Objective :
Linezolid is active against
drug-resistant gram-positive bacteria. However, the efficacy and safety of
linezolid in the treatment of the elderly have not been well characterized. The purpose of this study was to evaluate the efficacy of
linezolid in the treatment of the elderly with
gram-positive bacterial infection and to investigate the risk factors associated with the development of
thrombocytopenia in these patients.
METHODOLOGY: RESULTS: The overall clinical cure rate of
linezolid was 74%, and the bacteriological eradication rate was 69%.
Thrombocytopenia occurred in 24 patients, and
thrombocytopenia was associated with both the
duration of treatment (P = 0.005) and the baseline platelet count (P = 0.042). Based on a logistic regression analysis, the baseline platelet count <200×10(9)/L (OR = 0.244; 95% CI = 0.068- 0.874; P = 0.030) was identified as the only significant risk factor for
linezolid-associated
thrombocytopenia in elderly patients. The mean platelet count decreased significantly from the 7(th) day of treatment, and decreased to the lowest value 1-2 days after the end of
therapy. Conclusions :
Linezolid is effective and safe for the elderly with
gram-positive bacterial infections. Adverse effects such as
thrombocytopenia are of greater concern. Platelet counts should be monitored in patients who are treated with
linezolid and that measures should be taken in advance to avoid hemorrhagic tendencies.