Ceftriaxone‐induced neutropenia successfully overcome by a switch to penicillin G in Cardiobacterium hominis endocarditis

Leukopenia, including agranulocytosis, is a severe complication of treatment with all β‐lactam antibiotics. Its incidence increases with age. Cardiobacterium hominis endocarditis after implantation of an aortic valve bio‐prosthesis in a 77‐year‐old woman was treated with ceftriaxone 2 g/day plus gen...

Full description

Saved in:
Bibliographic Details
Published in:Clinical case reports 2023-06, Vol.11 (6), p.e7462-n/a
Main Authors: Nau, Roland, Schmidt‐Schweda, Stephan, Frank, Tobias, Gossner, Johannes, Djukic, Marija, Eiffert, Helmut
Format: Article
Language:English
Subjects:
Abdomen
Age
Antibiotics
Antidepressants
Bone marrow
Cardiobacterium hominis
Case Report
ceftriaxone
Chemotherapy
Drug dosages
Endocarditis
endocarditis – leukopenia
Geriatrics
Granulocytes
Infectious Diseases
Ions
Leukocytes
Leukopenia
Neutropenia
Neutrophils
Patients
Penicillin
penicillin G
Pharmacokinetics
Prostheses
Proteins
Tomography
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Leukopenia, including agranulocytosis, is a severe complication of treatment with all β‐lactam antibiotics. Its incidence increases with age. Cardiobacterium hominis endocarditis after implantation of an aortic valve bio‐prosthesis in a 77‐year‐old woman was treated with ceftriaxone 2 g/day plus gentamicin 160 mg/day intravenously. On Day 25 of treatment, blood leukocytes had decreased to 1800/μl (neutrophils 370/μl). Antibiotic therapy was switched to penicillin G 20 million international units (IU)/day. Thereafter, blood leukocytes including neutrophils normalized suggesting that penicillin G was less bone marrow‐toxic than ceftriaxone. High‐dose ciprofloxacin, the alternative to penicillin G, was avoided because of the risk of cognitive and behavioral side effects. The present case suggests that with close laboratory monitoring a β‐lactam with differing side chains should not be considered contraindicated after β‐lactam antibiotic‐induced neutropenia. Leukopenia which had developed during treatment with 2g ceftriaxone/day (yellow) resolved when antibiotic therapy was switched to penicillin G 20 million international units/day (green).
ISSN:2050-0904
2050-0904
DOI:10.1002/ccr3.7462