CASE REPORT article
Front. Immunol.
Sec. Microbial Immunology
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1537972
This article is part of the Research TopicAntibacterial polymers and their applications as antibiotic adjuvants or replacementsView all articles
Case report: Polymyxin E-associated reversible leukopenia
Provisionally accepted
- 1Department of Pharmacy, Three Gorges Hospital, Chongqing University, Chongqing, China
- 2Department of Endocrinology and Metabolism, Three Gorges Hospital, Chongqing University, Chongqing, China
- 3Fengdu People's Hospital, Chongqing, China
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Introduction: With the increasing challenge of antibiotic resistance, polymyxin E is considered the Last-line treatment option for infections caused by highly resistant bacteria. However, their use may lead to various adverse reactions such as nephrotoxicity, neurotoxicity, and allergic reactions.Case Presentation: This study describes a case of polymyxin E-associated leukopenia in a 50-yearold female treated for Klebsiella pneumoniae infection. During polymyxin E therapy, the patient developed leukopenia with white blood cell (WBC) counts declining from 5.65×10⁹/L to 0.91×10⁹/L, which resolved progressively after polymyxin E cessation. The Naranjo scale yielded a score of 7 for polymyxin E-associated leukopenia, while other medications scored ≤0. The WHO-Uppsala Monitoring Centre (WHO-UMC) causality classification system categorized the relationship as 'probable.'These findings suggest that polymyxin E likely induces leukopenia, emphasizing the necessity for rigorous WBC monitoring during treatment and prompt discontinuation when hematologic abnormalities emerge to minimize patient health risks.
Keywords: Polymyxin E, polymyxin, Leukopenia, Klebsiella pneumoniae, case report
Received: 03 Dec 2024; Accepted: 21 Jul 2025.
Copyright: © 2025 Wan, Wang and Zhu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jia-Quan Zhu, Fengdu People's Hospital, Chongqing, China
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