLF in 28% and 24%] were included. Thrombocytopenia developed in 12 patients and was associated with a higher frequency of bleeding from multiple sites and platelet transfusion. Severe/persistent thrombocytopenia correlated with in-hospital mortality. In conclusion, development of thrombocytopenia is frequent in cirrhotic patients treated with Piperacillin/Tazobactan and this complication, especially in most severe forms, is associated with high morbidity and mortality.

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Keywords : Thrombocytopenia, Liver cirrhosis, Piperacillin, Tazobactam drug combination

Abbreviations : ACLF, CNS, INR, IQR, LMWH, MELD, PTT, PTZ, PTZ-TCP, SE, SBP, SIRS, TCP