Reversible bone marrow depression by high-dose piperacillin/tazobactam

Br J Haematol. 1996 Dec;95(4):611-2. doi: 10.1046/j.1365-2141.1996.d01-1952.x.


Bone marrow toxicity, mainly neutropenia, has been described as an uncommon secondary effect of most beta-lactams, and it is usually related to large cumulative doses. Although previously described for piperacillin, no cases of marrow depression caused by piperacillin/tazobactam have been reported to date. We report a case of reversible pancytopenia, with evidence of bone marrow depression, which occurred after a 17 d course of piperacillin/tazobactam. The drug was given to an underweight 18-year-old woman, at the usual dosage of 4/0.5 g three times a day. We stress the need for reducing the recommended dosage when treating underweight adult patients, and also of monitoring haematological parameters during prolonged treatments.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Body Weight*
  • Bone Marrow Diseases / chemically induced*
  • Drug Therapy, Combination / administration & dosage
  • Drug Therapy, Combination / adverse effects*
  • Female
  • Fever / chemically induced
  • Humans
  • Neutropenia / chemically induced*
  • Pancytopenia / chemically induced*
  • Penicillanic Acid / administration & dosage
  • Penicillanic Acid / adverse effects
  • Penicillanic Acid / analogs & derivatives*
  • Piperacillin / administration & dosage
  • Piperacillin / adverse effects*
  • Tazobactam
  • Weight Loss


  • Penicillanic Acid
  • Tazobactam
  • Piperacillin