Analysis of literature case reports on hemolytic anemia induced by piperacillin-tazobactam
Objective To discuss the occurrence and characteristics of hemolytic anemia induced by piperacillin-tazobactam to provide a reference for clinically safe drug use.Methods PubMed,Web of Science,CNKI,WanFang Data,and VIP were electronically searched to collect case reports of hemolytic anemia induced by piperacillin-tazobactam from inception to December 2023,and statistical analysis was conducted on patients'basic information,drug use,hemolytic anemia,complications and outcomes.Results A total of 27 patients were included in 25 literature,including 14 males(51.85%)and 13 females(48.15%),aged from 4 days to 77 years old,and the time of first occurrence of hemolytic anemia ranged from 24 h to 18 days.The minimum hemoglobin level of hemolytic anemia was determined in 25 cases,ranging from 27 to 113 g·L-1,of which 14 cases were severe or extremely severe anemia(<60 g·L-1).After drug withdrawal,antibiotic change,and symptomatic supportive treatment,the hemolytic anemia of 25 patients(92.59%)was improved or recovered.Among them,the anemia of 1 patient was improved after stopping piperacillin-tazobactam,but the patient died of multiple organ failure 15 days after drug withdrawal.The other two patients of anemia did not improve,and eventually discharged themselves or died clinically.Conclusion Hemolytic anemia is a rare adverse reaction of piperacillin-tazobactam,and the clinical symptoms have no obvious specificity.Hemoglobin levels should be monitored in clinical use,and once the abnormality is found,if it is clear that piperacillin-tazobactam is the suspicious drug,it should be promptly discontinued,and measures such as red blood cell transfusion should be taken if necessary.
Piperacillin-tazobactamHemolytic anemiaAdverse drug reactionCase reportsHemoglobin level