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. 2021 Jan 8;8(1):002215.
doi: 10.12890/2021_002215. eCollection 2021.

Ceftriaxone-induced Agranulocytosis

Lénio Couto  1 , André Goulart  1 , Ivone Valadão  1 , Magda Garça  1 , Maria Beatriz Santos  1 , Pedro Cota  1 , Carolina Teixeira  1
Affiliations

Ceftriaxone-induced Agranulocytosis

Lénio Couto et al. Eur J Case Rep Intern Med. .

Abstract

Ceftriaxone is a widely used antibiotic regarded as safe and effective. Drug-induced agranulocytosis is a life-threatening adverse reaction and few reports related to ceftriaxone were found in a review of the literature. The authors present a case of ceftriaxone-induced agranulocytosis, in which a brain abscess was diagnosed and ceftriaxone was commenced. Neutropenic fever occurred on the 29th day of therapy with a cumulative dose of 116 g ceftriaxone and a neutrophil nadir of 0.1×109/l. Ceftriaxone was withheld, filgrastim was administered for 3 days and neutrophil normalization was achieved. Although rare, ceftriaxone-induced agranulocytosis may occur in patients on a long course of ceftriaxone therapy. Prompt recognition and drug withdrawal are required.

Learning points: Ceftriaxone-induced agranulocytosis is rare but may occur in patients with high cumulative doses.Prompt recognition, drug withdrawal and administration of recombinant human granulocyte colony-stimulating factor (rhG-CSF) are the mainstay approach.

Keywords: Ceftriaxone; drug-induced agranulocytosis; neutropenia.

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Conflict of interest statement

Conflicts of Interests: The Authors declare that there are no competing interests.

Figures

Figure 1
Figure 1
Neutrophil count evolution
See this image and copyright information in PMC

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