• Online Features  This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (16)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

A Report From the International Agranulocytosis and Aplastic Anemia Study

Arch Intern Med. 1989;149(5):1036-1040.

Abstract

• The risks of agranulocytosis and aplastic anemia in relation to the use of anti-infective drugs were estimated in a population-based case-control study conducted in Europe and Israel. Anti-infective drug use in the 2-week period before the onset of illness was compared between 251 patients admitted to hospital with agranulocytosis and 1271 controls hospitalized for reasons judged to be unrelated to previous use of anti-infective drugs. Anti-infectives significantly associated with agranulocytosis when used for at least 3 consecutive days were trimethoprim/sulfamethoxazole (relative risk, 12; 95% confidence interval, 3.9 to 40) and macrolides (). The relative risk estimate for any use of sulfonamides without trimethoprim was elevated, but not statistically significant (3.6; 0.7 to 18). These estimates took confounding by various factors, in particular the use of other drugs, into account. The estimated excess risks of agranulocytosis attributable to the use of trimethoprim/sulfamethoxazole and macrolides in a 2-week period were 1.6 and 7.1 per million, respectively. Anti-infective use during the 29- through 180-day period before hospital admission was compared between 135 patients with aplastic anemia and 1410 controls. Although relative risk point estimates were elevated for trimethoprim/sulfonamides (2.1), other sulfonamides (2.9), and β-lactams (1.5), none was statistically significant.

(Arch Intern Med. 1989;149:1036-1040)

Footnotes

Reprint requests to Slone Epidemiology Unit, Boston University School of Medicine, 1371 Beacon St, Brookline, MA 02146 (Dr Kaufman).

CiteULike    Connotea    Delicious    Digg    Facebook    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Systematic Review: Agranulocytosis Induced by Nonchemotherapy Drugs
Andersohn et al.
ANN INTERN MED 2007;146:657-665.
ABSTRACT | FULL TEXT  

Metabolism of Trimethoprim to a Reactive Iminoquinone Methide by Activated Human Neutrophils and Hepatic Microsomes
Lai et al.
J. Pharmacol. Exp. Ther. 1999;291:292-299.
ABSTRACT | FULL TEXT  

A Population-Based Case-Cohort Study of Drug-Associated Agranulocytosis
van der Klauw et al.
Arch Intern Med 1999;159:369-374.
ABSTRACT | FULL TEXT  

Low Drug Attributability of Aplastic Anemia in Thailand
Issaragrisil et al.
Blood 1997;89:4034-4039.
ABSTRACT | FULL TEXT  

Effect of Antibiotic Treatment on Outcome of Fevers in Institutionalized Alzheimer Patients
Fabiszewski et al.
JAMA 1990;263:3168-3172.
ABSTRACT