Automatic monitoring and assessment of antibiotics-related thrombocytopenia

doi:10.19803/j.1672-8629.20220348

Abstract

Abstract: Objective To find out about the clinical characteristics and risk factors for severity of antibiotics-related thrombocytopenia among inpatients. Methods Using the “ADE active surveillance and assessment system-Ⅱ” ( ADE-ASAS-Ⅱ), the electronic medical data on inpatients treated in our hospital between June 1, 2020 and May 31, 2021 was retrospectively monitored. Patients who met the standards were automatically identified before alarm was given. After the alarm, patients were manually assessed, and the clinical characteristics, drug distribution and risk factors for severity of antibiotics-related thrombocytopenia were analyzed. Results A total of 86 452 inpatients were included in the surveillance, with 1 606 system alerts. After screening, The age of the 204 positive cases averaged (62.8±15.46) years, and thrombocytopenia mostly occurred within 7 days of medication, involving a total of 189 cases (92.65%). The drugs involved were of 11 categories and 22 types. Most of the cases of thrombocytopenia were caused by cephalosporins (135 cases, 66.20%). The top three drugs were cefoperazone sulbactam (39 cases, 19.12%), cefuroxime (32 cases, 15.69%) and flomoxef (21 cases, 10.29%). Meropenem was the most likely drug responsible for severe thrombocytopenia (30 cases, 20%). Complications with abnormal liver function (OR=3.17, 95%CI:1.07~9.38), admissions to ICU (OR=3.17, 95%CI: 1.19~8.46), co-administration with antibiotics (OR=3.28, 95%CI: 1.38~7.79) and combination of antithrombotic agents (OR=2.80, 95%CI: 1.11~7.07) could increase the risk of severe thrombocytopenia. Among these cases, 145 had their drugs withdrawn, while the rest were mostly treated with dexamethasone (28 cases) and recombinant human thrombopoietin (25 cases). Conclusion There are many antibacterial drugs that cause thrombocytopenia. In clinical use of these drugs, the clinical manifestations of patients and the platelet count need to be monitored. Early warning and precautions are critical to high-risk groups and the combination of high-risk drugs.

Key words: antibiotics, thrombocytopenia, adverse drug reaction, automatic monitoring, risk factors

CLC Number:

HUANG Cuili, GAO Ao, WANG Jiaxi, GUO Haili, XU Xiaohan, CHENG Yinchu, GUO Daihong. Automatic monitoring and assessment of antibiotics-related thrombocytopenia[J]. Chinese Journal of Pharmacovigilance, 2023, 20(7): 807-811.

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