Neutropenia associated with cloxacillin and other semisynthetic penicillins in children

ABSTRACT

Five children treated with high dose of semisynthetic penicillin for three to four weeks developed neutropenia [< 1.5 x 10[9]/L]. All patients were on cloxaxillin. In addition, three patients received ampicillin, and one received piperacillin therapy for the same duration. All patients developed neutropenia 15 to 23 days following therapy and resolved 8 to 95 days after discontinuation of the penicillin. One patient developed serious perianal necrotizing fascitis as a complication of neutropenia. The red blood cell count and platelets were normal in all patients. Bone marrow aspiration performed on two patients revealed a maturation arrest of the granulocyte precursor. A complete cell count and differential should be monitored during high dose penicillin therapy