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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