The adverse reactions of piperacillin: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

ZHANG Hongru ^1,2 ,  YANG Liping ¹

1. Department of Pharmacy, Beijing Hospital; National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences; Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application (Beijing Hospital), Beijing 100730, P. R. China;
2. Department of Pharmacy, The First Hospital of Zhangjiakou, Zhangjiakou 075000, P. R. China;

Corresponding author：

YANG Liping, Email: yanglp-2000@hotmail.com

Keywords：

Piperacillin; Adverse drug reactions; Case reports; Systematic review

DOI：

10.7507/1672-2531.202208061

Video：

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Objective To systematically review the adverse drug reactions (ADRs) caused by piperacillin. Methods PubMed, EMbase, Web of Science, CNKI, WanFang Data and VIP databases were electronically searched to collect case reports on ADRs caused by piperacillin from inception to December 31, 2021. Two reviewers independently screened literature, extracted data and then a qualitative systematic review was performed. Results A total of 168 case reports involving 170 patients were included. The male to female ratio was 1.06∶1, and the median age was 54 year old. The statistical results showed that ADRs caused by piperacillin mostly involved the whole body (n=55), followed by the blood system (n=48), skin and soft tissue system (n=39) and nervous system (n=18). The most frequently reported cases were anaphylactic shock (n=29), followed by drug fever (n=19), rash (n=17) and thrombocytopenia (n=15). The most serious ADRs were anaphylactic shock (n=29) and bullous epidermal necrolysis (n=6). Conclusion Current evidence shows that ADRs caused by piperacillin mostly involved the whole body and the most serious ADRs are toxic epidermal necrolysis and anaphylactic shock.

Citation： ZHANG Hongru, YANG Liping. The adverse reactions of piperacillin: a systematic review. Chinese Journal of Evidence-Based Medicine, 2023, 23(2): 191-196. doi: 10.7507/1672-2531.202208061 Copy

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2.	Bassetti M, Giacobbe DR, Robba C, et al. Treatment of extended-spectrum β-lactamases infections: what is the current role of new β-lactams/β-lactamase inhibitors. Curr Opin Infect Dis, 2020, 33(6): 474-481.
3.	Wang Q, He Z, Wu X, et al. Hematologic adverse effects induced by piperacillin-tazobactam: a systematic review of case reports. Int J Clin Pharm, 2020, 42(4): 1026-1035.
4.	Kim TI, Jeong KH, Shin MK, et al. Piperacillin/tazobactam-associated hypersensitivity syndrome with overlapping features of acute generalized exanthematous pustulosis and drug-related rash with eosinophilia and systemic symptoms syndrome. Ann Dermatol, 2016, 28(1): 98-101.
5.	Gallardo A, Moreno EM, Laffond E, et al. Sensitization phenotypes in immediate reactions to piperacillin-tazobactam. J Allergy Clin Immunol Pract, 2020, 8(9): 3175-3177.
6.	Wong JC, Au EY, Yeung HH, et al. Piperacillin-tazobactam allergies: an exception to usual penicillin allergy. Allergy Asthma Immunol Res, 2021, 13(2): 284-294.
7.	Poggiali E, Benedetti I, Vertemati V, et al. Kounis syndrome: from an unexpected case in the Emergency Room to a review of the literature. Acta Biomed, 2022, 93(1): e2022002.
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19.	周法庭, 朱晓丹, 波顺庆, 等. β-内酰胺环和侧链结构诱导青霉素类抗生素过敏的研究进展. 医学综述, 2018, 24(3): 444-448.
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24.	刘立立, 黄玲, 胡正波, 等. 哌拉西林钠他唑巴坦钠致大疱表皮松解型药疹1例. 中国药物警戒, 2013, 10(11): 703-704.
25.	吴翠芳. 哌拉西林他唑巴坦相关性大疱性表皮坏死松解症1例. 南京: 2012年中国药学大会暨第十二届中国药师周, 2012.

1. Gaspar-Marques J, Finelli E, Martins PC, et al. Piperacillin-tazobactam anaphylaxis: a rare cause of occupational disease. Eur Ann Allergy Clin Immunol, 2018, 50(2): 89-91.
2. Bassetti M, Giacobbe DR, Robba C, et al. Treatment of extended-spectrum β-lactamases infections: what is the current role of new β-lactams/β-lactamase inhibitors. Curr Opin Infect Dis, 2020, 33(6): 474-481.
3. Wang Q, He Z, Wu X, et al. Hematologic adverse effects induced by piperacillin-tazobactam: a systematic review of case reports. Int J Clin Pharm, 2020, 42(4): 1026-1035.
4. Kim TI, Jeong KH, Shin MK, et al. Piperacillin/tazobactam-associated hypersensitivity syndrome with overlapping features of acute generalized exanthematous pustulosis and drug-related rash with eosinophilia and systemic symptoms syndrome. Ann Dermatol, 2016, 28(1): 98-101.
5. Gallardo A, Moreno EM, Laffond E, et al. Sensitization phenotypes in immediate reactions to piperacillin-tazobactam. J Allergy Clin Immunol Pract, 2020, 8(9): 3175-3177.
6. Wong JC, Au EY, Yeung HH, et al. Piperacillin-tazobactam allergies: an exception to usual penicillin allergy. Allergy Asthma Immunol Res, 2021, 13(2): 284-294.
7. Poggiali E, Benedetti I, Vertemati V, et al. Kounis syndrome: from an unexpected case in the Emergency Room to a review of the literature. Acta Biomed, 2022, 93(1): e2022002.
8. Rico Cepeda P, Palencia Herrejón E, Rodríguez Aguirregabiria MM. Kounis syndrome. Med Intensiva, 2012, 36(5): 358-364.
9. Alblaihed L, Huis In 't Veld MA. Allergic acute coronary syndrome-Kounis syndrome. Emerg Med Clin North Am, 2022, 40(1): 69-78.
10. Sciatti E, Vizzardi E, Cani DS, et al. Kounis syndrome, a disease to know: Case report and review of the literature. Monaldi Arch Chest Dis, 2018, 88(1): 898.
11. Calogiuri GF, Nettis E, Di Leo E, et al. Kounis Syndrome induced by intravenous administration of piperacillin/tazobactam: a case report. Int J Cardiol, 2012, 155(3): e42-44.
12. Yamashita T, Oguma Y, Kounis NG. Kounis syndrome: kill two birds with one stone. J Invasive Cardiol, 2021, 33(11): E920-E921.
13. Chow KM, Hui AC, Szeto CC. Neurotoxicity induced by beta-lactam antibiotics: from bench to bedside. Eur J Clin Microbiol Infect Dis, 2005, 24(10): 649-653.
14. Rezaei NJ, Bazzazi AM, Naseri Alavi SA. Neurotoxicity of the antibiotics: A comprehensive study. Neurol India, 2018, 66(6): 1732-1740.
15. Roger C, Louart B. Beta-lactams toxicity in the intensive care unit: an underestimated collateral damage. Microorganisms, 2021, 9(7): 1505.
16. Man BL, Fu YP. Piperacillin/tazobactam-induced myoclonic jerks in a man with chronic renal failure. BMJ Case Rep, 2015, 2015: bcr2015210184.
17. Mattappalil A, Mergenhagen KA. Neurotoxicity with antimicrobials in the elderly: a review. Clin Ther, 2014, 36(11): 1489-1511.
18. 黄雅群, 文睿婷, 于芝颖, 等. 哌拉西林及其复方制剂致过敏性休克的病例报道及文献分析. 中国药房, 2021, 32(1): 82-87.
19. 周法庭, 朱晓丹, 波顺庆, 等. β-内酰胺环和侧链结构诱导青霉素类抗生素过敏的研究进展. 医学综述, 2018, 24(3): 444-448.
20. 田力. 注射用哌拉西林钠他唑巴坦钠的含量测定及其配伍稳定性的考察. 大连医科大学, 2011.
21. 胡丽, 黄琨, 俞仁涛. Stevens-Johnson综合征和中毒性表皮坏死松解症的疾病进展和治疗转归分析. 中国皮肤性病学杂志, 2022, 36(3): 290-294.
22. 中华医学会皮肤性病学分会药物不良反应研究中心. Stevens-Johnson综合征/中毒性表皮坏死松解症诊疗专家共识. 中华皮肤科杂志, 2021, 54(5): 376-381.
23. 李希国, 谢娇. 1例大疱性表皮松解坏死型药疹患者的治疗与探讨. 中国医药指南, 2011, 9(8): 139.
24. 刘立立, 黄玲, 胡正波, 等. 哌拉西林钠他唑巴坦钠致大疱表皮松解型药疹1例. 中国药物警戒, 2013, 10(11): 703-704.
25. 吴翠芳. 哌拉西林他唑巴坦相关性大疱性表皮坏死松解症1例. 南京: 2012年中国药学大会暨第十二届中国药师周, 2012.

Chinese Journal of Evidence-Based Medicine

The adverse reactions of piperacillin: a systematic review

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