Shibata Yuichi, Hagihara Mao, Asai Nobuhiro, Shiota Arufumi, Hirai Jun, Mori Nobuaki, Mikamo Hiroshige
Department of Pharmacy, Aichi Medical University Hospital, Yazakokarimata, Nagakute 480-1195, Aichi, Japan.
Department of Clinical Infectious Diseases, Aichi Medical University, Yazakokarimata, Nagakute 480-1195, Aichi, Japan.
Antibiotics (Basel). 2023 Feb 7;12(2):345. doi: 10.3390/antibiotics12020345.
Linezolid (LZD) and Tedizolid (TZD) are oxazolidinone antibiotic for meticillin-resistant (MRSA). Severe hyponatremia after LZD administration have been reported. Severe hyponatremia cause seizures, unconsciousness, and even death. Therefore, we conducted a study to assess the change of serum sodium level after LZD and TZD therapy. We enrolled 67 patients treated with LZD and 28 treated with TZD. We monitored the serum sodium level from the administration to 14 days after administration of oxazolidinone drug. Hyponatremia was defined a sodiuln level ≤134 mmol/L after the initiation of oxazolidinone drug. The frequency of hyponatremia in the LZD group was significantly higher than that in the TZD group (39.7% vs. 11.1%, < 0.05). The rate of patients administered by injection was significantly higher than in the LZD group than in the TZD group (52.9% vs. 14.8%, < 0.01). Multiple logistic regression analyses identified the albumin level before the oxazolidinone drug therapy as the independent variables associated with the development of hyponatremia. We revealed that TZD is safer than LZD in terms of hyponatremia. Therefore, cases that LZD is administered by injection should be used more carefully with hyponatremia in patients with low albumin level.
利奈唑胺（LZD）和替加环素（TZD）是用于耐甲氧西林金黄色葡萄球菌（MRSA）的恶唑烷酮类抗生素。已有报道称使用LZD后会出现严重低钠血症。严重低钠血症会导致癫痫发作、意识丧失甚至死亡。因此，我们开展了一项研究，以评估LZD和TZD治疗后血清钠水平的变化。我们纳入了67例接受LZD治疗的患者和28例接受TZD治疗的患者。我们监测了从恶唑烷酮类药物给药至给药后14天的血清钠水平。低钠血症定义为恶唑烷酮类药物开始使用后血清钠水平≤134 mmol/L。LZD组低钠血症的发生率显著高于TZD组（39.7%对11.1%，<0.05）。LZD组注射给药的患者比例显著高于TZD组（52.9%对14.8%，<0.01）。多因素logistic回归分析确定恶唑烷酮类药物治疗前的白蛋白水平为与低钠血症发生相关的独立变量。我们发现，在低钠血症方面，TZD比LZD更安全。因此，对于白蛋白水平低的患者，LZD注射给药时应更谨慎地考虑低钠血症情况。
