A retrospective test for a possible relationship between linezolid‐induced thrombocytopenia and hyponatraemia

Abstract

What is known and objective Thrombocytopenia is one of the typical adverse events caused by linezolid (LZD). Recently, some cases of severe hyponatraemia occurring while receiving LZD have been reported. This study investigated a possible relationship between LZD‐induced hyponatraemia and thrombocytopenia and identified the risk factors for hyponatraemia and/or thrombocytopenia. Methods In this retrospective, single‐centre, observational cohort study, 63 hospitalized patients aged over 18 years who received intravenous injection of LZD for more than seven consecutive days in Oita University Hospital between April 2015 and March 2018 were analysed. Results Thrombocytopenia occurred in 25 (39.7%) patients and hyponatraemia in 11 (17.5%) patients. Seven of 11 patients with hyponatraemia had concurrent thrombocytopenia. Although both serum sodium level and platelet count declined in most patients who developed hyponatraemia, no significant association between thrombocytopenia and hyponatraemia was found. Creatinine clearance level (Ccr) was significantly lower not only in the thrombocytopenia (vs no‐thrombocytopenia) but also in the hyponatraemia group (vs no‐hyponatraemia group). Univariate and multivariate logistic regression analyses identified different risk factors for thrombocytopenia and/or hyponatraemia (thrombocytopenia: Ccr and administration period; hyponatraemia: serum albumin; thrombocytopenia and hyponatraemia: administration period and serum albumin). What is new and conclusion In conclusion, this study found no significant relationship between LZD‐induced thrombocytopenia and hyponatraemia and identified some possible risk factors associated with onset of the two adverse events. These require further validation.

Effect of renal function on the risk of thrombocytopaenia in patients receiving linezolid therapy: A systematic review and meta‐analysis

“…The search process identified 696 publications (Supplementary Table S1 ), and a total of 24 observational studies 5 , 7 , 8 , 9 , 10 , 11 , 12 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 met the inclusion criteria. The literature selection process is shown in Figure 1 .…”

“…The search process identified 696 publications (Supplementary Table S1), and a total of 24 observational studies [5,[7][8][9][10][11][12][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] met the inclusion criteria. The literature selection process is shown in Figure 1.…”

“…The characteristics of the studies included in the meta-analysis are presented in Table 1. Eighteen studies were conducted in Asia [5,[9][10][11][12][17][18][19][20][22][23][24][25][27][28][30][31][32], and six [7,8,16,21,26,29] were conducted in Western countries. The included studies comprised a total of 3580 patients, with a study mean or median age between 46 and 81 years.…”

“…The sample size of each included study ranged from 30 to 549 patients, and the reported incidence of LIT ranged from 13.9% to 60.5%. A fixed conventional dose of linezolid (600 mg every 12 h) was administered in most of the studies, and the details of the dose were unavailable in eight studies [5,18,19,21,22,[29][30][31]. The mean or median duration of linezolid therapy ranged from 8.2 to 16.9 days.…”

“…Ten studies [8,10,12,16,17,[22][23][24]30,31] reported the comparison of the baseline Ccr between thrombocytopenia and non-thrombocytopenia patients (Supplementary Table S9). The pooled analysis showed that the mean baseline Ccr was significantly lower in patients with LIT than in patients without LIT (WMD -28.25; 95% Cl -41.02 to -15.47; I 2 =73.5%).…”