Reversal of linezolid-associated cytopenias, but not peripheral neuropathy, by administration of vitamin B6.
OBJECTIVE
We sought to determine if vitamin B6 therapy would reverse linezolid-associated cytopenias and/or peripheral neuropathy.


METHODS
We have recently treated two patients with disseminated Mycobacterium abscessus infections with prolonged (> or =9 month) courses of linezolid. Both patients developed cytopenias related to linezolid, and one patient also developed peripheral neuropathy. Because continuing linezolid therapy was required, we administered vitamin B6 (50 mg orally once a day) in an attempt to mitigate the associated cytopenias.


RESULTS
The cytopenias in both patients reversed following administration of vitamin B6, and stabilized during prolonged linezolid therapy, although the peripheral neuropathy did not.


CONCLUSIONS
Vitamin B6 treatment may be useful to prevent or modify the course of linezolid-associated cytopenias. More formal and rigorous study of vitamin B6 therapy in patients receiving prolonged courses of linezolid is warranted.
Department of Medicine, Harbor-UCLA Research and Education Institute, 1124 West Carson St., St. John's Cardiovascular Research Center, Torrance, CA 90502, USA. bjs@humc.edu
Brad
B
Spellberg
Thomas
T
Yoo
Arnold S
AS
Bayer
D000081:Acetamides / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001772:Blood Cell Count; D005260:Female; D006801:Humans; D000069349:Linezolid; D008297:Male; D008875:Middle Aged; D009164:Mycobacterium Infections / Q000188:drug therapy* / Q000382:microbiology; D023303:Oxazolidinones / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D010198:Pancytopenia / Q000139:chemically induced / Q000517:prevention & control*; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced / Q000517:prevention & control*; D016896:Treatment Outcome; D025101:Vitamin B 6 / Q000008:administration & dosage / Q000627:therapeutic use*
D000081:Acetamides; D000900:Anti-Bacterial Agents; D023303:Oxazolidinones; D025101:Vitamin B 6; D000069349:Linezolid