Kaya Kılıç Esra, Bulut Cemal, Sönmezer Meliha Çağla, Ozel Özlem, Ataman Hatipoğlu Çiğdem, Tuncer Ertem Günay, Tülek Necla, Kınıklı Sami
Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey.
Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Gülhane Training and Research Hospital, Ankara, Turkey.
J Infect Dev Ctries. 2019 Oct 31;13(10):886-891. doi: 10.3855/jidc.10859.
Linezolid is a synthetic antimicrobial agent with a broad spectrum of activity against virtually all Gram-positive bacteria. Although linezolid is generally well tolerated, the prolonged use of linezolid can lead to myelosuppression, including neutropenia, thrombocytopenia, and anemia. The aim of this study was investigating the risk factors for thrombocytopenia in patients who received linezolid therapy.
This retrospective study was performed on patients who received linezolid therapy between July 2007 and December 2017. Thrombocytopenia was defined as either a platelets count of < 100×109/L or a 25% reduction from the baseline platelet count.
A total of 371 patients, (198 (53%) male and 173(47%) female were included into the study. Mean duration of therapy was 12.81 ± 5.19 days. Linezolid-induced thrombocytopenia was detected in a total of 111 patients. Using the univariate analysis advanced sex, serum urea concentration, baseline platelet level and low eGFR value were found to be risk factors for linezolid associated thrombocytopenia (p < 0.05). According to a multivariate analysis, patients undergoing carbapenem treatment combination therapy (p = 0.003) and with a baseline platelet level of < 200×109/L (p = 0.00) were found to have a high risk of developing thrombocytopenia.
Several factors may influence of linezolid associated thrombocytopenia. Platelet count should be monitored during therapy and thrombocytopenia should be kept in mind in patients with baseline platelet level of < 200×109/L, low eGFR, linezolid-carbapenem combination therapy.
利奈唑胺是一种合成抗菌剂，对几乎所有革兰氏阳性菌都有广泛的活性。尽管利奈唑胺通常耐受性良好，但长期使用利奈唑胺会导致骨髓抑制，包括中性粒细胞减少、血小板减少和贫血。本研究的目的是调查接受利奈唑胺治疗的患者发生血小板减少的危险因素。
本回顾性研究对2007年7月至2017年12月期间接受利奈唑胺治疗的患者进行。血小板减少定义为血小板计数<100×10⁹/L或血小板计数较基线水平降低25%。
共有371例患者纳入研究，其中男性198例（53%），女性173例（47%）。平均治疗时间为12.81±5.19天。共111例患者检测到利奈唑胺诱导的血小板减少。单因素分析发现，高龄、血清尿素浓度、基线血小板水平和低估算肾小球滤过率（eGFR）值是利奈唑胺相关血小板减少的危险因素（p<0.05）。多因素分析显示，接受碳青霉烯类联合治疗的患者（p=0.003）和基线血小板水平<200×10⁹/L的患者（p=0.00）发生血小板减少的风险较高。
多种因素可能影响利奈唑胺相关血小板减少。治疗期间应监测血小板计数，对于基线血小板水平<200×10⁹/L、eGFR低、接受利奈唑胺-碳青霉烯类联合治疗的患者，应警惕血小板减少。
