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High frequency of linezolid-associated thrombocytopenia among patients with renal insufficiency

2006; Elsevier BV; Volume: 28; Issue: 4 Linguagem: Inglês

10.1016/j.ijantimicag.2006.04.017

1872-7913

Yen‐Hung Lin, Vin‐Cent Wu, I‐Jung Tsai, Yi‐Lwun Ho, Juey‐Jen Hwang, Yong‐Kwei Tsau, Chen‐Yi Wu, Kwan‐Dun Wu, Po‐Ren Hsueh,

Antibiotic Resistance in Bacteria

This retrospective case–control study compared the tolerability and efficacy of linezolid between patients with and without renal insufficiency (serum creatinine ≥1.3 mg/dL for women and ≥1.5 mg/dL for men). All patients with Gram-positive infections treated with linezolid for more than 7 days were included. Data were collected from medical charts and differences between patients with and without renal insufficiency were analysed. Sixty-two patients (40 men), with a mean age of 56.9 years, were enrolled in this study. At the start of linezolid treatment, 17 patients (27.4%) had impaired renal function. Patients with renal insufficiency had a higher prevalence of diabetes mellitus compared with those with normal renal function (64.7% vs. 22.2%; P = 0.002). At the start of therapy, patients with renal impairment had a higher frequency of elevated blood urea nitrogen (51.0 ± 21.1 mg/dL vs. 18.3 ± 9.7 mg/dL; P < 0.001), elevated serum creatinine (2.3 ± 0.7 mg/dL vs. 0.9 ± 0.3 mg/dL; P < 0.001) and decreased initial haemoglobin (9.2 ± 1.5 g/dL vs. 10.4 ± 1.7 g/dL; P = 0.017). Development of severe thrombocytopenia (<100 × 109/L) was significantly more common in patients with renal insufficiency (64.7% vs. 35.6%; P = 0.039). The incidence of linezolid-associated thrombocytopenia was higher among patients with renal insufficiency. When patients with renal insufficiency are treated with linezolid for more than 2 weeks, the platelet count should be monitored at least twice a week owing to the increased likelihood of thrombocytopenia.