The Annals of pharmacotherapy · 2014
Moxifloxacin-Induced Immune-Mediated Thrombocytopenia in a Chronic Kidney Disease Patient Receiving Hemodialysis.
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Mailman Jonathan F, Stigant Caroline, Martinusen Dan
Аннотация
OBJECTIVE: To alert clinicians to a serious complication from a commonly prescribed medication, moxifloxacin.
CASE SUMMARY: A 65-year-old male, septic, hemodialysis patient developed thrombocytopenia following exposure to vancomycin, ceftazidime, and moxifloxacin. Drug-specific immunoglobulin testing showed positive autoantibodies against only moxifloxacin, and the probability stratification proposed by Naranjo et al would give this case a score of 7-a probable association between moxifloxacin and the adverse event.
DISCUSSION: Idiopathic thrombocytopenic purpura (ITP) results in immune-mediated platelet destruction, with bleeding risk frequently manifested by purpuric skin and mucosal lesions. Although many drugs are associated with ITP, moxifloxacin has only been characterized in 2 previous case reports. This is the first case report where specific immunoglobulin antibody testing showed a positive association between ITP and moxifloxacin.
CONCLUSIONS: Moxifloxacin is a commonly prescribed medication because of its wide spectrum of activity, high bioavailability, and convenient dose schedule. Clinicians need to be aware of this little-known side effect of this commonly prescribed antibiotic.
CASE SUMMARY: A 65-year-old male, septic, hemodialysis patient developed thrombocytopenia following exposure to vancomycin, ceftazidime, and moxifloxacin. Drug-specific immunoglobulin testing showed positive autoantibodies against only moxifloxacin, and the probability stratification proposed by Naranjo et al would give this case a score of 7-a probable association between moxifloxacin and the adverse event.
DISCUSSION: Idiopathic thrombocytopenic purpura (ITP) results in immune-mediated platelet destruction, with bleeding risk frequently manifested by purpuric skin and mucosal lesions. Although many drugs are associated with ITP, moxifloxacin has only been characterized in 2 previous case reports. This is the first case report where specific immunoglobulin antibody testing showed a positive association between ITP and moxifloxacin.
CONCLUSIONS: Moxifloxacin is a commonly prescribed medication because of its wide spectrum of activity, high bioavailability, and convenient dose schedule. Clinicians need to be aware of this little-known side effect of this commonly prescribed antibiotic.