A case of febrile neutropenia caused by meropenem in an infant after congenital heart surgery and data mining analysis
- VernacularTitle:美罗培南致婴儿先天性心脏病术后发热性中性粒细胞减少症1例及文献挖掘分析
- Author:
Fan WU
1
;
Shisi LI
2
;
Fang MENG
1
;
Wenxiu XU
1
Author Information
1. Dept. of Pharmacy，Fuwai Yunnan Hospital，Chinese Academy of Medical Sciences，Kunming 650032，China
2. Dept. of Cardiac Surgery，Fuwai Yunnan Hospital，Chinese Academy of Medical Sciences，Kunming 650032，China
- Publication Type:Journal Article
- Keywords:
meropenem;
febrile neutropenia;
hematologic
- From:
China Pharmacy
2024;35(18):2304-2309
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To provide a reference for the safe clinical use of meropenem. METHODS The relationship of adverse reactions was analyzed based on a case of febrile neutropenia after using meropenem in an infant after congenital heart surgery by clinical pharmacists. By retrieving Chinese and English databases， case reports of adverse reactions induced by meropenem in blood system were summarized and analyzed. Relevant risk signals of adverse events were excavated from the FDA Adverse Event Reporting System， and the characteristics of meropenem-induced hematologic adverse reactions were summarized. RESULTS This case was assessed as “very likely” according to the Naranjo’s assessment scale by clinical pharmacists. A total of 16 patients were included in the literature analysis， of which one was febrile neutropenia， 13 patients had grade 4 serious adverse reactions that were life-threatening or required urgent treatment. All adverse reactions improved after drug withdrawal. Data mining revealed that the median occurrence time of hematologic adverse events induced by meropenem was 6 d； neonatal thrombocytopenia， intravascular hemolysis and neutrophil count decrease were the top 3 signals of risk intensity for adverse events. CONCLUSIONS Early use of meropenem may induce serious life-threatening hematological adverse reactions， especially in infants and elderly， those who use higher doses of meropenem， those who have previous antibiotic allergies， those with complex underlying diseases， those who use multiple antibiotics in combination， and those who experience high fever and bleeding after medication.Close monitoring should be provided in clinical practice.
