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Risk factors for linezolid‐induced thrombocytopenia in patients without haemato‐oncologic diseases
Author(s) -
Choi Go Wun,
Lee JuYeun,
Chang Min Jung,
Kim Young Kyung,
Cho Yoonsook,
Yu Yun Mi,
Lee Euni
Publication year - 2019
Publication title -
basic and clinical pharmacology and toxicology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.805
H-Index - 90
eISSN - 1742-7843
pISSN - 1742-7835
DOI - 10.1111/bcpt.13123
Subject(s) - medicine , linezolid , odds ratio , confidence interval , creatinine , aspirin , retrospective cohort study , platelet , gastroenterology , surgery , vancomycin , biology , bacteria , genetics , staphylococcus aureus
This study aimed to describe the occurrence and to evaluate the predictive factors of thrombocytopenia caused by parenteral linezolid in hospitalised patients without haemato‐oncologic diseases. Using electronic medical records, a retrospective safety evaluation was performed among all hospitalised adult patients who received parenteral linezolid therapy between January 2005 and June 2016. Of all identified 264 patients with an average age of 63.4 ( SD 15.8) years, thrombocytopenia occurred at a rate of 29.2% after an average of 11.2 ( SD 7.4) days of the initiation of linezolid therapy. Significant predictive factors for thrombocytopenia included the duration of linezolid therapy longer than or equal to 7 days (adjusted odds ratios [ORs] 7.25, 19.51 and 28.80; 95% confidence intervals [CIs] 1.92‐27.38, 4.76‐79.95 and 6.48‐127.92 for 7‐13 days, 14‐20 days and ≥21 days, respectively; P < 0.01 for all values), baseline platelet count <150 × 10 3 /mm 3 (adjusted OR , 5.08; 95% CI , 2.06‐12.55; P < 0.001), creatinine clearance <30 mL/min (adjusted OR , 4.19; 95% CI , 1.59‐11.06; P = 0.004) and concurrent low‐dose aspirin therapy (adjusted OR , 2.99; 95% CI , 1.26‐7.08; P = 0.013). Baseline platelet count less than 150 × 10 3 /mm 3 was an independent predictor of early‐onset (≤6 days) thrombocytopenia (adjusted OR , 5.07; 95% CI , 1.46‐17.58; P = 0.011). Closer monitoring of platelet count is required in patients who receive parenteral linezolid therapy for 7 days or more, and have low baseline platelet counts or impaired renal function.