Moxifloxacin-Induced Immune-Mediated Thrombocytopenia in a Chronic Kidney Disease Patient Receiving Hemodialysis. (July 2014)

• Record Type: Journal Article
• Authors: Mailman, Jonathan F.; Stigant, Caroline; Martinusen, Dan
• Is Part Of: Annals of pharmacotherapy. Volume 48:Number 7(2014:Jul.)
• Page Start: 919
• Page End: 922
• Publication Date: 2014-07
• Subjects: moxifloxacin -- antibiotics -- quinolone -- dialysis -- hemodialysis -- drug safety -- thrombocytopenia -- blood dyscrasias; Chemotherapy -- Periodicals; Pharmacology -- Periodicals; 615.5805
• DOI: 10.1177/1060028014529929
• Languages: English
• ISSNs: 1060-0280

Abstract

Objective: To alert clinicians to a serious complication from a commonly prescribed medication, moxifloxacin.Case Summary: A 65-year-old male, septic, hemodialysis patient developed thrombocytopenia following exposure to vancomycin, ceftazidime, and moxifloxacin. Drug-specific immunoglobulin testing showed positive autoantibodies against only moxifloxacin, and the probability stratification proposed by Naranjo et al would give this case a score of 7—a probable association between moxifloxacin and the adverse event.Discussion: Idiopathic thrombocytopenic purpura (ITP) results in immune-mediated platelet destruction, with bleeding risk frequently manifested by purpuric skin and mucosal lesions. Although many drugs are associated with ITP, moxifloxacin has only been characterized in 2 previous case reports. This is the first case report where specific immunoglobulin antibody testing showed a positive association between ITP and moxifloxacin.Conclusions: Moxifloxacin is a commonly prescribed medication because of its wide spectrum of activity, high bioavailability, and convenient dose schedule. Clinicians need to be aware of this little-known side effect of this commonly prescribed antibiotic.