Linezolid Induced Thrombocytopenia: A Case Report

H. Patel, Harsha D Makwana, S. Malhotra
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Abstract

Linezolid (LZD) is an antimicrobial agent with a broad spectrum of activity against virtually all clinically important Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), methicillin-resistant coagulase-negative staphylococci (MRCoNS) and vancomycin-resistant enterococci (VRE). Thrombocytopenia (TP) is a common adverse effect of Linezolid (LZD). Prolonged treatment duration, renal insufficiency, chronic liver disease, malignancy, previous vancomycin use, baseline platelet count, and lower body weight have been reported as possible risk factors for LZD-associated TP. Here, we illustrate a case of a 51-year-old male patient diagnosed with pancreatitis and urinary tract infection and was prescribed several antibiotics including Linezolid. In this case, platelets count which were initially normal started declining from day 7 of initiating Linezolid. Linezolid was withdrawn from treatment from day 9. Platelet count gradually came back to normal on day 16. This suggests reversible type of thrombocytopenia by Linezolid. This case illustrates need for careful observation of platelet count during the treatment with Linezolid. Keywords: Linezolid, Thrombocytopenia, Dechallenge
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利奈唑胺致血小板减少1例报告
利奈唑胺(LZD)是一种抗菌剂,对几乎所有临床重要的革兰氏阳性细菌具有广谱活性,包括耐甲氧西林金黄色葡萄球菌(MRSA)、耐甲氧西林凝固酶阴性葡萄球菌(MRCoNS)和耐万古霉素肠球菌(VRE)。血小板减少症(TP)是利奈唑胺(LZD)常见的不良反应。据报道,延长治疗时间、肾功能不全、慢性肝病、恶性肿瘤、既往使用万古霉素、基线血小板计数和体重过低是lzd相关TP的可能危险因素。在此,我们报告一例51岁男性患者,诊断为胰腺炎和尿路感染,并开了几种抗生素,包括利奈唑胺。在这种情况下,血小板计数从开始使用利奈唑胺的第7天开始下降。从第9天起停用利奈唑胺。第16天血小板计数逐渐恢复正常。这提示利奈唑胺可引起可逆型血小板减少症。本病例说明在利奈唑胺治疗期间需要仔细观察血小板计数。关键词:利奈唑胺;血小板减少症
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