Therapeutic drug monitoring · 2025
Effects of Different Linezolid Concentration Levels on Hematologic Side Effects: A New Target for Therapeutic Drug Monitoring.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Liu Tingting, Liu Bing, Geng Guangrui, Yang Ping, Wang Zidu, Wang Fang, Zhao Junshuai, Liu Jiaxin, Ma Xuewei, Li Zeyu, Zhang Lulu, Chen Xiaomin, Fang Xiangqun, Xie Lixin, Li Hongxia
Аннотация
BACKGROUND: The emergence of a linezolid minimum inhibitory concentration creep (2-4 mg/L) necessitates higher trough concentrations (C min ), which may increase the risk of hematological side effects. Evaluating the effects of different linezolid C min levels on hematological indices and determining a new target C min range are essential.
METHODS: Elderly patients receiving linezolid at 4 tertiary hospitals between May 2021 and March 2024 were grouped according to their C min levels. Linezolid C min and hematological indices were monitored dynamically.
RESULTS: A total of 320 patients were enrolled, and 128 patients were included in the analysis of hematological side effects following propensity score matching between C min >16 mg/L and C min ≤16 mg/L. The incidence of thrombocytopenia and the reduction in platelet count were significantly greater in patients with C min >16 mg/L compared with those with C min ≤16 mg/L. However, no significant differences were observed in the incidence of anemia or changes in hemoglobin levels. Among the 96 patients with C min ≤16 mg/L, multivariate analysis identified C min as an independent risk factor for thrombocytopenia but not for anemia. Furthermore, no significant difference in thrombocytopenia risk was found between patients with C min levels of 8-14.5 mg/L and those with C min of <8 mg/L (odds ratio, 1.183; 95% confidence interval, 0.428-3.275; P = 0.746).
CONCLUSIONS: In elderly patients, hematological side effects did not increase with increasing C min levels up to 14.5 mg/L. These findings suggest that a target C min range of 2-14.5 mg/L may be appropriate for the elderly population receiving linezolid.
CLINICAL TRIAL REGISTRATION NUMBER: ChiCTR2100045707; April 23, 2021.
METHODS: Elderly patients receiving linezolid at 4 tertiary hospitals between May 2021 and March 2024 were grouped according to their C min levels. Linezolid C min and hematological indices were monitored dynamically.
RESULTS: A total of 320 patients were enrolled, and 128 patients were included in the analysis of hematological side effects following propensity score matching between C min >16 mg/L and C min ≤16 mg/L. The incidence of thrombocytopenia and the reduction in platelet count were significantly greater in patients with C min >16 mg/L compared with those with C min ≤16 mg/L. However, no significant differences were observed in the incidence of anemia or changes in hemoglobin levels. Among the 96 patients with C min ≤16 mg/L, multivariate analysis identified C min as an independent risk factor for thrombocytopenia but not for anemia. Furthermore, no significant difference in thrombocytopenia risk was found between patients with C min levels of 8-14.5 mg/L and those with C min of <8 mg/L (odds ratio, 1.183; 95% confidence interval, 0.428-3.275; P = 0.746).
CONCLUSIONS: In elderly patients, hematological side effects did not increase with increasing C min levels up to 14.5 mg/L. These findings suggest that a target C min range of 2-14.5 mg/L may be appropriate for the elderly population receiving linezolid.
CLINICAL TRIAL REGISTRATION NUMBER: ChiCTR2100045707; April 23, 2021.