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已发表论文
碳青霉烯类药物所致血小板异常：碳青霉烯类药物引起血小板异常的系统文献综述分析
Authors Pan J, Peng W, Ye C, Zhou L, Zhang X, Li Z, Zhang X, Yang Q, Wu M
Received 23 July 2025
Accepted for publication 6 November 2025
Published 21 November 2025 Volume 2025:18 Pages 6059—6070
DOI https://doi.org/10.2147/IDR.S555737
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Hazrat Bilal
Juan Pan,1,* Wei Peng,1,* Chao Ye,2,* Lingzhi Zhou,1,* Xu Zhang,1 ZuYi Li,1 Xiaojuan Zhang,1 Qiongliang Yang,1 MingHui Wu3
1Department of Pharmacy, Liuyang Hospital of Traditional Chinese Medicine, Changsha, Hunan, 410300, People’s Republic of China; 2Department of Pharmacy, Guangdong Provincial Second Hospital of Traditional Chinese Medicine(Guangdong Provincial Engineering Technology Research Institute of Traditional Chinese Medicine), Guangzhou, Guangdong, 510095, People’s Republic of China; 3Department of Oncology and Hematology, Liuyang Hospital of Traditional Chinese Medicine, Changsha, Hunan, 410300, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Chao Ye, Department of Pharmacy,Guangdong Provincial Second Hospital of Traditional Chinese Medicine(Guangdong Provincial Engineering Technology Research Institute of Traditional Chinese Medicine), No. 60, Hengfu Road, Guangzhou, Guangdong, 510095, People’s Republic of China, Email yechao1234256@163.com Lingzhi Zhou, Department of Pharmacy, Liuyang Hospital of Traditional Chinese Medicine, Changsha, Hunan, 410300, People’s Republic of China, Email 1024482174@qq.com
Objective: To analyze and discuss the clinical characteristics of carbapenem-induced platelet abnormalities.
Methods: The databases of CNKI, Wanfang Data, Chinese VIP, Web of science, PubMed, Embase and Elsevier were searched (up to June 30,2025), and the case reports of carbapenem-induced platelet abnormalities were collected and descriptively analyzed.
Results: A total of 42 patients (21 males and 21 females) were included, with a median age of 64 years (range:0– 96 years). Thrombocytosis was observed in 20 patients, while thrombocytopenia occurred in 22 patients. Platelet abnormality most often occurred in patients receiving meropenem (64.3%) followed by imipenem (26.2%). All cases occurred during carbapenem therapy. The median time to platelet count abnormality was 3 days (range 0.125– 12), with 79.5% of cases occurring within one week. Specifically, the median time to carbapenem-induced thrombocytopenia was 2.5 days (range 0.125– 9), while the median time to carbapenem-induced thrombocytosis was 3 days (range 3– 12). The nadir of platelet count was reached at 5 days (range 1– 10) after medication, with a median platelet count nadir of 21.5× 109 /L (range 0– 136). The peak of platelet count was reached at 8 days (range 3– 18), with a median platelet count peak of 900× 109 /L (range 570– 1,440). Complications occurred in 10 thrombocytopenia cases, all of which were bleeding events. After discontinuation of the drug and symptomatic treatment, all cases showed significant improvement in platelet counts and resolution of complications, except for one patient who died from multiple organ dysfunction syndrome.
Conclusion: Carbapenem-induced platelet abnormalities appear to be more frequent than previously recognized, predominantly occurring within the first week of therapy. This potentially severe adverse drug reaction should be particularly considered in elderly patients receiving meropenem therapy.
Keywords: carbapenem, platelet abnormality, adverse drug reaction, clinical characteristics, systematic review
1Department of Pharmacy, Liuyang Hospital of Traditional Chinese Medicine, Changsha, Hunan, 410300, People’s Republic of China; 2Department of Pharmacy, Guangdong Provincial Second Hospital of Traditional Chinese Medicine(Guangdong Provincial Engineering Technology Research Institute of Traditional Chinese Medicine), Guangzhou, Guangdong, 510095, People’s Republic of China; 3Department of Oncology and Hematology, Liuyang Hospital of Traditional Chinese Medicine, Changsha, Hunan, 410300, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Chao Ye, Department of Pharmacy,Guangdong Provincial Second Hospital of Traditional Chinese Medicine(Guangdong Provincial Engineering Technology Research Institute of Traditional Chinese Medicine), No. 60, Hengfu Road, Guangzhou, Guangdong, 510095, People’s Republic of China, Email yechao1234256@163.com Lingzhi Zhou, Department of Pharmacy, Liuyang Hospital of Traditional Chinese Medicine, Changsha, Hunan, 410300, People’s Republic of China, Email 1024482174@qq.com
Objective: To analyze and discuss the clinical characteristics of carbapenem-induced platelet abnormalities.
Methods: The databases of CNKI, Wanfang Data, Chinese VIP, Web of science, PubMed, Embase and Elsevier were searched (up to June 30,2025), and the case reports of carbapenem-induced platelet abnormalities were collected and descriptively analyzed.
Results: A total of 42 patients (21 males and 21 females) were included, with a median age of 64 years (range:0– 96 years). Thrombocytosis was observed in 20 patients, while thrombocytopenia occurred in 22 patients. Platelet abnormality most often occurred in patients receiving meropenem (64.3%) followed by imipenem (26.2%). All cases occurred during carbapenem therapy. The median time to platelet count abnormality was 3 days (range 0.125– 12), with 79.5% of cases occurring within one week. Specifically, the median time to carbapenem-induced thrombocytopenia was 2.5 days (range 0.125– 9), while the median time to carbapenem-induced thrombocytosis was 3 days (range 3– 12). The nadir of platelet count was reached at 5 days (range 1– 10) after medication, with a median platelet count nadir of 21.5× 109 /L (range 0– 136). The peak of platelet count was reached at 8 days (range 3– 18), with a median platelet count peak of 900× 109 /L (range 570– 1,440). Complications occurred in 10 thrombocytopenia cases, all of which were bleeding events. After discontinuation of the drug and symptomatic treatment, all cases showed significant improvement in platelet counts and resolution of complications, except for one patient who died from multiple organ dysfunction syndrome.
Conclusion: Carbapenem-induced platelet abnormalities appear to be more frequent than previously recognized, predominantly occurring within the first week of therapy. This potentially severe adverse drug reaction should be particularly considered in elderly patients receiving meropenem therapy.
Keywords: carbapenem, platelet abnormality, adverse drug reaction, clinical characteristics, systematic review