Early lactic acidosis associated with linezolid therapy in paediatric patients

Özkaya-Parlakay, Aslınur; Kara, Ateş; Celik, Melda; Özsürekçi, Yasemin; Öncel, Eda Karadağ; Ceyhan, Mehmet; Cengiz, Ali Bülent

doi:10.1016/j.ijantimicag.2014.06.017

Cited by 20 publications

(15 citation statements)

References 27 publications

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“…As a matter of fact, linezolid is a relatively recent drug with limited data in neonates. Previous data in children that linezolid could induce reversible myelosuppression (mostly thrombocytopenia but also anemia and leucopenia) (20), lactic acidosis (21), gut disorders (13) and in rare cases neuropathy (22). In our cohort no side effects were reported.…”

Section: Discussionsupporting

confidence: 47%

Increasing use of linezolid in a tertiary NICU during a 10-year period: reasons and concerns for the future

Matrat

Plaisant

Barreto

et al. 2020

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Background: Linezolid has been increasingly used in tertiary NICUs. The objectives of this study were to explore the indications of these linezolid prescriptions, to analyze a possible misuse and to provide solutions to avoid such misuse.Methods: A monocentric retrospective cohort study included all neonates hospitalized in one tertiary NICU between January 1st, 2010 and December 31st, 2019 and who received at least one administration of linezolid. These data were confronted to epidemiological and antibiotic use data from the same NICU. Two independent pediatricians secondarily classified linezolid uses as adequate or not.Results: During the study period, 66 infections in 57 patients led to linezolid use. Most patients were pre-term and 21 patients (37%) died. Infections were mainly related to methicillin-resistant coagulase negative staphylococci and were frequently either pneumoniae (35%) or isolated bacteremia (48%), including 25 persistent bacteremia (64% of the 39 bacteremia). Need for a better tissue distribution or first-line treatment failure were the main reasons to initiate linezolid. Linezolid was administered for a median duration of 7 [3;10] days. No side effects were reported. Twenty-two (33%) of the 66 linezolid prescriptions were retrospectively classified as inadequate. Conclusions: A rapid increase in linezolid prescriptions has been observed in our tertiary NICU, from 2014 to 2019, with 33% inadequate uses. This worrisome trend should lead to search for therapeutic alternatives and to work on antibiotic stewardship to prevent the emergence of new antimicrobial bacterial resistance.

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Section: Discussionsupporting

confidence: 47%

Increasing use of linezolid in a tertiary NICU during a 10-year period: reasons and concerns for the future

Matrat

Plaisant

Barreto

et al. 2020

Preprint

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“…Previous reports have shown that LILA is associated with a longer duration of medication [15,16,[22][23][24] . In a retrospective study, a duration of linezolid therapy > 6 weeks was a risk factor for LILA [19] , but LILA has been reported to occur after a shorter duration of linezolid therapy (4 hours-7 days) [21,[25][26][27][28] and to occur even earlier in children, with a median time of 2 (1,13) days [29] . Del Pozo showed that the median duration of the administration of linezolid in lactic acidosis patients was 8 days [20] .…”

Section: Discussionmentioning

confidence: 99%

The risk factors for linezolid-induced lactic acidosis in patients older than 85 years

Liu

Li²,

Liu

et al. 2020

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Background Lactate is considered a prognostic indicator in critically ill patients; however, studies on linezolid-induced lactic acidosis (LILA) are limited, and data from patients older than 85 are even more scarce, therefore we evaluated the risk factors for LILA in patients older than 85 years and established a risk prediction model. Methods In a retrospective cohort study, patients older than 85 years who were monitored for blood gas analysis and arterial lactate levels during the use of teicoplanin or linezolid were enrolled. After using propensity score-matched analyses we compared the incidence of lactic acidosis between teicoplanin or linezolid therapy and identified the risk factors of LILA. Results After propensity score-matched analyses, the incidence of lactic acidosis with teicoplanin therapy was significantly lower than that with linezolid therapy (0% vs 35.7%; p<0.0001). Duration of linezolid therapy ≥9 days (OR,3.541;95%CI,1.161-10.793; p=0.026), arterial blood glucose level ≥8 mmol/L (OR, 4.548; 95% CI, 1.507-13.725; p=0.007) and high sequential organ failure assessment (SOFA) score (OR, 1.429; 95% CI, 1.213-1.685; p<0.0001) were risk factors for LILA. A risk model is predictive of LILA (area under the curve, 0.849; specificity, 65.1%; sensitivity, 91.4%, with a negative predictive value of 93.2% and a positive predictive value of 59.3%) with high stability. Conclusions LILA can occur in patients older than 85 years with a relatively shorter duration of linezolid; hence, the close monitoring of blood gas and arterial lactate levels during the use of linezolid in the super-elderly population is necessary.

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“…21 However, linezolid-related lactic acidosis in children tends to develop earlier than adults that in two reports, lactic acidosis had been detected on the first two days of linezolid administrations. 22,23 Thus, it can be assumed that adverse effects in children may occur earlier than adults due to differences in pharmacokinetics and toxicodynamics of linezolid in pediatric population.…”

Section: Discussionmentioning

confidence: 99%

Linezolid-related adverse effects in clinical practice in children

et al. 2017

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Introduction:Linezolid may cause adverse effects such as thrombocytopenia, which were found to be dependent on receiving linezolid for longer than 2 weeks. There are limited studies concerning the safety and timing of linezolidrelated adverse effects in children. Objective of this study was to evaluate the incidence of adverse effects associated with linezolid, with especially focusing on the time of occurrence. Population and Methods: All children (≤18 years of age) who received ≥3 days of linezolid therapy were included in this study. Adverse effects attributed to linezolid and time of occurrence of side effects was evaluated.

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Early lactic acidosis associated with linezolid therapy in paediatric patients

Cited by 20 publications

References 27 publications

Increasing use of linezolid in a tertiary NICU during a 10-year period: reasons and concerns for the future

Increasing use of linezolid in a tertiary NICU during a 10-year period: reasons and concerns for the future

The risk factors for linezolid-induced lactic acidosis in patients older than 85 years

Linezolid-related adverse effects in clinical practice in children

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