{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T16:56:27Z","timestamp":1773248187773,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2015,12,19]],"date-time":"2015-12-19T00:00:00Z","timestamp":1450483200000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2015,12]]},"abstract":"\n Drug\u2010induced thrombocytopenia is a rare but serious adverse event that has been associated with multiple drugs including \u03b2\u2010lactams. Although it mostly occurs with prolonged medication use, some cases of rapid\u2010onset thrombocytopenia have been reported. We describe the case of a 69\u2010year\u2010old man who developed severe and immediate thrombocytopenia following reexposure to piperacillin\u2010tazobactam in the critical care setting. He received a 6\u2010day course of piperacillin\u2010tazobactam for a possible pneumonia immediately after cardiac surgery. During this course of therapy, his platelet count decreased (fluctuating between 69\u00a0\u00d7\u00a010\n 3<\/jats:sup>\n \/mm\n 3<\/jats:sup>\n and 104\u00a0\u00d7\u00a010\n 3<\/jats:sup>\n \/mm\n 3<\/jats:sup>\n ) and then progressively increased after completion of the antibiotic to 340\u00a0\u00d7\u00a010\n 3<\/jats:sup>\n \/mm\n 3<\/jats:sup>\n on postoperative day 15. Ten days after the antibiotic course was completed (postoperative day 16), the patient developed new signs of infection (fever and neutrophilia), and piperacillin\u2010tazobactam was restarted. Eight hours after reintroducing the antibiotic, his platelet count dropped from 317\u00a0\u00d7\u00a010\n 3<\/jats:sup>\n \/mm\n 3<\/jats:sup>\n to 7\u00a0\u00d7\u00a010\n 3<\/jats:sup>\n \/mm\n 3<\/jats:sup>\n . After reviewing all the medications administered to the patient as well as other potential causes of thrombocytopenia, and given the chronology of events, piperacillin\u2010tazobactam was suspected as the most likely offending agent and was therefore replaced by meropenem on postoperative day 17. The patient's platelet count began to rise 2\u00a0days after discontinuation of piperacillin\u2010tazobactam and reached 245\u00a0\u00d7\u00a010\n 3<\/jats:sup>\n \/mm\n 3<\/jats:sup>\n by postoperative day 30. No spontaneous bleeding or thrombosis occurred while the patient was thrombocytopenic. Use of the Naranjo Adverse Drug Reaction Probability Scale indicated a probable relationship (score of 6) between the patient's development of thrombocytopenia and piperacillin\u2010tazobactam therapy. This case highlights the severity and swiftness in which drug\u2010induced thrombocytopenia may present in the context of cardiac surgery.\n <\/jats:p>","DOI":"10.1002\/phar.1675","type":"journal-article","created":{"date-parts":[[2015,12,19]],"date-time":"2015-12-19T02:57:39Z","timestamp":1450493859000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Rapid\u2010Onset Thrombocytopenia Following Piperacillin\u2010Tazobactam Reexposure"],"prefix":"10.1002","volume":"35","author":[{"given":"Van Dong","family":"Nguyen","sequence":"first","affiliation":[{"name":"Department of Pharmacy Services McGill University Health Center Montreal Quebec Canada"},{"name":"Faculty of Pharmacy University of Montreal Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean\u2010Fran\u00e7ois","family":"Tourigny","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services McGill University Health Center Montreal Quebec Canada"},{"name":"Faculty of Pharmacy University of Montreal Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renaud","family":"Roy","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy University of Montreal Montreal Quebec Canada"},{"name":"Department of Pharmacy Services Jewish General Hospital Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denis","family":"Brouillette","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services Montreal Heart Institute Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,12,19]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation.V2010.1.377.3643150"},{"key":"e_1_2_5_3_1","first-page":"380","volume-title":"Essential haematology","author":"Hoffbrand AV","year":"2006"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2009.03360.x"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.5858\/133.2.309"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1086\/517143"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.3109\/09537104.2010.549973"},{"key":"e_1_2_5_8_1","first-page":"53","article-title":"Piperacillin\/tazobactam induced myelosuppression","volume":"1","author":"Lee KW","year":"2009","journal-title":"J Clin Med Res"},{"issue":"2","key":"e_1_2_5_9_1","first-page":"1","article-title":"Piperacillin induced bone marrow suppression: a case report","volume":"3","author":"Kumar A","year":"2003","journal-title":"BMC Clin Pharmacol"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0897190014566302"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365548.2012.697638"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2010.1.135"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0190-9622(95)90098-5"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1592\/phco.22.9.697.34072"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11096-014-9914-0"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa065066"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/phar.1132"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21536"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1981.154"},{"key":"e_1_2_5_20_1","unstructured":"University of Oklahoma Health Science Center.Platelets on the Web April 2015. Available fromwww.ouhsc.edu\/platelets. Accessed May 14 2015."}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fphar.1675","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/phar.1675","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T16:41:00Z","timestamp":1761064860000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1002\/phar.1675"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,12]]},"references-count":19,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2015,12]]}},"alternative-id":["10.1002\/phar.1675"],"URL":"https:\/\/doi.org\/10.1002\/phar.1675","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"value":"0277-0008","type":"print"},{"value":"1875-9114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,12]]},"assertion":[{"value":"2015-12-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}