Department of Pharmacy, The Fifth Affiliated Hospital of Guangxi Medical University & The First People's Hospital of Nanning, Nanning, China.
Department of Pharmacy, Guangxi International Zhuang Medicine Hospital, Nanning, China.
J Infect Dev Ctries. 2024 Aug 31;18(8):1258-1264. doi: 10.3855/jidc.18366.
This single-center, observational cohort study aimed to investigate the risk factors associated with linezolid-induced hematological toxicity by analyzing the linezolid trough concentration (Cmin) obtained from patients undergoing treatment between January 2020 and December 2021.
A total of 111 eligible individuals were included in the study, of which 47 were diagnosed with linezolid-induced thrombocytopenia and 18 were diagnosed with linezolid-induced hemoglobin decrease.
Binary logistic regression analysis revealed that creatinine clearance level (Ccr) < 50 mL/min/1.73 m2 (OR, 5.463; 95% CI, 1.249-23.888, p = 0.024) and Cmin > 7 mg/L (OR, 62.660; 95% CI, 14.293-274.708, p = 0.001) were risk factors associated with linezolid-induced thrombocytopenia. Area under the ROC curve for Cmin was 0.955, with a maximum Youden index of 0.837. The corresponding critical value was 6.94 mg/L (sensitivity 91.5%; specificity 92.2%). Ccr < 50 mL/min/1.73 m2 (OR, 7.282; 95% CI, 1.765-30.048, p = 0.006) and Cmin > 7mg/L (OR, 6.364; 95% CI, 1.937-20.910, p = 0.020) were found to be associated with linezolid-induced hemoglobin reduction. The area under the ROC curve for Cmin was 0.755, Youden index was 0.477 at the maximum, and the corresponding critical value was 7.53 mg/L (sensitivity 77.8%; specificity 69.9%).
Renal insufficiency is a related risk factor for linezolid-induced hematological toxicity. Patients receiving linezolid treatment should be closely monitored with blood routine and plasma concentration, particularly in patients with moderate or severe renal insufficiency. The plasma trough concentration of linezolid could be a suitable predictor for linezolid-induced thrombocytopenia and anemia.
本单中心观察性队列研究旨在通过分析 2020 年 1 月至 2021 年 12 月期间接受治疗的患者的利奈唑胺谷浓度（Cmin），来探讨与利奈唑胺引起的血液毒性相关的危险因素。
共纳入 111 名符合条件的个体，其中 47 名诊断为利奈唑胺引起的血小板减少症，18 名诊断为利奈唑胺引起的血红蛋白减少症。
二元逻辑回归分析显示，肌酐清除率（Ccr）<50 mL/min/1.73 m2（OR，5.463；95%CI，1.249-23.888，p=0.024）和 Cmin>7mg/L（OR，62.660；95%CI，14.293-274.708，p=0.001）是与利奈唑胺引起的血小板减少症相关的危险因素。Cmin 的 ROC 曲线下面积为 0.955，最大 Youden 指数为 0.837。相应的临界值为 6.94mg/L（敏感性 91.5%；特异性 92.2%）。Ccr<50 mL/min/1.73 m2（OR，7.282；95%CI，1.765-30.048，p=0.006）和 Cmin>7mg/L（OR，6.364；95%CI，1.937-20.910，p=0.020）与利奈唑胺引起的血红蛋白减少有关。Cmin 的 ROC 曲线下面积为 0.755，最大 Youden 指数为 0.477，相应的临界值为 7.53mg/L（敏感性 77.8%；特异性 69.9%）。
肾功能不全是利奈唑胺引起血液毒性的相关危险因素。接受利奈唑胺治疗的患者应密切监测血常规和血浆浓度，特别是在中重度肾功能不全的患者中。利奈唑胺的血药谷浓度可作为预测利奈唑胺引起血小板减少症和贫血的合适指标。
