Impact of vancomycin or linezolid therapy on development of renal dysfunction and thrombocytopenia in Japanese patients.
BACKGROUND
Vancomycin and linezolid therapies are associated with renal dysfunction and thrombocytopenia, respectively.


METHODS
We retrospectively investigated Japanese patients with renal dysfunction or thrombocytopenia possibly associated with vancomycin and linezolid therapies, including 235 patients treated with parenteral vancomycin and 178 treated with parenteral linezolid.


RESULTS
Renal dysfunction occurred more frequently in patients receiving vancomycin (24%) than in those receiving linezolid (13%; p = 0.032), whereas thrombocytopenia occurred more frequently in linezolid-treated patients (41%) than in vancomycin-treated patients (17%; p < 0.001). Controlling trough vancomycin concentrations (<20 μg/ml) protects against renal dysfunction, but thrombocytopenia may occur after >7.5 days of linezolid treatment.


CONCLUSIONS
Controlling trough vancomycin concentrations to <20 μg/ml protects Japanese patients against renal dysfunction. Linezolid is an appropriate initial therapy for severe infections in patients with acute renal dysfunction, but monitoring of platelet counts is essential after initiation of therapy.
Department of Hospital Pharmacy, Sapporo Medical University Hospital, Sapporo, Japan.
Satoshi
S
Fujii
Satoshi
S
Takahashi
Shinki
S
Makino
Yusuke
Y
Kunimoto
Hiromasa
H
Nakata
Norimasa
N
Noda
Koichi
K
Sakurai
Atsushi
A
Miyamoto
D000081:Acetamides / Q000008:administration & dosage / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D044466:Asian People; D016903:Drug Monitoring / Q000379:methods; D005260:Female; D006801:Humans; D000069349:Linezolid; D008297:Male; D008875:Middle Aged; D023303:Oxazolidinones / Q000008:administration & dosage / Q000009:adverse effects*; D010976:Platelet Count; D051437:Renal Insufficiency / Q000139:chemically induced* / Q000453:epidemiology; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000453:epidemiology; D013997:Time Factors; D014640:Vancomycin / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D055815:Young Adult
D000081:Acetamides; D000900:Anti-Bacterial Agents; D023303:Oxazolidinones; D014640:Vancomycin; D000069349:Linezolid