A retrospective cohort study to screen linezolid-induced thrombocytopenia in adult patients hospitalized in the Midwestern Region of Brazil

Lima, Letícia Souza; Brito, Eliana da Costa Alvarenga de; Mattos, Karine; Parisotto, Eduardo Benedetti; Perdomo, Renata Trentin; Weber, Simone Schneider

doi:10.1016/j.htct.2019.07.004

Cited by 20 publications

(33 citation statements)

References 29 publications

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“…In the pivotal CTs, the incidence of tedizolid-induced thrombocytopenia was 6.4% at the end of treatment visit (4), and Kim et al reported 1 patient (4%) developing thrombocytopenia out of 25 patients being treated with tedizolid during a median of 91 days (11). Here, we described thrombocytopenia in 7.4% of patients after a median of 26.5 days of tedizolid, which is in line with previous results and suggests a lower incidence than the one reported with linezolid in real-life studies (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). Since anemia at baseline was common in our patients, we decided to evaluate the proportion of patients with a reduction of Ն2 g/liter of hemoglobin at any time during treatment with tedizolid.…”

Section: Discussionsupporting

confidence: 90%

Safety and Tolerability of More than Six Days of Tedizolid Treatment

Mensa-Vendrell

Pitarch

Lletí

et al. 2020

Antimicrob Agents Chemother

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Tedizolid has demonstrated its efficacy and safety in clinical trials; however, data concerning its tolerability in long-term treatments are scarce. The aim of the study was to assess the indications and to describe the long-term safety profile of tedizolid. A multicentric retrospective study of patients who received tedizolid for more than 6 days was conducted. Adverse events (AEs) were identified from patients’ medical records and laboratory data. The World Health Organization causality categories were used to discern AEs that were probably associated with tedizolid. Eighty-one patients, treated with tedizolid 200 mg once daily for a median (interquartile range [IQR]) duration of 28 (14 to 59) days, were included; 36 (44.4%) had previously received linezolid. The most common reasons for selecting tedizolid were to avoid linezolid potential toxicities or interactions (53.1%) or due to previous linezolid-related toxicities (27.2%). The most common indications were off-label, including prosthetic joint infections, osteomyelitis, and respiratory infections (77.8%). Overall, 9/81 patients (11.1%) experienced a probably associated AE. Two patients (2.5%) developed gastrointestinal disorders, 1 (1.2%) developed anemia, and 6 developed thrombocytopenia (7.4%) after a median (IQR) duration of treatment of 26.5 (17 to 58.5) days. Four (5%) patients discontinued tedizolid due to AEs. Among 23 patients with chronic renal failure (CRF), the rate of myelotoxicity was 17.4%, and only 8.7% had to stop tedizolid; 20 out of 22 with previous linezolid-associated toxicity had no AE. Long-term tedizolid treatments had good tolerance with rates of gastrointestinal AE and hematological toxicity lower than those reported with linezolid, particularly in patients with CRF and in those with a history of linezolid-associated toxicity.

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Section: Discussionsupporting

confidence: 90%

Safety and Tolerability of More than Six Days of Tedizolid Treatment

Mensa-Vendrell

Pitarch

Lletí

et al. 2020

Antimicrob Agents Chemother

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“…According to recent studies, the incidence of thrombocytopenia ranged from 16.7-48.4% in adults treated with linezolid [4][5][6][7][8][9][10][11][12][13]. Kim et al [10] revealed a 48.3% risk of thrombocytopenia in a cohort of 60 ICU patients, and thrombocytopenia was de ned as a platelet count of < 150,000 cells/mm 3 or a decrease of at least 50% from the baseline.…”

Section: Discussionmentioning

confidence: 99%

“…Although under longer treatment durations, linezolid-treated patients had a higher potential for lower platelet counts compared to the comparator, the difference was not statistically signi cant. However, emerging observational studies have demonstrated the thrombocytopenic effect of linezolid [4][5][6][7][8][9][10][11][12][13]. Depending on different de nitions of thrombocytopenia, the incidence of thrombocytopenia ranged from 16.7-48.4% in adults treated with intravenous or oral linezolid [4][5][6][7][8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

“…Although several studies have highlighted the susceptible population of linezolid-associated thrombocytopenia, the results are inconclusive. Possible risk factors including high daily dose per kg [4,6], long duration [5,8,11,13], renal impairment [5][6][7][8][10][11][12][13], and low baseline platelet counts [9,11,12] have been reported. One study [9] showed that carbapenem combination therapy and low baseline platelet count were signi cant predictors, and the duration of linezolid administration or renal function had little effect.…”

Section: Introductionmentioning

confidence: 99%

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Renal Replacement Therapy and Concurrent Fluconazole Therapy Increase Linezolid-Related Thrombocytopenia Among Adult Patients

Hsu

Chen

Hung

et al. 2021

Preprint

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Background: Linezolid, an antibiotic used against gram-positive pathogens, has been reported to be associated with thrombocytopenia. However, limited information is available on susceptibility to thrombocytopenia after linezolid usage. We aimed to investigate the risk factors for linezolid-associated thrombocytopenia. Methods: We conducted a retrospective cohort study of patients aged ≥ 18 years who received linezolid for ≥ 5 d during hospitalization in 2019. Demographic information, hospitalized information and laboratory data were extracted from electronic medical records. Thrombocytopenia was defined as a platelet count of <100,000 cells/mm3 or a reduction from baseline ≥ 25%. Binary logistic regression and survival analyses were used to evaluate the risk factors for linezolid-associated thrombocytopenia.Results: A total of 98 patients were enrolled. Thrombocytopenia occurred in 52 patients (53.1%), with a median first presentation 9 d after initiation of linezolid. There was no significant difference in the mortality or proportion of platelet transfusions between patients with and without thrombocytopenia. A higher risk of linezolid-associated thrombocytopenia was found in patients who received renal replacement therapy (RRT) (OR 4.8 [1.4-16.4]), concurrent fluconazole (OR 3.5 [1.2-9.8]), or a longer duration of linezolid treatment (OR 1.1 [1.0-1.1]). Patients who received RRT or concurrent fluconazole therapy had a shorter median time to develop thrombocytopenia (with vs. without RRT: 8 vs. 15 d; with vs. without fluconazole: 11 vs. 15 d). Those who simultaneously received RRT and fluconazole had the shortest median of time (6.5 d) and the highest risk of developing thrombocytopenia (87.5%).Conclusions: Patients who received RRT, concurrent fluconazole treatment, or a longer-duration linezolid had a higher risk of developing linezolid-associated thrombocytopenia.

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“…Although under longer treatment durations, linezolidtreated patients had a higher potential for lower platelet counts compared to the comparator, the difference was not statistically signi cant. However, emerging observational studies have demonstrated the thrombocytopenic effect of linezolid [4][5][6][7][8][9][10][11][12][13] . Depending on different de nitions of thrombocytopenia, the incidence of thrombocytopenia ranged from 16.7-48.4% in adults treated with intravenous or oral linezolid [4][5][6][7][8][9][10][11][12][13] .…”

Section: Introductionmentioning

confidence: 99%

Renal Replacement Therapy and Concurrent Fluconazole Therapy Increase Linezolid-Related Thrombocytopenia Among Adult Patients

Hsu

Chen

Hung

et al. 2021

Preprint

View full text Add to dashboard Cite

Linezolid has been reported to be associated with thrombocytopenia. However, limited information is available on susceptibility to thrombocytopenia after linezolid usage. We aimed to investigate the risk factors for linezolid-associated thrombocytopenia (LAT). We conducted a retrospective cohort study of patients aged ≥ 18 years who received linezolid for ≥ 5 d during hospitalization in 2019. Information was extracted from electronic medical records. Thrombocytopenia was defined as a platelet count of < 100×109/L or a reduction from baseline ≥ 25%. Binary logistic regression and survival analyses were used to evaluate the risk factors for LAT. A total of 98 patients were enrolled. Thrombocytopenia occurred in 53.1% patients, with a median of 9 d after initiation of linezolid. There was no significant difference in the mortality or proportion of platelet transfusions between patients with and without thrombocytopenia. A higher risk of LAT was found in patients who received renal replacement therapy (RRT) (OR 4.8 [1.4–16.4]), concurrent fluconazole (OR 3.5 [1.2–9.8]), or a longer duration of linezolid treatment (OR 1.1 [1.0-1.1]). Patients who received RRT (8 vs. 15 d) or concurrent fluconazole (11 vs. 15 d) had a shorter median time to develop thrombocytopenia. Those who simultaneously received RRT and fluconazole had the shortest median of time (6.5 d) and the highest risk of developing thrombocytopenia (87.5%).

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A retrospective cohort study to screen linezolid-induced thrombocytopenia in adult patients hospitalized in the Midwestern Region of Brazil

Cited by 20 publications

References 29 publications

Safety and Tolerability of More than Six Days of Tedizolid Treatment

Safety and Tolerability of More than Six Days of Tedizolid Treatment

Renal Replacement Therapy and Concurrent Fluconazole Therapy Increase Linezolid-Related Thrombocytopenia Among Adult Patients

Renal Replacement Therapy and Concurrent Fluconazole Therapy Increase Linezolid-Related Thrombocytopenia Among Adult Patients

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