Applying the Lasso Model to Identify Risk Factors for Piperacillin-Tazobactam-Induced Leukopenia.

OBJECTIVE

We conducted a retrospective study to investigate the prevalence, clinical characteristics, and risk factors for leukopenia in patients receiving piperacillin-tazobactam (TZP) therapy.

METHODS

This observational study was conducted from January to December 2022 at a tertiary general hospital in China. All patients over 18 years old who received TZP for more than 48 hours were included. Patients were stratified into adverse drug reactions (ADR) (n=41, TZP-induced leukopenia or neutropenia) and Control (n=8014, no ADR) groups. To balance covariates, 1:2 propensity score matching (PSM) was applied using age, infection type, gender, and comorbidity index, resulting in 82 matched controls for comparative analysis. We employed least absolute shrinkage and selection operator (LASSO) regression to identify risk factors for TZP-induced leukopenia.

RESULTS

A total of 123 patients were analyzed. The average duration of treatment was 10 days (IQR: 7, 19). In 41 patients with TZP-induced leukopenia, the mean onset time was 17.7 ± 6.6 days. Among these, 29 (70.7%) developed neutropenia (including 1 severe case), and 3 (7.3%) had drug-induced fever. Therapy duration (odds ratio (OR) = 1.53, 95% confidence interval (CI) 1.32-1.76) was identified as a significant influencing factor for leukopenia caused by TZP through the LASSO regression screening process.

CONCLUSION

Clinicians should recognize the potential association between TZP administration and leukopenia. Routine hematologic monitoring should emphasize leukocyte trends to assess both therapeutic response and drug safety.