title: Reduction of linezolid-associated thrombocytopenia by the dose adjustment based on the risk factors such as basal platelet count and body weight.
abstract: The aim of the present study was to evaluate the efficacy of dose modification based on the risk factor for linezolid-induced thrombocytopenia. A multivariate logistic regression analysis performed in the observational study showed that low body weight of <55 kg (odds ratio [OR]: 33.2, 95% confidence interval [CI]: 2.16-510.1, P = 0.012) and the baseline platelet count of <200 × 10(3)/mm(3) (OR: 24.9, 95% CI: 1.53-404.7, P = 0.024) were found to be risk factors for linezolid-induced thrombocytopenia. In the subsequent intervention study, in which daily dose of linezolid was set to 20 mg/kg in patients with either one of the risk factors or 1200 mg in those without any risk factor, the onset of thrombocytopenia was significantly prolonged in the intervention study group (P = 0.043), without reducing clinical efficacy. These findings suggest that dose adjustment of linezolid is effective in preventing thrombocytopenia without reducing its clinical efficacy in patients having risk factors.
authors.affiliation: Department of Pharmacy, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan; The Center for Nutrition Support & Infection Control, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan. Electronic address: ta-niwa@gifu-u.ac.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Niwa
authors.affiliation: The Center for Nutrition Support & Infection Control, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan.
authors.forename: Tamayo
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Department of Pharmacy, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Suzuki
authors.affiliation: Department of Pharmacy, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan.
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Ohmori
authors.affiliation: The Center for Nutrition Support & Infection Control, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Tsuchiya
authors.affiliation: The Center for Nutrition Support & Infection Control, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: The Center for Nutrition Support & Infection Control, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan.
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Ohta
authors.affiliation: The Center for Nutrition Support & Infection Control, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Murakami
authors.affiliation: Department of Pharmacy, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Itoh
mesh_terms: D000081:Acetamides / Q000008:administration & dosage* / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000009:adverse effects; D001835:Body Weight / Q000187:drug effects*; D005260:Female; D006801:Humans; D000069349:Linezolid; D008297:Male; D008875:Middle Aged; D023303:Oxazolidinones / Q000008:administration & dosage* / Q000009:adverse effects*; D010976:Platelet Count; D012044:Regression Analysis; D012307:Risk Factors; D013921:Thrombocytopenia / Q000097:blood / Q000139:chemically induced* / Q000517:prevention & control
chemical_list: D000081:Acetamides; D000890:Anti-Infective Agents; D023303:Oxazolidinones; D000069349:Linezolid
keywords: Basal platelet count; Body weight; Dose adjustment; Linezolid; Thrombocytopenia