title: Bicytopenia, especially thrombocytopenia in hemodialysis and non-hemodialysis patients treated with linezolid therapy.
abstract: One of the major adverse events associated with linezolid treatment is pancytopenia. However, there are few reports about the tolerability of linezolid among patients undergoing hemodialysis. This study retrospectively investigated the frequency of bicytopenia (thrombocytopenia and erythropenia) secondary to linezolid treatment in patients undergoing and not-undergoing hemodialysis. In total, 181 patients treated with linezolid from January 2010 to July 2012 at Aichi Medical University Hospital were divided into three groups; patients undergoing hemodialysis (HD group), those with creatinine clearance (CLCR) of <50 mL/min (CLCR < 50 group) and those with CLCR of ≥ 50 mL/min (CLCR ≥ 50 group). The incidence of thrombocytopenia, and changes in the platelet (PLT) counts during and after linezolid therapy were compared among three groups. Thrombocytopenia (<75% of the baseline level) occurred in 125 patients (69.1%). PLT reached its nadir 3-4 days after the end of linezolid therapy. In particular, the PLT nadir in HD group occurred earlier than that in non-HD groups (HD, 11.5 days [4-31 days]; CLCR < 50, 14 days [5-43 days]; CLCR ≥ 50, 15.5 days [4-49 days]; p = 0.11). HD group exhibited the greatest rate of reduction of PLT (HD, 24.0% [0.4-93.8%]; CLCR < 50, 23.8% [0.8-92.9%]; CLCR ≥ 50, 22.4% [0.92-92.9%]; p = 0.003). Finally, HD group exhibited the slowest recovery of PLT to its baseline level (HD, 10 days [5-29 days]; CLCR < 50, 9 days [2-16 days]; CLCR ≥ 50, 8 days [3-17 days]; p = 0.09). The incidence of erythropenia was not significantly different among three groups. These results indicate the need to monitor the PLT count during and after linezolid treatment in patients undergoing hemodialysis.
authors.affiliation: Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Pharmacy, Aichi Medical University Hospital, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Kato
authors.affiliation: Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Pharmacy, Aichi Medical University Hospital, Japan.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Hamada
authors.affiliation: Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Pharmacy, Aichi Medical University Hospital, Japan.
authors.forename: Mao
authors.initials: M
authors.lastname: Hagihara
authors.affiliation: Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Hirai
authors.affiliation: Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Yamagishi
authors.affiliation: Department of Pharmacy, Aichi Medical University Hospital, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Matsuura
authors.affiliation: Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan. Electronic address: mikamo@aichi-med-u.ac.jp.
authors.forename: Hiroshige
authors.initials: H
authors.lastname: Mikamo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D004912:Erythrocytes / Q000187:drug effects*; D005260:Female; D006801:Humans; D007564:Japan; D000069349:Linezolid / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010198:Pancytopenia / Q000150:complications* / Q000628:therapy; D010976:Platelet Count; D006435:Renal Dialysis / Q000009:adverse effects; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000097:blood / Q000139:chemically induced* / Q000628:therapy; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000069349:Linezolid
keywords: Bicytopenia; Hemodialysis; Linezolid; Thrombocytopenia