title: A reduced linezolid dosage maintains favorable efficacy with minimal hematologic toxicity in a methicillin-resistant Staphylococcus aureus-infected patient with renal insufficiency.
abstract: The optimal dosage of linezolid to avoid hematologic toxicity is unknown. We report the case of an 87-y-old woman with renal insufficiency who developed a surgical site infection with refractory methicillin-resistant Staphylococcus aureus. The standard dosage of linezolid (1200 mg daily) was not initially tolerated by the patient due to severe thrombocytopenia, but she was successfully treated when the dose was reduced by half (600 mg daily) based on a population pharmacokinetic-pharmacodynamic model. Appropriate dose adjustments can be made to optimize linezolid therapy especially in cases with preexisting renal dysfunction.
authors.affiliation: Department of Pharmacy, Kumamoto University Hospital, Kumamoto, Japan.
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Taguchi
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Miyakawa
authors.forename: Takafumi
authors.initials: T
authors.lastname: Ohmura
authors.forename: Momoko
authors.initials: M
authors.lastname: Horio
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Anraku
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Okada
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mizuta
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Saito
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kawaguchi
mesh_terms: D000081:Acetamides / Q000008:administration & dosage*; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D000069349:Linezolid; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D023303:Oxazolidinones / Q000008:administration & dosage*; D010976:Platelet Count; D051437:Renal Insufficiency / Q000097:blood / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000097:blood / Q000150:complications / Q000188:drug therapy*
chemical_list: D000081:Acetamides; D000890:Anti-Infective Agents; D023303:Oxazolidinones; D000069349:Linezolid