Al Qamariat Zahra, Aljaffar Amnah A, Alabdulaal Zahra Salman, Alnezir Fatima, Al-Zawad Weaam M, Alqattan Mohammed, Almahdi Abdulmohsen
Pharmaceutical Affairs, Dammam Health Network, Dammam, Eastern Province, Saudi Arabia.
Pharmacy Department, Saudi German Hospital, Dammam, Eastern Province, Saudi Arabia.
Drug Healthc Patient Saf. 2024 May 21;16:43-49. doi: 10.2147/DHPS.S458284. eCollection 2024.
Thrombocytopenia is a common and potentially severe adverse effect of linezolid, but the time to onset during treatment has varied substantially across studies. Moreover, the time to recovery after linezolid withdrawal has not been examined in a larger patient sample.
The first objective of this study was to measure the mean time to linezolid-induced thrombocytopenia (LIT) and the second was to measure the mean time to recovery after linezolid discontinuation.
A retrospective observational cohort study was conducted between January 2017 and December 2022 at Dammam Medical Complex using the medical records of hospitalized adults with normal baseline platelet counts receiving intravenous linezolid for a minimum of 48 hours. All patients included in the analyses received daily platelet count monitoring for up to 14 days after linezolid initiation and 14 days after discontinuation. Thrombocytopenia was defined as a drop in platelet count to <150 × 10/L or <50% of baseline within 14 days. The dose duration-risk relationship and recovery rate were analyzed by constructing Kaplan-Meier survival curves.
In total, 334 patients met study inclusion criteria. The mean time to develop thrombocytopenia after starting linezolid was five days, and the mean time of recovery was also 5 days. The cumulative risk of thrombocytopenia reached 100% by day six of therapy, and cumulative recovery reached 100% by day six after linezolid withdrawal, with half of the study population recovering by day four.
Thrombocytopenia can develop rapidly during linezolid treatment, but recovery after discontinuation is also rapid. Rapid thrombocytopenia is a common adverse effect of linezolid that must be considered prior to prescription, and routine monitoring of platelet count is recommended so that linezolid treatment can be discontinued, if thrombocytopenia occurs.
血小板减少症是利奈唑胺常见且可能严重的不良反应，但治疗期间发病时间在各项研究中差异很大。此外，在更大规模的患者样本中尚未对停用利奈唑胺后的恢复时间进行研究。
本研究的首要目的是测量利奈唑胺诱导的血小板减少症（LIT）的平均发病时间，第二个目的是测量停用利奈唑胺后的平均恢复时间。
2017年1月至2022年12月在达曼医疗中心进行了一项回顾性观察队列研究，使用接受静脉注射利奈唑胺至少48小时且基线血小板计数正常的住院成人的病历。所有纳入分析的患者在利奈唑胺开始使用后最多14天以及停药后14天接受每日血小板计数监测。血小板减少症定义为血小板计数在14天内降至<150×10⁹/L或低于基线的50%。通过构建Kaplan-Meier生存曲线分析剂量持续时间-风险关系和恢复率。
共有334名患者符合研究纳入标准。开始使用利奈唑胺后发生血小板减少症的平均时间为5天，恢复的平均时间也是5天。治疗第6天时血小板减少症的累积风险达到100%，利奈唑胺停药后第6天时累积恢复率达到100%，一半的研究人群在第4天恢复。
利奈唑胺治疗期间血小板减少症可能迅速发生，但停药后恢复也很快。快速血小板减少症是利奈唑胺常见的不良反应，在开处方前必须考虑，建议常规监测血小板计数，以便在发生血小板减少症时停用利奈唑胺治疗。
