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I would like to offer the following comment to the short article in the November 26, 2001, issue of ARCHIVES by Drs Andrès and Maloisel¹ titled "Antibiotic-Induced Agranulocytosis: A Monocentric Study of 21 Cases." The authors describe a study in one center of 21 cases of agranulocytosis and make the following comments: (1) the mortality rate, 5%, was low compared with previously reported mortality rates, which have ranged between 6% and 20%; (2) granulocyte colony-stimulating factor (G-CSF) treatment of agranulocytosis may improve the prognosis and shorten the neutropenia time.¹

Both conclusions were based on the assumption the drug-induced neutropenias are similar regardless the causative drug. That is not so. Keisu and coworkers showed that the neutropenia time caused by treatment with trimethoprim-sulfamethoxazole and salazopyrine differ considerably.^2-3 Also, the mortality rate for drug-induced neutropenia varies with the drug. In these particular studies,^2-3 no deaths attributable to trimethoprim-sulfamethoxazole were observed, whereas the . . . [Full Text of this Article]