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Mailman JF, Stigant C, Martinusen D. Moxifloxacin-Induced Immune-Mediated Thrombocytopenia in a Chronic Kidney Disease Patient Receiving Hemodialysis. Ann Pharmacother. 2014;48(7):919-922doi: 10.1177/1060028014529929.
Mailman, J. F., Stigant, C., & Martinusen, D. (2014). Moxifloxacin-Induced Immune-Mediated Thrombocytopenia in a Chronic Kidney Disease Patient Receiving Hemodialysis. The Annals of pharmacotherapy, 48(7), 919-922. https://doi.org/10.1177/1060028014529929
Mailman, Jonathan F, et al. "Moxifloxacin-Induced Immune-Mediated Thrombocytopenia in a Chronic Kidney Disease Patient Receiving Hemodialysis." The Annals of pharmacotherapy vol. 48,7 (2014): 919-922. doi: https://doi.org/10.1177/1060028014529929
Mailman JF, Stigant C, Martinusen D. Moxifloxacin-Induced Immune-Mediated Thrombocytopenia in a Chronic Kidney Disease Patient Receiving Hemodialysis. Ann Pharmacother. 2014 Jul;48(7):919-922. doi: 10.1177/1060028014529929. Epub 2014 Mar 31. PMID: 24687544.
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Ann Pharmacother. 2014 Jul;48(7):919-922. doi: 10.1177/1060028014529929. Epub 2014 Mar 31.

Moxifloxacin-Induced Immune-Mediated Thrombocytopenia in a Chronic Kidney Disease Patient Receiving Hemodialysis.

The Annals of pharmacotherapy

Jonathan F Mailman, Caroline Stigant, Dan Martinusen

Affiliations

  1. Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.
  2. Royal Jubilee Hospital-Vancouver Island Health Authority, Victoria, BC, Canada.
  3. Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada Royal Jubilee Hospital-Vancouver Island Health Authority, Victoria, BC, Canada [email protected].

PMID: 24687544 DOI: 10.1177/1060028014529929

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.

© The Author(s) 2014.

Keywords: antibiotics; blood dyscrasias; dialysis; drug safety; hemodialysis; moxifloxacin; quinolone; thrombocytopenia

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