莫西沙星注射液致白细胞、中性粒细胞伴其百分比减少2例

Two cases of leukopenia, neutropenia with lower percentage induced by moxifloxacin injection

病例1:患者,女性,81岁,因"咳嗽、咳痰10 d"入院,静脉使用莫西沙星注射液(0.4 g,qd,ivgtt)治疗感染,给药前白细胞计数(WBC)6.42×10~9·L^(-1)、中性粒细胞计数(NEUT)3.85×10~9·L^(-1)、中性粒细胞百分比(N%)59.9%,治疗10 d后WBC 2.96×10~9·L^(-1)、NEUT 0.97×10~9·L^(-1)、N%32.82%,未停药,予重组人粒细胞刺激因子注射液对症治疗,5 d后三项指标恢复到正常范围。病例2:患者,女性,42岁,因"咳嗽、咳痰2 d"入院,静脉使用莫西沙星注射液(0.4 g,qd,ivgtt)治疗感染,给药前WBC、NEUT、N%分别为7.73×10~9·L^(-1)、5.06×10~9·L^(-1)、65.4%,治疗8 d后WBC 3.94×10~9·L^(-1)、NEUT 1.27×10~9·L^(-1)、N%32.22%。立即停用莫西沙星,3 d后三项指标恢复到正常范围。临床药师从药品不良反应发生的关联性、药物作用机制等方面分析引起WBC、NEUT、N%同时降低可能是由莫西沙星所致。

Case 1： A 81-year-old female patient was admitted to hospital because of cough, expectoration for ten days. Lab test showed that the white blood cell count （WBC） was 6.42 × 10^9·L^-1, the neutrophilic granulocyte count （NEUT） was 3.85 × 10^9·L^-1 and the neutrophil percentage （N%） was 59.9%. And then moxifoxacin injection （0.4 g, qd） were intravenously given to the patient. Ten days later, blood routine test showed WBC was 2.96 × 10^9·L^-1, NEUT was 0.97 × 10^9·L^-1 and N% was 32.82%. Recombinant human granulocyte stimulating factor injection was given to her immediately without discounting moxifoxacin. After 5 days, WBC, NEUT and N% returned to the normal range. Case 2： A 42-year-old female patient was admitted to hospital because of cough and expectoration for two days. Lab test showed that WBC was 7.73 × 10^9·L^-1, NEUT was 5.06 × 10^9·L^-1 and N% was 65.4%. Eight days after being treated with moxifoxacin injection （0.4 g, qd, ivgtt）, her blood routine test showed that WBC was 3.94 × 10^9·L^-1, NEUT was 1.27 × 10^9·L^-1 and N% was 32.22%. Moxifoxacin was stopped immediately. Three days later, WBC, NEUT and N% returned to the normal range. Leukopenia and neutropenia induced by moxifoxacin was considered by clinical pharmacists according to analysis on ADR revelance evaluation and drug action.