Antimicrobial Therapy: An Important Risk for Acquired Aplastic Anemia

Background: Aplastic anemia although a rare hematological disorder but it is associated with poor prognosis and high mortality. It is a matter of greater public health concern for the Asian population with prevalence 3 times greater than other part of the globe. Exposures of specific drugs, chemicals and others have been connected with an AA etiology. We aimed to examine the association of antimicrobial drugs exposures with AA. Methods: We conducted a case-control study in Karachi, Pakistan, selecting the patients with two blood lineages depressed on bone marrow biopsy as the cases while patients without any hematological disorder as controls. For each case four age-sex matched control were enrolled. Information associated to socio-demographics and exposure to antibiotics was collected on a questionnaire during personal interview. Results: We identified 191 cases with an age range of 1-66 years and 696 controls. Predominant participants were male (67%), female being 33%. Antimicrobial drugs were used by 49.74% of aplastic anemia cases whereas the use was reported in 29.31% controls. Beta-lactam antibiotics, chloramphenicol, macrolides, Trimethoprim/Sulfamethoxazole, tetracycline and others were the drug categories evaluated. Conclusion: Antimicrobials were reported to be used more frequently in aplastic anemia cases as compared to their normal controls