View source for Β-lactam-associated neutropenia

{{DISPLAYTITLE:β-lactam-associated neutropenia}}

== Background ==

* Adverse reaction to [[Β-lactams|β-lactam antibiotics]] occurring in about 10% of courses longer than 2 weeks
* Higher risk with [[penicillin G]], [[nafcillin]], [[oxacillin]], [[piperacillin-tazobactam]], [[ceftriaxone]], and [[ceftaroline]]
* Risk increases with cumulative exposure
* Mechanism is unclear; may be some combination of a direct toxic effect or an [[Hypersensitivity reaction|immune-mediated hypersensitivity reaction]]

== Clinical Manifestations ==

* [[Neutropenia]]
* Usually presents after 2 to 3 weeks of parenteral antibiotics
* Rash in 25-50% of cases
* May have associated [[eosinophilia]] or [[thrombocytopenia]]
* Can progress to [[agranulocytosis]]

== Management ==

* Consider stopping the offending antibiotic if ANC falls below 1
* Other β-lactam antibiotics are probably still safe to use

== Further Reading ==

* A Review of β-Lactam-Associated Neutropenia and Implications for Cross-reactivity. ''Ann Pharmacother''. 2021;55(8):1037-1049. doi: [https://doi.org/10.1177/1060028020975646 10.1177/1060028020975646]