Julia et al identified prognostic features for patients with drug-induced agranulocytosis. These can help identify a patient who may require more aggressive management. The authors are from multiple hospitals in Spain.
Drug-induced agranulocytosis has a mortality rate that ranges from 10-50%. Lower mortality rates are associated with better clinical management.
Factors associated with increased mortality in the multivariate analysis:
(1) bacteremia, especially with septic shock
(2) renal insufficiency at diagnosis (serum creatinine > 2 mg/dL and/or serum BUN > 50 mg/dL)
Factors associated with improved outcome:
(1) prompt discontinuation of causative drug
(2) prompt therapy with antibiotics
(3) broad spectrum in antibiotic coverage, with inclusion of antipseudomonal activity
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