Department of Clinical Pharmacy, Oita University Hospital, Yufu-shi, Japan.
Department of Respiratory Medicine and Infectious Diseases, Faculty of Medicine, Oita University, Yufu-shi, Japan.
J Clin Pharm Ther. 2021 Apr;46(2):343-351. doi: 10.1111/jcpt.13287. Epub 2020 Oct 5.
Thrombocytopenia is one of the typical adverse events caused by linezolid (LZD). Recently, some cases of severe hyponatraemia occurring while receiving LZD have been reported. This study investigated a possible relationship between LZD-induced hyponatraemia and thrombocytopenia and identified the risk factors for hyponatraemia and/or thrombocytopenia.
In this retrospective, single-centre, observational cohort study, 63 hospitalized patients aged over 18 years who received intravenous injection of LZD for more than seven consecutive days in Oita University Hospital between April 2015 and March 2018 were analysed.
Thrombocytopenia occurred in 25 (39.7%) patients and hyponatraemia in 11 (17.5%) patients. Seven of 11 patients with hyponatraemia had concurrent thrombocytopenia. Although both serum sodium level and platelet count declined in most patients who developed hyponatraemia, no significant association between thrombocytopenia and hyponatraemia was found. Creatinine clearance level (Ccr) was significantly lower not only in the thrombocytopenia (vs no-thrombocytopenia) but also in the hyponatraemia group (vs no-hyponatraemia group). Univariate and multivariate logistic regression analyses identified different risk factors for thrombocytopenia and/or hyponatraemia (thrombocytopenia: Ccr and administration period; hyponatraemia: serum albumin; thrombocytopenia and hyponatraemia: administration period and serum albumin).
In conclusion, this study found no significant relationship between LZD-induced thrombocytopenia and hyponatraemia and identified some possible risk factors associated with onset of the two adverse events. These require further validation.
血小板减少症是利奈唑胺（LZD）引起的典型不良反应之一。最近，有报道称在使用 LZD 时会发生严重低钠血症。本研究调查了 LZD 引起的低钠血症和血小板减少症之间的可能关系，并确定了低钠血症和/或血小板减少症的危险因素。
在这项回顾性、单中心、观察性队列研究中，分析了 2015 年 4 月至 2018 年 3 月期间在大分大学医院接受 LZD 静脉注射超过 7 天的 63 名年龄在 18 岁以上的住院患者。
25 名（39.7%）患者出现血小板减少症，11 名（17.5%）患者出现低钠血症。7 名低钠血症患者同时伴有血小板减少症。尽管大多数发生低钠血症的患者的血清钠水平和血小板计数都下降了，但血小板减少症与低钠血症之间没有显著关联。虽然血小板减少症（与无血小板减少症相比）和低钠血症组（与无低钠血症组相比）的肌酐清除率（Ccr）都显著降低，但无统计学意义。单因素和多因素逻辑回归分析确定了血小板减少症和/或低钠血症的不同危险因素（血小板减少症：Ccr 和给药期；低钠血症：血清白蛋白；血小板减少症和低钠血症：给药期和血清白蛋白）。
总之，本研究发现 LZD 引起的血小板减少症与低钠血症之间没有显著关系，并确定了一些可能与两种不良反应发生相关的危险因素。这些需要进一步验证。
