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已发表论文
应用套索模型识别哌拉西林 - 他唑巴坦所致白细胞减少症的风险因素
Authors Liu J, Yuan X , Liu X , Liu L , Wen L, Zheng F
Received 2 June 2025
Accepted for publication 18 November 2025
Published 5 December 2025 Volume 2025:19 Pages 10765—10773
DOI https://doi.org/10.2147/DDDT.S544195
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Anastasios Lymperopoulos
Jiheng Liu,1,* Xuefeng Yuan,2,* Xiaohui Liu,3 Lihua Liu,4 Long Wen,5 Fang Zheng6
1Department of Hematology & Oncology, The First Hospital of Changsha (The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University), Changsha, Hunan, People’s Republic of China; 2Department of Nosocomial Infection Management, The First Hospital of Changsha (The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University), Changsha, Hunan, People’s Republic of China; 3Department of Pharmacy, The First Hospital of Changsha (The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University), Changsha, Hunan, People’s Republic of China; 4Department of Pharmacy, The Third Hospital of Changsha, The Affiliated Changsha Hospital of Hunan University, Changsha, Hunan, People’s Republic of China; 5Department of Respiratory and Critical Care Medicine, The First Hospital of Changsha(The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University), Changsha, Hunan, People’s Republic of China; 6Department of Infectious Diseases, The First Hospital of Changsha (The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University), Changsha, Hunan, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Xiaohui Liu, Department of Pharmacy, The First Hospital of Changsha (The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University), Changsha, Hunan, People’s Republic of China, Tel +86 731 84667573, Fax +86 731 84667680, Email gcys2021@126.com
Objective: We conducted a retrospective study to investigate the prevalence, clinical characteristics, and risk factors for leukopenia in patients receiving piperacillin-tazobactam (TZP) therapy.
Methods: This observational study was conducted from January to December 2022 at a tertiary general hospital in China. All patients over 18 years old who received TZP for more than 48 hours were included. Patients were stratified into adverse drug reactions (ADR) (n=41, TZP-induced leukopenia or neutropenia) and Control (n=8014, no ADR) groups. To balance covariates, 1:2 propensity score matching (PSM) was applied using age, infection type, gender, and comorbidity index, resulting in 82 matched controls for comparative analysis. We employed least absolute shrinkage and selection operator (LASSO) regression to identify risk factors for TZP-induced leukopenia.
Results: A total of 123 patients were analyzed. The average duration of treatment was 10 days (IQR: 7, 19). In 41 patients with TZP-induced leukopenia, the mean onset time was 17.7 ± 6.6 days. Among these, 29 (70.7%) developed neutropenia (including 1 severe case), and 3 (7.3%) had drug-induced fever. Therapy duration (odds ratio (OR) = 1.53, 95% confidence interval (CI) 1.32– 1.76) was identified as a significant influencing factor for leukopenia caused by TZP through the LASSO regression screening process.
Conclusion: Clinicians should recognize the potential association between TZP administration and leukopenia. Routine hematologic monitoring should emphasize leukocyte trends to assess both therapeutic response and drug safety.
Keywords: piperacillin-tazobactam, TZP, leukopenia, neutropenia, adverse effect, least absolute shrinkage and selection operator, LASSO
1Department of Hematology & Oncology, The First Hospital of Changsha (The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University), Changsha, Hunan, People’s Republic of China; 2Department of Nosocomial Infection Management, The First Hospital of Changsha (The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University), Changsha, Hunan, People’s Republic of China; 3Department of Pharmacy, The First Hospital of Changsha (The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University), Changsha, Hunan, People’s Republic of China; 4Department of Pharmacy, The Third Hospital of Changsha, The Affiliated Changsha Hospital of Hunan University, Changsha, Hunan, People’s Republic of China; 5Department of Respiratory and Critical Care Medicine, The First Hospital of Changsha(The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University), Changsha, Hunan, People’s Republic of China; 6Department of Infectious Diseases, The First Hospital of Changsha (The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University), Changsha, Hunan, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Xiaohui Liu, Department of Pharmacy, The First Hospital of Changsha (The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University), Changsha, Hunan, People’s Republic of China, Tel +86 731 84667573, Fax +86 731 84667680, Email gcys2021@126.com
Objective: We conducted a retrospective study to investigate the prevalence, clinical characteristics, and risk factors for leukopenia in patients receiving piperacillin-tazobactam (TZP) therapy.
Methods: This observational study was conducted from January to December 2022 at a tertiary general hospital in China. All patients over 18 years old who received TZP for more than 48 hours were included. Patients were stratified into adverse drug reactions (ADR) (n=41, TZP-induced leukopenia or neutropenia) and Control (n=8014, no ADR) groups. To balance covariates, 1:2 propensity score matching (PSM) was applied using age, infection type, gender, and comorbidity index, resulting in 82 matched controls for comparative analysis. We employed least absolute shrinkage and selection operator (LASSO) regression to identify risk factors for TZP-induced leukopenia.
Results: A total of 123 patients were analyzed. The average duration of treatment was 10 days (IQR: 7, 19). In 41 patients with TZP-induced leukopenia, the mean onset time was 17.7 ± 6.6 days. Among these, 29 (70.7%) developed neutropenia (including 1 severe case), and 3 (7.3%) had drug-induced fever. Therapy duration (odds ratio (OR) = 1.53, 95% confidence interval (CI) 1.32– 1.76) was identified as a significant influencing factor for leukopenia caused by TZP through the LASSO regression screening process.
Conclusion: Clinicians should recognize the potential association between TZP administration and leukopenia. Routine hematologic monitoring should emphasize leukocyte trends to assess both therapeutic response and drug safety.
Keywords: piperacillin-tazobactam, TZP, leukopenia, neutropenia, adverse effect, least absolute shrinkage and selection operator, LASSO