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. 2020 Mar;39(3):527-538.
doi: 10.1007/s10096-019-03754-1. Epub 2019 Dec 18.

Risk factor analysis for linezolid-associated thrombocytopenia in critically ill patients

Julien Cazavet  1   2 , Fanny Vardon Bounes  1   2 , Stéphanie Ruiz  1   2 , Thierry Seguin  1   2 , Laure Crognier  1   2 , Antoine Rouget  1   2 , Olivier Fourcade  1   2 , Vincent Minville  1   2 , Jean-Marie Conil  1   2 , Bernard Georges  3   4
Affiliations

Risk factor analysis for linezolid-associated thrombocytopenia in critically ill patients

Julien Cazavet et al. Eur J Clin Microbiol Infect Dis. 2020 Mar.

Abstract

Linezolid is an antibiotic used against gram-positive bacteria, including methicillin-resistant Staphylococcus aureus. Its primary adverse effect is haematotoxicity. The objective of this study was to analyse the risk factors for onset of thrombocytopenia in critically ill patients treated with linezolid. This was a retrospective, single-centre study of 72 patients. Platelets were measured from D0 to D20 after the start of treatment. The risk factors for thrombocytopenia were identified using a multivariate logistic regression analysis following a Monte Carlo simulation. Following ROC curve analysis, a baseline platelet count lower than 108 × 109/L and a Cmin higher than 4 mg/L, with respective odds ratios of 117 (95% CI [97-206]) and 3 (95% CI [1.5-6.2]) in the simulated population, were identified as risk factors. Among the source population patients combining these 2 factors, a significantly higher number developed thrombocytopenia (66.7% vs. 33.3%, p = 0.0042). A baseline platelet count lower than 108 × 109/L and a Cmin higher than 4 mg/L are risk factors for the onset of thrombocytopenia in critically ill patients treated with linezolid.

Keywords: Haematotoxicity; Linezolid; Thrombocytopenia.

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