Compassionate use of linezolid for adult Taiwanese patients with bone and joint infections.

BACKGROUND

Compassionate use of linezolid for bone and joint infections has been reported and hematological adverse reactions are a cause for concern. A similar experience in Asian people has not been reported.

METHODS

Adult cases that received linezolid for bone and joint infections at 3 Taiwanese medical centers from 2002 to 2006 were analyzed. We investigated factors associated with treatment outcome and hematological adverse reactions.

RESULTS

Of the 51 cases that received linezolid for more than 3 days, 41 (80.4%) had a favorable outcome and 10 had a failed outcome. Based on univariate analysis, patients with renal/urinary tract diseases, gastrointestinal diseases, higher WBC counts, a higher alanine aminotransferase level, or a higher creatinine level prior to linezolid treatment were significantly associated with a failed outcome. Based on multivariate analysis, underlying gastrointestinal disease was the only significant factor for a failed outcome. Six patients stopped linezolid use due to adverse reactions. A failed outcome was significantly associated with anemia caused by linezolid.

CONCLUSION

Linezolid is an effective salvage agent for bone and joint infections. However, adverse effects, especially hematological reactions, may cause drug discontinuation.