Chest Infections: Chest Infections: Bacterial |

A Retrospective Study on Linezolid-Induced Hematological Adverse Reactions in Chinese Population FREE TO VIEW

Fang Jie
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Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A95. doi:10.1016/j.chest.2016.02.100
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SESSION TITLE: Chest Infections: Bacterial

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: To study cases of linezolid-induced hematological adverse reactions and to examine the risk factors associated with hematological adverse reactions.

METHODS: Retrospective analysis of clinic data of 197 hospitalized patients in Ruijin hospital from October 2012 to June 2013 who had been treated with Linezolid; Univariate and multivariate logistic regression were adopt to analyse the risk factors of linezolid-related hematological adverse reactions.

RESULTS:1. The rate of decreased hemoglobin (Hb) level during linezolid treatment was 31.98%. These with decreased hemoglobin (Hb) level had senior ageand lower creatinine clearance rate (CCr). Multivariate Logistic Regression Analysis showed that the risk factors leading to linezolid-related decreased Hb level included age, treatment course, CCr, and basal Hb level. 2. The rate of thrombocytopenia during linezolid treatment was 13.71%. Compared with non-thrombocytopenia, they had senior age, lower CCr, and lower basal platelet count. Binary Logistic Regression Analysis showed that the risk factors of linezolid-related thrombocytopenia included age CCr, alanine aminotransferase (ALT), aspartate transaminase (AST), total bilirubin (TB) and basal platelet count.

CONCLUSIONS:1. Doctors should be warned of the probability of decreased Hb count during linezolid treatment in Chinese population, especially when the patient is 65 years old or elder and has a CCr bellow 65ml/min plus a basal Hb level bellow 95g/L. 2. Doctors should be warned of the probability of Thrombocytopenia during linezolid treatment in Chinese population. We should be more careful about it when the patient is above 65 years old, has a CCr bellow 40ml/min, ALT above 70U/L, AST above 80U/L and a basal platelet level bellow175×109/L.

CLINICAL IMPLICATIONS: Linezolid has unique advantages, such as slight renal toxicity, strong tissue penetration, high bioavailability when given orally and so on, these advantages make it one of the first-line drugs against Gram-positive bacteria. But Linezolid also can causes toxic reaction in hematological system, such as low platelet count and anemia, raises concerns about the safety of its clinical use. And there has been scarcity of reports on the risk factors associated with linezolid-induced anemia in China. For enhancing safety of linezolid treatment in clinic practice, we need to explore effective controlling measures, including, of high importance, how to find the risk factors of hematological adverse reactions and how to monitor them.

DISCLOSURE: The following authors have nothing to disclose: Fang Jie

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