Abstract

PIPERACILLIN/TAZOBACTAM INDUCED CHILLS AND BREATH-LESSNESS IN A PATIENT WITH DIABETES MELLITUS: A RARE CASE REPORT

Kush Nimron, Johncy Nathasha, Jithin*, Mariya Shaju, Parvathi K. and Atrisha Mariyam Vincent

ABSTRACT

Objective: To report a rare case of a diabetes mellitus patient who de-veloped chills and breathlessness secondary to Piperacillin Tazobac-tum use. Case Summary: In our case report, we describe an unusual case of an immediate reaction to Piperacillin /Tazobactam. A 77-year-old male patient was admitted to the hospital with chief complaints of pain, swelling, and a non-healing ulcer on the left foot. The patient was ini-tially managed with an injection of Pantoprazole and injection of Para-cetamol with subsequent administration of Piperacillin Tazobactum (4.5 gm) antibiotic to treat the underlying infection. The patient devel-oped chills and breathlessness after receiving the first dose of Pipera-cillin Tazobactum, the antibiotic was stopped and supportive treatment with antihistamine and corticosteroid was provided to treat adverse reactions. The symptoms were resolved and the patient condition improved within one day of discontinuation of the suspected drug. The suspected drug reaction with Piperacillin Tazobactum was found to have a “probable” causal relationship through the Naranjo causality assessment and WHO-UMC scale. The severity of the ADR falls under level 3 as a “moderate” severe reaction as per Adapted Hartwig‟s assessment. The report suggests close monitoring of Piperacillin-Tazobactam usage among the patient population. Practice Implications: Through the obser-vation of this event we could figure out the association between Piperacillin Tazobactum and chills and breathlessness. Prompt withdrawal of the offending agent and the initiation of the therapy with injection pheniramine and injection hydrocortisone was found to be effective.

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