Renal replacement therapy and concurrent fluconazole therapy increase linezolid-related thrombocytopenia among adult patients

• Published in: Scientific reports Vol. 12; no. 1; p. 9894
• Main Authors: Hsu, Yueh-Chun, Chen, Szu-Ying, Hung, Yung-Jun, Huang, Yu-Wei
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 14.06.2022; Nature Publishing Group; Nature Portfolio
• Subjects: 692/499; 692/700/565/1436/2774; 692/700/565/2194; Antifungal agents; Electronic medical records; Fluconazole; Humanities and Social Sciences; Linezolid; multidisciplinary; Patients; Platelets; Renal replacement therapy; Risk factors; Science; Science (multidisciplinary); Thrombocytopenia
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-022-13874-y

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 × 10 9 /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]), or concurrent fluconazole (OR 3.5 [1.2–9.8]). 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%).