Severe acute hypokalaemia associated with piperacillin/tazobactam in an HIV-infected patient under antiretroviral therapy with tenofovir alafenamide: case report and literature review
Cheng-Chun Tai A B , Ruey-Yi Chou A , Jiun-Yu Guo C and Hsin-Pai Chen B D EA Department of Medical Education, Taipei Veterans General Hospital, 201 Shih-Pai Road, Sec. 2, Taipei 11247, Taiwan.
B School of Medicine, National Yang Ming University, 155 Linong Street, Sec. 2, Taipei 11221, Taiwan.
C Department of Medicine, Taipei Veterans General Hospital, 201 Shih-Pai Road, Sec. 2, Taipei 11247, Taiwan.
D Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, 201 Shih-Pai Road, Sec. 2, Taipei 11247, Taiwan.
E Corresponding author. Email: chenhp1970tw@gmail.com
Sexual Health 17(2) 194-197 https://doi.org/10.1071/SH19069
Submitted: 18 April 2019 Accepted: 21 October 2019 Published: 3 March 2020
Abstract
Piperacillin/tazobactam is a commonly prescribed antimicrobial agent. Tenofovir alafenamide (TAF) is increasingly being used in antiretroviral therapy (ART) of HIV. Herein we report a case of a 57-year-old male with AIDS receiving TAF-containing ART in whom severe refractory hypokalaemia developed after coadministration of piperacillin/tazobactam for suspected hospital-acquired infection. Upon withdrawal of piperacillin/tazobactam, serum potassium concentrations returned to normal within 2 days. Hypokalaemia is a rare adverse effect of piperacillin/tazobactam and may be aggravated with the underlying use of TAF. We also reviewed past reported cases of hypokalaemia after piperacillin/tazobactam administration. We want to highlight that a more cautious approach should be considered when combining piperacillin/tazobactam and TAF in clinical practice.
Additional keywords: adverse events, antibiotic treatment, antiretroviral treatment, electrolyte imbalance.
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