Department of Pharmacy, Seoul National University Hospital, Seoul, Republic of Korea.
College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea.
Basic Clin Pharmacol Toxicol. 2019 Feb;124(2):228-234. doi: 10.1111/bcpt.13123. Epub 2018 Oct 9.
This study aimed to describe the occurrence and to evaluate the predictive factors of thrombocytopenia caused by parenteral linezolid in hospitalised patients without haemato-oncologic diseases. Using electronic medical records, a retrospective safety evaluation was performed among all hospitalised adult patients who received parenteral linezolid therapy between January 2005 and June 2016. Of all identified 264 patients with an average age of 63.4 (SD 15.8) years, thrombocytopenia occurred at a rate of 29.2% after an average of 11.2 (SD 7.4) days of the initiation of linezolid therapy. Significant predictive factors for thrombocytopenia included the duration of linezolid therapy longer than or equal to 7 days (adjusted odds ratios [ORs] 7.25, 19.51 and 28.80; 95% confidence intervals [CIs] 1.92-27.38, 4.76-79.95 and 6.48-127.92 for 7-13 days, 14-20 days and ≥21 days, respectively; P < 0.01 for all values), baseline platelet count <150 × 10 /mm (adjusted OR, 5.08; 95% CI, 2.06-12.55; P < 0.001), creatinine clearance <30 mL/min (adjusted OR, 4.19; 95% CI, 1.59-11.06; P = 0.004) and concurrent low-dose aspirin therapy (adjusted OR, 2.99; 95% CI, 1.26-7.08; P = 0.013). Baseline platelet count less than 150 × 10 /mm was an independent predictor of early-onset (≤6 days) thrombocytopenia (adjusted OR, 5.07; 95% CI, 1.46-17.58; P = 0.011). Closer monitoring of platelet count is required in patients who receive parenteral linezolid therapy for 7 days or more, and have low baseline platelet counts or impaired renal function.
本研究旨在描述无血液肿瘤疾病住院患者接受注射用利奈唑胺治疗后血小板减少症的发生情况，并评估其预测因素。采用电子病历，对 2005 年 1 月至 2016 年 6 月期间所有接受注射用利奈唑胺治疗的成年住院患者进行回顾性安全性评估。所有患者平均年龄为 63.4（15.8）岁，在接受利奈唑胺治疗平均 11.2（7.4）天后，血小板减少症的发生率为 29.2%。血小板减少症的显著预测因素包括利奈唑胺治疗持续时间超过或等于 7 天（校正后的比值比[OR]为 7.25、19.51 和 28.80；95%置信区间[CI]为 1.92-27.38、4.76-79.95 和 6.48-127.92，持续 7-13 天、14-20 天和≥21 天；所有 P 值均<0.01），基线血小板计数<150×10 /mm（校正 OR，5.08；95%CI，2.06-12.55；P<0.001），肌酐清除率<30 mL/min（校正 OR，4.19；95%CI，1.59-11.06；P=0.004）和同时使用小剂量阿司匹林治疗（校正 OR，2.99；95%CI，1.26-7.08；P=0.013）。基线血小板计数<150×10 /mm是早期（≤6 天）血小板减少症的独立预测因素（校正 OR，5.07；95%CI，1.46-17.58；P=0.011）。对于接受利奈唑胺治疗 7 天或更长时间、基线血小板计数较低或肾功能受损的患者，需要更密切地监测血小板计数。
