Department of Pharmacy, Aomori Prefectural Central Hospital, Aomori, Japan,
Int J Clin Pharm. 2014 Aug;36(4):795-9. doi: 10.1007/s11096-014-9961-6. Epub 2014 Jun 10.
Thrombocytopenia is a major side effect of linezolid therapy. However, there are few reports about the risk factors for linezolid-induced thrombocytopenia.
The aim of this study is to evaluate the risk factors for thrombocytopenia in patients who undergo linezolid therapy.
Aomori Prefectural Central Hospital in Japan, a tertiary 695 beds hospital.
A retrospective review was performed using the hospital's medical records. From January 2010 to August 2012, 75 adult patients who received linezolid therapy were enrolled in this study.
Linezolid-induced thrombocytopenia was defined as a decrease in the patient's platelet count to <10 × 10⁴/μL or a reduction of ≥30 % from their baseline value. Odds ratios (OR) for thrombocytopenia were analyzed using multivariate stepwise logistic regression analysis.
Thrombocytopenia occurred in 29 patients (38.6 %), seven of whom required platelet transfusions. The patients who developed thrombocytopenia were significantly older, displayed a significantly higher frequency of renal insufficiency, and received linezolid therapy for significantly longer than the patients without thrombocytopenia. Stepwise logistic regression analysis suggested that receiving linezolid therapy for ≥14 days was a significant risk factor for thrombocytopenia [OR 13.3, 95 % confidence interval (CI) 3.2-55.6, p < 0.01], whereas the creatinine clearance rate exhibited a significant negative correlation with the incidence of the condition [OR 0.98, 95 % CI 0.96-0.99, p = 0.037]. The incidence of thrombocytopenia among the patients who demonstrated creatinine clearance rates of <30 mL/min was 60 % (12/20), which was significantly higher than that observed among the patients who displayed creatinine clearance rates of more than 60 mL/min (26.4 %, 9/34, p = 0.014).
Receiving linezolid therapy for ≥14 days and a low creatinine clearance rate were suggested to be risk factors for linezolid-induced thrombocytopenia. The platelet counts of patients with these risk factors should be closely monitored.
血小板减少症是利奈唑胺治疗的主要副作用。然而，关于利奈唑胺引起血小板减少症的危险因素的报道很少。
本研究旨在评估接受利奈唑胺治疗的患者发生血小板减少症的危险因素。
日本青森县立中央医院，一家拥有 695 张床位的三级医院。
使用医院病历进行回顾性研究。从 2010 年 1 月至 2012 年 8 月，共有 75 名接受利奈唑胺治疗的成年患者纳入本研究。
利奈唑胺引起的血小板减少症定义为患者血小板计数<10×104/μL 或较基线值下降≥30%。采用多变量逐步逻辑回归分析分析血小板减少症的比值比（OR）。
29 名患者（38.6%）发生血小板减少症，其中 7 名患者需要血小板输注。发生血小板减少症的患者年龄明显较大，肾功能不全发生率明显较高，接受利奈唑胺治疗的时间明显长于无血小板减少症的患者。逐步逻辑回归分析提示，接受利奈唑胺治疗≥14 天是血小板减少症的显著危险因素[OR 13.3，95%置信区间（CI）3.2-55.6，p<0.01]，而肌酐清除率与该疾病的发生率呈显著负相关[OR 0.98，95%CI 0.96-0.99，p=0.037]。肌酐清除率<30ml/min 的患者血小板减少症发生率为 60%（12/20），明显高于肌酐清除率>60ml/min 的患者（26.4%，9/34，p=0.014）。
接受利奈唑胺治疗≥14 天和低肌酐清除率提示是利奈唑胺引起血小板减少症的危险因素。这些危险因素的患者血小板计数应密切监测。
