PFPC Daily - July 15, 2005

Starr JA, Ragucci KR - "Thrombocytopenia associated with intravenous
ciprofloxacin" Pharmacotherapy 25(7):1030-4 (2005)

A variety of disease states, disorders, hereditary conditions,
environmental toxins, and drugs may cause thrombocytopenia.
Fluoroquinolones, however, are not thought to be common offenders. We
report the case of a 72-year-old woman who was receiving intravenous
ciprofloxacin for a urinary tract infection and developed
thrombocytopenia during her hospital stay. Her platelet count
dropped from 147 x 10 3 /mm 3 on admission to as low as 21 x 10 3 /mm
3 . On discontinuation of the drug, her platelet counts began to
return to normal. After discharge, the patient continued to improve
clinically. Four days after discharge, her platelet count was 197 x
10 3/mm 3 . In the primary literature, we found two case reports on
thrombocytopenia associated with ciprofloxacin and one case report
with alatrofloxacin. In addition, six additional case reports
were found in non-English journals that describe
fluoroquinolone-associated thrombocytopenia. Clinicians should be
aware of the possible relationship between thrombocytopenia and
fluoroquinolones, and platelet counts should be monitored accordingly.