title: High frequency of linezolid-associated thrombocytopenia among patients with renal insufficiency.
abstract: This retrospective case-control study compared the tolerability and efficacy of linezolid between patients with and without renal insufficiency (serum creatinine > or =1.3mg/dL for women and > or =1.5mg/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+/-21.1mg/dL vs. 18.3+/-9.7mg/dL; P<0.001), elevated serum creatinine (2.3+/-0.7mg/dL vs. 0.9+/-0.3mg/dL; P<0.001) and decreased initial haemoglobin (9.2+/-1.5g/dL vs. 10.4+/-1.7g/dL; P=0.017). Development of severe thrombocytopenia (<100 x 10(9)/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.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Yen-Hung
authors.initials: YH
authors.lastname: Lin
authors.forename: Vin-Cent
authors.initials: VC
authors.lastname: Wu
authors.forename: I-Jung
authors.initials: IJ
authors.lastname: Tsai
authors.forename: Yi-Luwn
authors.initials: YL
authors.lastname: Ho
authors.forename: Juey-Jen
authors.initials: JJ
authors.lastname: Hwang
authors.forename: Yong-Kwei
authors.initials: YK
authors.lastname: Tsau
authors.forename: Chen-Yi
authors.initials: CY
authors.lastname: Wu
authors.forename: Kwan-Dun
authors.initials: KD
authors.lastname: Wu
authors.forename: Po-Ren
authors.initials: PR
authors.lastname: Hsueh
mesh_terms: D000081:Acetamides / Q000009:adverse effects*; D000328:Adult; D000740:Anemia / Q000139:chemically induced / Q000453:epidemiology; D000890:Anti-Infective Agents / Q000009:adverse effects*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D000069349:Linezolid; D008297:Male; D008875:Middle Aged; D023303:Oxazolidinones / Q000009:adverse effects*; D006435:Renal Dialysis; D012189:Retrospective Studies; D012449:Safety; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000453:epidemiology
chemical_list: D000081:Acetamides; D000890:Anti-Infective Agents; D023303:Oxazolidinones; D000069349:Linezolid