粒细胞减少症的抗生素应用策略（英文PPT）AgranulocytosisDuring Antibiotic Therapy Drug Sensitivity or .ppt

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粒细胞减少症的抗生素应用策略（英文PPT）AgranulocytosisDuring Antibiotic Therapy Drug Sensitivity or .ppt

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粒细胞减少症的抗生素应用策略（英文PPT）AgranulocytosisDuring Antibiotic Therapy Drug Sensitivity or

Agranulocytosis During Antibiotic Therapy:Drug Sensitivity or Sepsis? Anthony V. Pisciotta Department of Hematology, Medical College of Wisconsin, Milwaukee, American Journal of Hematology 42:132-137 (1993) Ri 曹思宏 INTRODUCTION 1957: antibiotic medication: an etiologic factor in agranulocytosis Ristocetin: leukopenia and thrombocytopenia. 1963: AMA Registry of Adverse Drug Reactions an “innocent” drug, concomitantly given with other drugs more likely to be offending. since 1965: agranulocytosis during antibiotic therapy has been reported with increasing frequency INTRODUCTION Chloramphenicol: one of the first antibiotics to be recognized as a cause of leukopenia. usually part of total bone marrow suppression, which may be a reversible or a permanent feature of aplastic anemia. Shortly thereafter, a group of antibiotics were implicated in selective granulocytopenia (Table I). INTRODUCTION It is not certain that leukopenia is truly drug-related as opposed to bone marrow suppression induced by overwhelming sepsis. This study was planned in order to examine the characteristics of agranulocytosis associated with antibiotics. MATERIALS AND METHODS Antibiotic-induced agranulocytosis: very rare a prospective analysis of a relationship between drugs and agranulocytosis is not possible. For this reason, 43 previously reported cases from the literature have been examined retrospectively. 27 male, 12 female, 4 gender was unspecified MATERIALS AND METHODS MATERIALS AND METHODS 5 cases studied by the author were added (Table II). MATERIALS AND METHODS suppression of postphagocytosis respiratory burst by the method of McIntyre suppression of trypan blue ejection from PMNs exposed to test serum colony-forming units granulocyte-macrophage (CFU-GM) RESULTS: Clinical Considerations Many of the patients who subsequently developed agranulocytosis during antibiotic therapy were severely ill with infection long before they developed hematologic changes. predominant symptoms duri