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Initially Reduced Linezolid Dosing Regimen to Prevent Thrombocytopenia in Hemodialysis Patients

Authors :
Hitoshi Kawasuji
Yasuhiro Tsuji
Chika Ogami
Makito Kaneda
Yushi Murai
Kou Kimoto
Akitoshi Ueno
Yuki Miyajima
Yasutaka Fukui
Ippei Sakamaki
Yoshihiro Yamamoto
Source :
Antibiotics, Vol 10, Iss 5, p 496 (2021)
Publication Year :
2021
Publisher :
MDPI AG, 2021.

Abstract

This retrospective cohort study investigated the effects of an initially reduced linezolid dosing regimen in hemodialysis patients through therapeutic drug monitoring (TDM). Patients were divided into two groups depending on their initial dose of linezolid (standard dose of 600 mg every 12 h or initially reduced dose of 300 mg every 12 h/600 mg every 24 h). The cumulative incidence rates of thrombocytopenia and severe thrombocytopenia were compared between both groups using the Kaplan–Meier method and log-rank test. Eleven episodes of 8 chronic hemodialysis patients were included; 5 were in the initially reduced-dose group. Thrombocytopenia developed in 81.8% of patients. The cumulative incidence rates of thrombocytopenia and severe thrombocytopenia in the initially reduced-dose group were significantly lower than in the standard-dose group (p < 0.05). At the standard dose, the median linezolid trough concentration (Cmin) just before hemodialysis was 49.5 mg/L, and Cmin at the reduced doses of 300 mg every 12 h and 600 mg every 24 h were 20.6 mg/L and 6.0 mg/L, respectively. All five episodes underwent TDM in the standard-dose group required dose reduction to 600 mg per day. Our findings indicate that initial dose reduction should be implemented to reduce the risk of linezolid-induced thrombocytopenia among hemodialysis patients.

Details

Language :
English
ISSN :
20796382
Volume :
10
Issue :
5
Database :
Directory of Open Access Journals
Journal :
Antibiotics
Publication Type :
Academic Journal
Accession number :
edsdoj.41331327c76842328692af7cc42ac7d1
Document Type :
article
Full Text :
https://doi.org/10.3390/antibiotics10050496