From the FDA Drug Label
As with other cephalosporins, anaphylaxis including anaphylactic shock, transient leukopenia, neutropenia, agranulocytosis and thrombocytopenia have been reported
- Neutropenia is listed as a potential adverse reaction associated with cephalosporins, including cefepime.
- The FDA drug label for cefepime indicates that neutropenia has been reported in patients treated with cephalosporin-class antibiotics, including cefepime 1.
- Key points:
- Neutropenia is a potential side effect of cephalosporins.
- Cefepime, a type of cephalosporin, has been associated with neutropenia.
- The incidence of neutropenia is not specified in the provided drug label.
From the Research
Yes, cephalosporins can cause neutropenia as a potential adverse effect, with the most recent and highest quality study suggesting that ceftaroline use is independently associated with neutropenia 2. This class of antibiotics, which includes medications like cefazolin, ceftriaxone, cefepime, and ceftaroline, has been associated with bone marrow suppression that can lead to decreased neutrophil production. Some key points to consider:
- Neutropenia typically develops after prolonged therapy (usually after 10-14 days of treatment) but can occasionally occur earlier.
- The risk is higher with certain cephalosporins, particularly those containing the N-methylthiotetrazole (NMTT) side chain such as cefoperazone.
- Patients with renal impairment, elderly patients, and those receiving concurrent medications that can affect bone marrow function may be at increased risk.
- The mechanism involves direct toxicity to myeloid precursor cells in the bone marrow.
- Neutropenia is usually reversible upon discontinuation of the medication, with neutrophil counts typically recovering within 1-2 weeks after stopping the antibiotic, as seen in a case where cefepime-induced neutropenia was reversed after discontinuation of the medication 3. Regular monitoring of complete blood counts is recommended for patients on prolonged cephalosporin therapy, especially those with risk factors for developing neutropenia, with some studies suggesting that monitoring should be done weekly or even twice-weekly in certain cases 4, 2. It is also important to note that while mortalities from antibiotic-induced neutropenia remain rare, severe neutropenia may lead to severe life-threatening sepsis, shock, and even death, highlighting the need for prompt recognition and treatment of this adverse effect 5.