哌拉西林钠他唑巴坦钠致重症肝病患者贫血加重及血小板减少3例

3例重症肝病合并感染患者（均为男性，年龄分别为40、68、50岁）接受碳青霉烯类、利奈唑胺及氟康唑联合治疗，期间未出现明显血象变化。因疗效不佳换用哌拉西林钠他唑巴坦钠4.5 g，8 h/次静脉滴注。其中例1于换用哌拉西林钠他唑巴坦钠11 d后出现贫血及血小板计数下降；例2、例3分别于换用哌拉西林钠他唑巴坦钠4、7 d后出现贫血加重及血小板计数下降。3例患者分别在停用哌拉西林钠他唑巴坦钠后31、21、7 d，血红蛋白及血小板计数明显恢复。

Aggravated anemia and thrombocytopenia caused by piperacillin sodium and tazobactam sodium in three patients with severe liver disease

Three patients with severe liver diseases and infections （all males, aged 40, 68, and 50, respectively） were treated with carbapenem, linezolid, and fluconazole. No obvious change of hemogram result was found during the period of drugs use. The therapy was replaced with an Ⅳ infusion of piperacillin sodium and tazobactam sodium 4.5 g every 8 hours due to poor efficacy. Patient 1 devdoped platelet count decrease and anemia after the treatment with piperacillin sodium and tazobactam sodium for 11 days. Patients 2 and 3 developed platelet count decrease and exacerbation of anemia after the treatment with piperacillin sodium and tazobactam sodium for 4 and 7 days, respectively. Three patients＇ hemoglobin levels and platelet counts apparently recovered on days 31, 21, and 7 after the discontinuation of medication, respectively.