Occurrence of linezolid induced thrombocytopenia and its association with the risk factors: a review article

Radha A.; Anuradha H. V.; Radhika K.

doi:10.18203/2319-2003.ijbcp20184871

Authors

Radha A. Department of Pharmacology, M.S. Ramaiah Medical College, Bangalore, Karnataka, India
Anuradha H. V. Department of Pharmacology, M.S. Ramaiah Medical College, Bangalore, Karnataka, India
Radhika K. Department of Community Medicine, M.S. Ramaiah Medical College, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20184871

Keywords:

Baseline platelet count, Linezolid, Occurrence, Oxazolidinone, Risk factors, Thrombocytopenia

Abstract

Linezolid is the oxazolidinone group of antibiotic with wide range of activity against the gram positive bacteria including methicillin resistant staphylococcus aureus and penicillin resistant pneumococci and vancomycin resistant enterococci. Patients who are on linezolid were reported to have reversible myelosuppression especially thrombocytopenia and anaemia. Since there are less number of studies regarding the occurrence of thrombocytopenia and the risk factors associated with it, this study was undertaken to evaluate the occurrence of linezolid induced thrombocytopenia and its association with risk factors. It was a systematic review with synthesis of available literature in English language. Articles were retrieved using search terms included “linezolid”, “and”, “or”, “thrombocytopenia” from Clinical key and PubMed, published during 2000 - 2017. Out of 16 studies retrieved, only 7 studies were analysed based on inclusion and exclusion criteria; of them, 3 were found to be prospective and retrospective cohort each and only one was retrospective cross-sectional study. The occurrence of linezolid induced thrombocytopenia range from 18-50% with normal renal function and 57% of incidence associated with renal insufficiency patients. The risk factors were found to be dose of linezolid >18-27mg/kg, body weight of subjects <55kg, creatinine clearance <88.39 to 60ml/min/1.73m² and baseline platelet count <200*103/mm³, serum albumin concentration, serum creatinine, concomitant caspofungin therapy and duration of linezolid therapy.

Metrics

Metrics Loading ...

References

Niwa T, Watanabe T, Suzuki A, Ohmori T, Tsuchiya M, Suzuki T et al. Reduction of linezolid-associated thrombocytopenia by the dose adjustment based on the risk factors such as basal platelet count and body weight. Diagnostic Microbiology and Infectious Disease. 2014;79(1):93-7.

Dryden MS. Linezolid pharmacokinetics and pharmacodynamics in clinical treatment. J Antim chemoth. 2011;66(4):7-15.

Miller M, Schimz K. Oxazolidinones: a novel class of antibiotics. Cellular and Molecular Life Sciences (CMLS). 1999;56(3-4):280-5.

Zahedi BA, Rahbar M, Yousefi M, Asgharzadeh M, Samadi KH. Linezolid: a promising option in the treatment of Gram-positives. J Ant Chemoth. 2016;72(2):354-64.

Gemmell C. Virulence factor expression by Gram-positive cocci exposed to subinhibitory concentrations of linezolid. J Ant Chemoth. 2002;50(5):665-72.

Natsumoto B, Yokota K, Omata F, Furukawa K. Risk factors for linezolid-associated thrombocytopenia in adult patients. Infection. 2014;42(6):1007-12.

Hanai Y, Matsuo K, Ogawa M, Higashi A, Kimura I, Hirayama S, et al. A retrospective study of the risk factors for linezolid-induced thrombocytopenia and anemia. J Inf Chemoth. 2016;22(8):536-42.

Sweetman S. Antibacterial. In: Sweetman S, Blake P, editors. Martindale.The complete drug reference. 36th ed. London: Pharmaceutical Press; 2009:158-361.

MacDougall C. Protein synthesis inhibitors and miscellaneous antibacterial agents. In: brunton L, Dandan R, Knollman B, editors. Goodman and Gilman’s. The pharmacological basis of therapeutics. 13th ed. New york: Mc Graw Hill education; 2018:1049-1066.

Nukui Y, Hatakeyama S, Okamoto K, Yamamoto T, Hisaka A, Suzuki H, et al. High plasma linezolid concentration and impaired renal function affect development of linezolid-induced thrombocytopenia. J Ant Chemoth. 2013;68(9):2128-33.

Chen C, Guo D, Cao X, Cai Y, Xu Y, Zhu M, et al. Risk Factors for Thrombocytopenia in Adult Chinese Patients Receiving Linezolid Therapy. Current Therapeutic Research. 2012;73(6):195-206.

Loo A, Gerzenshtein L, Ison M. Antimicrobial Drug-Induced Thrombocytopenia: A Review of the Literature. Seminars in Thrombosis and Hemostasis. 2012;38(08):818-29.

Bi L, Zhou S. Thrombocytopenia in Elderly Patients Who Received Intravenous Linezolid Therapy. Int J Gerontol. 2014;8(1):46-7.

Wu H, Wen C, Jang Y, Chen H. DI-056 Linezolid induced thrombocytopenia in a patient with renal insufficiency: A case report and a retrospective case study. European J Hos Pharm. 2016;23(1):A142.2-43.

Garazzino S, De Rosa F, Bargiacchi O, Audagnotto S, Maiello A, Di Perri G. Haematological safety of long-term therapy with linezolid. Int J Antimi Agent. 2007;29(4):480-3.