Terbinafine 於 1991 年上市為第一個口服  allylamine 類的抗黴菌藥，臨床上用於治療甲黴菌病(onychomycosis)與皮 癬菌病(dermatophytosis)，其藥品不良反應的發生率約為10%，通常以胃腸道或 皮膚方面的副作用居多。在此，我們報 導一例疑似為terbinafine導致顆粒性白血球缺乏症(agranulocytosis)的個案，該 名患者是因甲黴菌病而至本院皮膚科門診接受 terbinafine 的治療，6 週之後，便因發燒和咽喉痛而至急診就醫，於急診檢查發現該病患嗜中性球嚴重低下，住院期間又因為肺炎感染，必須接受注 射劑型抗生素的治療而延長住院時間。Terbinafine 所引起的顆粒性白血球缺乏症在臨床上極為罕見，但是此藥品不良反應卻有可能導致患者併發嚴重的感染。本文藉由該案例的報導與相關文獻資料的回顧，以提醒醫療同仁於臨床藥 事照護服務之警覺。

Terbinafine,the first orally active allylamine to be marketed in 1991,is used in the treatment of onychomycosis and dermatophytosis.Adverse effects have been reported in approximately 10% of  the  patients  receiving the drug; there are mainly transient gastrointestinal and skin events.Here,we report a patient who developed agranulocytosis after taking oral terbinafine for the treatment of onychomycosis.After six weeks,he visited our emergency department because of fever,sore throat and severe neutropenia.During admission,the patient had a complication of pneumonia requiring intravenous antibiotics therapy and thus resulted in prolongation of length of stay.Agranulocytosis is a rare side effect of terbinafine but may cause severe infectious complications.We describe a case of terbinafine-induced agranulocytosis and conduct a review of the literatures in order to make an alert for medical staffs in pharmaceutical care.