Risk factors for linezolid-induced thrombocytopenia in patients without haemato-oncologic diseases.

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Risk factors for linezolid-induced thrombocytopenia in patients without haemato-oncologic diseases.

Basic Clin Pharmacol Toxicol. 2018 Sep 01;:

Authors: Choi GW, Lee JY, Chang MJ, Kim YK, Cho Y, Yu YM, Lee E

Abstract
This study aimed to describe the occurrence and to evaluate the predictive factors of thrombocytopenia caused by parenteral linezolid in hospitalised patients without haemato-oncologic diseases. Using electronic medical records, a retrospective safety evaluation was performed among all hospitalised adult patients who received parenteral linezolid therapy between January 2005 and June 2016. Of all identified 264 patients with an average age of 63.4 (SD 15.8) years, thrombocytopenia occurred at a rate of 29.2% after an average of 11.2 (SD 7.4) days of the initiation of linezolid therapy. Significant predictive factors for thrombocytopenia included the duration of linezolid therapy longer than or equal to 7 days (adjusted odds ratios [ORs] 7.25, 19.51, and 28.80; 95% confidence intervals [CIs] 1.92-27.38, 4.76-79.95, and 6.48-127.92 for 7-13 days, 14-20 days, and ≥21 days, respectively; p < 0.01 for all values), baseline platelet count less than 150 ×103 /mm3 (adjusted OR, 5.08; 95% CI, 2.06-12.55; p < 0.001), creatinine clearance less than 30 mL/min (adjusted OR, 4.19; 95% CI, 1.59-11.06; p = 0.004), and concurrent low-dose aspirin therapy (adjusted OR, 2.99; 95% CI, 1.26-7.08; p = 0.013). Baseline platelet count less than 150 ×103 /mm3 was an independent predictor of early-onset (≤6 days) thrombocytopenia (adjusted OR, 5.07; 95% CI, 1.46-17.58; p = 0.011). Closer monitoring of platelet count is required in patients who receive parenteral linezolid therapy for 7 days or more, and have low baseline platelet counts or impaired renal function. This article is protected by copyright. All rights reserved.

PMID: 30171804 [PubMed - as supplied by publisher]