The association between risk factors and time of onset for thrombocytopenia in Japanese patients receiving linezolid therapy: a retrospective analysis.
OBJECTIVE
Linezolid (LZD) is an oxazolidinone antibiotic that is active against Gram-positive bacteria including methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci. The major adverse effect related to its use in humans is reversible myelosuppression, which mostly manifests as thrombocytopenia. This retrospective study was conducted to identify risk factors that might contribute towards the development of thrombocytopenia due to intravenous administration of LZD.


METHODS
Patients who were administered LZD between January 2008 and March 2013 were included. Thrombocytopenia was defined as a decrease in platelet count of ≥10 × 10(4) cell/μL from baseline or of ≥30%.


RESULTS
A total of 47 patients were included in this study. These patients were divided into two groups: 22 patients (46·8%) were assigned to a non-thrombocytopenia group and 25 patients (53·2%) to a thrombocytopenia group. Multivariate logistic regression analysis revealed significant intergroup differences in duration of LZD treatment [odds ratio (OR) = 1·278; 95% confidence interval (CI) = 1·068-1·529; P = 0·007] and white blood cell (WBC) count (>12000 cells/μL; OR = 10·399; 95% CI = 1·667-64·882; P = 0·012).


CONCLUSIONS
This finding suggests that duration of LZD treatment and WBC count (>12000 cells/μL) are risk factors associated with thrombocytopenia resulting from LZD administration.
Department of Pharmacy, Kainan Hospital, Aichi, Japan; Laboratory of Pharmacy Practice and Social Science, Gifu Pharmaceutical University, Gifu, Japan.
T
T
Ichie
D
D
Suzuki
K
K
Yasui
H
H
Takahashi
M
M
Matsuda
H
H
Hayashi
Y
Y
Sugiura
T
T
Sugiyama
D000282:Administration, Intravaginal; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001424:Bacterial Infections / Q000188:drug therapy; D005260:Female; D006801:Humans; D007564:Japan; D000069349:Linezolid / Q000008:administration & dosage / Q000009:adverse effects*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010976:Platelet Count; D012189:Retrospective Studies; D012307:Risk Factors; D013921:Thrombocytopenia / Q000139:chemically induced*; D013997:Time Factors; D055815:Young Adult
D000900:Anti-Bacterial Agents; D000069349:Linezolid
adverse effect; linezolid; risk factor; thrombocytopenia