Retrospective analysis of the risk factors for linezolid-induced thrombocytopenia in adult Japanese patients.

Abstract

BACKGROUND:

Thrombocytopenia is a major side effect of linezolid therapy. However, there are few reports about the risk factors for linezolid-induced thrombocytopenia.

OBJECTIVE:

The aim of this study is to evaluate the risk factors for thrombocytopenia in patients who undergo linezolid therapy.

SETTING:

Aomori Prefectural Central Hospital in Japan, a tertiary 695 beds hospital.

METHOD:

A retrospective review was performed using the hospital's medical records. From January 2010 to August 2012, 75 adult patients who received linezolid therapy were enrolled in this study.

MAIN OUTCOME MEASURE:

Linezolid-induced thrombocytopenia was defined as a decrease in the patient's platelet count to <10 × 10⁴/μL or a reduction of ≥30 % from their baseline value. Odds ratios (OR) for thrombocytopenia were analyzed using multivariate stepwise logistic regression analysis.

RESULTS:

Thrombocytopenia occurred in 29 patients (38.6 %), seven of whom required platelet transfusions. The patients who developed thrombocytopenia were significantly older, displayed a significantly higher frequency of renal insufficiency, and received linezolid therapy for significantly longer than the patients without thrombocytopenia. Stepwise logistic regression analysis suggested that receiving linezolid therapy for ≥14 days was a significant risk factor for thrombocytopenia [OR 13.3, 95 % confidence interval (CI) 3.2-55.6, p < 0.01], whereas the creatinine clearance rate exhibited a significant negative correlation with the incidence of the condition [OR 0.98, 95 % CI 0.96-0.99, p = 0.037]. The incidence of thrombocytopenia among the patients who demonstrated creatinine clearance rates of <30 mL/min was 60 % (12/20), which was significantly higher than that observed among the patients who displayed creatinine clearance rates of more than 60 mL/min (26.4 %, 9/34, p = 0.014).

CONCLUSION:

Receiving linezolid therapy for ≥14 days and a low creatinine clearance rate were suggested to be risk factors for linezolid-induced thrombocytopenia. The platelet counts of patients with these risk factors should be closely monitored.

• Authors: Ryuichi Hirano, Yuichi Sakamoto, Naoki Tachibana, Motoki Ohnishi
• Journal: International journal of clinical pharmacy (Int J Clin Pharm) Vol. 36 Issue 4 Pg. 795-9 (Aug 2014) ISSN: 2210-7711 [Electronic] Netherlands
• PMID: 24913359 (Publication Type: Journal Article)

Chemical References

• Acetamides
• Anti-Infective Agents
• Oxazolidinones
• Linezolid

Topics

• Acetamides (administration & dosage, adverse effects, therapeutic use)
• Age Factors
• Aged
• Aged, 80 and over
• Anti-Infective Agents (administration & dosage, adverse effects, therapeutic use)
• Female
• Hospitals, District
• Humans
• Incidence
• Infections (complications, drug therapy)
• Japan (epidemiology)
• Linezolid
• Male
• Middle Aged
• Oxazolidinones (administration & dosage, adverse effects, therapeutic use)
• Platelet Count
• Platelet Transfusion
• Renal Insufficiency (complications)
• Retrospective Studies
• Risk Factors
• Tertiary Care Centers
• Thrombocytopenia (blood, chemically induced, epidemiology, therapy)