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Analysis of the risk factors of linezolid‐related haematological toxicity in Chinese patients
Author(s) -
Dai Ying,
Jiang Shuying,
Chen Xiaoou,
Han Lu,
Zhang Chunhong,
Yu Xuben,
Zhang Xiuhua
Publication year - 2021
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/jcpt.13359
Subject(s) - medicine , toxicity , renal function , gastroenterology , linezolid , adverse effect , incidence (geometry) , univariate analysis , multivariate analysis , physics , vancomycin , biology , bacteria , optics , genetics , staphylococcus aureus
What is known and objectives Haematological toxicity including thrombocytopenia, anaemia and leucopenia is the main adverse events of linezolid (LZD) therapy. This study aimed to investigate the risk factors for LZD‐induced haematological toxicity and define the threshold of plasma trough concentration to minimize the haematological toxicity. Methods 145 patients who received LZD for more than 10 days were retrospectively reviewed to determine the incidence of LZD‐induced haematological toxicity. Meanwhile, the risk factors of haematological toxicity were confirmed by univariate and multivariate logistic regression analysis. Results and discussion 9 (6.2%) patients developed leucopenia, while 52 (35.9%) and 26 (17.9%) patients developed thrombocytopenia and anaemia, respectively. The estimated glomerular filtration rate (eGFR) <90 ml/min/1.73 m 2 (OR, 2.744; 95% CI, 1.117–6.734; p = 0.028) and baseline platelet count <200 × 10 9 /L (OR, 6.817; 95% CI, 2.870–16.193; p < 0.0001) were found to be significant risk factors for LZD‐related thrombocytopenia. Aspartate aminotransferase (AST) >80 U/L (OR, 4.844; 95% CI, 1.207–19.451; p = 0.026) and eGFR <90 ml/min/1.73 m 2 (OR, 7.132; 95% CI, 2.088–24.357; p = 0.002) were the risk factors for LZD‐related anaemia. However, no significant risk factors were identified for LZD‐related leucopenia. Moreover, LZD plasma trough concentration >8 mg/L [OR, 3.047; 95% CI, 1.233–7.539; p = 0.016] could be a predictor for the development of thrombocytopenia and anaemia. What is new and conclusion Hepatic and/or renal dysfunction are the risk factors for LZD‐related haematological toxicity, while the target plasma trough concentration within 8 mg/L via dose reduction could minimize the haematological toxicity induced by LZD.