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Piperacillin-Tazobactam Toxicity Questions the Need for Pediatric Adverse Event Profiling

Sabrina A Gmuca *,Nicole Pouppirt ,Gabrielle Gold-von Simson

A 14-year-old, 86 kg, female treated with piperacillin-tazobactam [cumulative dose of 114.75 g (1.3 g/kg)] for a
bone-related infection developed neutropenia and bone marrow suppression/cell line destruction after 10 days of
treatment. Reported cases of piperacillin-induced myelosuppression in adults typically occur after 15 days of therapy,
and this adolescent received a much shorter duration of therapy. As we are beginning to understand how the frequent
use of antibiotics in the pediatric population affects their unique microbiome, which may have long-term implications
on their health, we also need to consider if adverse event profiles are distinct or different in children. While this
case will not answer these important questions, it underscores the need for further investigation. One could postulate
that pediatric pharmacovigilance is better served by restricting data mining analysis to a smaller pediatric subset, as
adverse/possible events in children cannot be solely compared to or tabulated with adult data. Further studies are
needed to determine pediatric-specific drug safety profiles for piperacillin-tazobactam and other drugs used in the
pediatric population.