Antibacterials

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Antibacterials Various toxicities: 16 case reports

In a retrospective population-based analysis conducted between 1 January 2010 and 31 December 2012, 16 patients [7 males and 9 females], including six patients aged 4–53 years [not all ages stated] were described, who developed allergy, anaphylaxis, nephropathy, haemolytic anaemia, Stevens-Johnson syndrome or treatment-related death following antibiotic therapy with azithromycin, cefaclor, cefadroxil, cefalexin, cefazolin, cefdinir, cefixime, cefoxitin, ceftazidime, ceftriaxone, cotrimoxazole or vancomycin [dosages not stated; not all routes, durations of treatments to reactions onsets and outcomes stated]. A 53-year-old woman, who had been receiving antibiotic therapy with ceftazidime and vancomycin, developed Stevens-Johnson syndrome secondary to ceftazidime and vancomycin. An 18-year-old man, who had been receiving antibiotic therapy with cefalexin [cephalexin] and cotrimoxazole, developed Stevens-Johnson syndrome secondary to cephalexin and cotrimoxazole. A 20-year-old man, who had been receiving antibiotic therapy with ceftriaxone and azithromycin, developed Stevens-Johnson syndrome secondary to ceftriaxone and azithromycin. A 4-year-old boy developed haemolytic anaemia during antibiotic therapy with ceftazidime. The boy, who was newly diagnosed with T-cell lymphoblastic lymphoma, was initiated on antibiotic therapy with ceftazidime the day after his diagnosis with lymphoma. His hemoglobin level was recorded at 7.5 g/dL 1 day later, and his lactate dehydrogenase level was recorded at 4774 U/L 3 days later. He started chemotherapy [specific drug not stated] 4 days after his lymphoma diagnosis. Ceftazidime-associated haemolytic anaemia was suspected. A 6-year-old girl developed haemolytic anaemia during antibiotic therapy with ceftazidime. The girl was diagnosed with B-cell acute lymphoblastic leukaemia 1 day after receiving antibiotic therapy with parenteral ceftazidime. Six days after receiving ceftazidime, her haemoglobin level was recorded at 7.9 g/dL, and 1 day later, her lactate dehydrogenase level was 3752 U/L. Ceftazidime-associated haemolytic anaemia was suspected. She started chemotherapy [specific drug not stated] 3 days after her leukaemia diagnosis (i.e. 4 days after receiving ceftazidime). A 37-year-old woman developed haemolytic anaemia during prophylactic antibiotic therapy with cefazolin. The woman, who underwent cardiac catheterisation, started receiving prophylactic antibiotic therapy with parenteral cefazolin. She then developed what was reported to be "idiopathic haemolytic anaemia" by her treating physician. Her haemoglobin level was recorded at 7.6 g/dL 5 days later, and her lactate dehydrogenase level was recorded at 2447 U/L 3 days later. Cefazolin-associated haemolytic anaemia was suspected. Her anaemia resolved over the next month, and she had no further exposure to cefazolin. A man (described in table E1) developed cefixime-related allergy within 30 days of antibiotic therapy with oral cefixime. A man (described in table E1) dev