Ichie T, Suzuki D, Yasui K, Takahashi H, Matsuda M, Hayashi H, Sugiura Y, Sugiyama T
Department of Pharmacy, Kainan Hospital, Aichi, Japan; Laboratory of Pharmacy Practice and Social Science, Gifu Pharmaceutical University, Gifu, Japan.
J Clin Pharm Ther. 2015 Jun;40(3):279-84. doi: 10.1111/jcpt.12260. Epub 2015 Mar 2.
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.
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%.
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).
This finding suggests that duration of LZD treatment and WBC count (>12000 cells/μL) are risk factors associated with thrombocytopenia resulting from LZD administration.
利奈唑胺（LZD）是一种恶唑烷酮类抗生素，对革兰氏阳性菌有效，包括耐甲氧西林金黄色葡萄球菌和耐万古霉素肠球菌。其在人体使用中的主要不良反应是可逆性骨髓抑制，主要表现为血小板减少。本回顾性研究旨在确定静脉注射LZD导致血小板减少发生的可能危险因素。
纳入2008年1月至2013年3月期间接受LZD治疗的患者。血小板减少定义为血小板计数较基线水平降低≥10×10⁴个细胞/μL或降低≥30%。
本研究共纳入47例患者。这些患者被分为两组：22例患者（46.8%）被归入非血小板减少组，25例患者（53.2%）被归入血小板减少组。多因素逻辑回归分析显示，LZD治疗持续时间[比值比（OR）=1.278；95%置信区间（CI）=1.068 - 1.529；P = 0.007]和白细胞（WBC）计数（>12000个细胞/μL；OR = 10.399；95% CI = 1.667 - 64.882；P = 0.012）在两组间存在显著差异。
这一发现表明，LZD治疗持续时间和WBC计数（>12000个细胞/μL）是与LZD给药导致的血小板减少相关的危险因素。
