阿莫西林致严重血小板减少1例并文献复习

A case of severe thrombocytopenia caused by amoxicillin and literature review

1例69岁女性患者,因确诊急性膀胱炎,在青霉素皮试结果阴性后,于2021年5月21日开始首次服用阿莫西林胶囊(0.5 g,bid)治疗。服药前1周,患者查血常规示血小板156×10^(9)·L^(-1)。服药后第2天,患者右上肢出现皮下瘀斑,面积约1.5 cm×2.5 cm,查血常规示血小板52×10^(9)·L^(-1)。随后患者血小板进行性减少,血小板最低至24×10^(9)·L^(-1)。经临床药师会诊后考虑可能为阿莫西林导致的药源性血小板减少。经停药并对症治疗1周后,患者血小板恢复正常。

A 69-year-old female patient with a diagnosis of acute cystitis was firstly treated with amoxicillin capsules(0.5 g,bid)on May 21st,2021 after the penicillin skin test showed negative.One week before taking amoxicillin,the platelet count of the patient was 156×10^(9)·L^(-1).However,on the second day after taking amoxicillin,she developed subcutaneous ecchymosis on the right upper limb,the area of which was about 1.5 cm×2.5 cm.Routine blood test showed that the platelet count decreased to 52×10^(9)·L^(-1)and progressively decreased to 24×10^(9)·L^(-1).Clinical pharmacist considered that the drug-induced thrombocytopenia might be caused by amoxicillin.After discontinuing amoxicillin and giving symptomatic treatment for one week,the patient’s platelet count returned to normal.