No Effect of Pyridoxine on the Incidence of Myelosuppression during Prolonged Linezolid Treatment

Plachouras, Diamantis; Giannitsioti, Efthymia; Athanassia, Sofia; Kontopidou, Flora; Papadopoulos, A; Kanellakopoulou, K.; Giamarellou, Helen

doi:10.1086/508280

Cited by 27 publications

(17 citation statements)

References 13 publications

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“…These data suggest that pyridoxine does not prevent linezolid-related hematological adverse events, since the frequencies of hematological adverse events were similar to or even higher than those reported in patients who did not receive pyridoxine (19,22). The study of Plachouras et al (18) was a noncomparative study in which variables that could influence the rate of cytopenia, such as age, sex, comorbidity, the coadministration of other antibiotics, or renal function, were not controlled. In our study, the influence of pyridoxine on hematological adverse events was analyzed by comparing two consecutive cohorts with similar baseline characteristics and similar lengths of linezolid treatment.…”

Section: Discussionmentioning

confidence: 88%

“…The administration of 50 mg pyridoxine (vitamin B 6 ) orally once a day to two patients who developed hematological disturbances was useful in reverting these adverse events (24). In a recent study, Plachouras et al (18) administered 125 mg of pyridoxine to 24 patients who received linezolid for bone infections, and the rates of thrombocytopenia (Ͻ140 ϫ 10 9 platelets/liter) and anemia (hematocrit, Ͻ30%) were 45.8% and 25%, respectively. These data suggest that pyridoxine does not prevent linezolid-related hematological adverse events, since the frequencies of hematological adverse events were similar to or even higher than those reported in patients who did not receive pyridoxine (19,22).…”

Section: Discussionmentioning

confidence: 99%

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Comparative Study of the Effects of Pyridoxine, Rifampin, and Renal Function on Hematological Adverse Events Induced by Linezolid

Soriano

Ortega

García

et al. 2007

Antimicrob Agents Chemother

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Hematological disturbances that develop during linezolid treatment are a major concern when linezolid is administered for prolonged periods of time. The aim of this study was to evaluate the influences of pyridoxine, rifampin, and renal function on hematological adverse events. From January 2002 to April 2006, 52 patients received a long-term course of linezolid. Blood cell counts were monitored weekly. Thrombocytopenia was defined as a decrease to <75% of the baseline platelet count, and anemia was defined when the hemoglobin concentration decreased by >2 g/liter from the baseline value. Twenty-four patients received linezolid alone, and 28 patients received linezolid plus 200 mg of pyridoxine. The Kaplan-Meier survival method, followed by the log-rank test, was used to estimate the cumulative probability of adverse events, and Cox regression analysis was performed to evaluate the independent predictors of toxicity. The baseline characteristics of the patients in both groups were similar. The cumulative probability of thrombocytopenia and anemia in patients who received pyridoxine was not different from that in patients who did not receive it. Hematological adverse events were less frequent in patients taking rifampin and were more frequent in patients with renal failure. However; the Cox regression analysis showed that rifampin was the only independent predictor associated with a lower risk of thrombocytopenia (hazard ratio, 0.37; 95% confidence interval, 0.14 to 0.98; P ‫؍‬ 0.045). In conclusion, pyridoxine did not prevent linezolid-related hematological adverse events, and the coadministration of rifampin was associated with a lower risk of thrombocytopenia.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Comparative Study of the Effects of Pyridoxine, Rifampin, and Renal Function on Hematological Adverse Events Induced by Linezolid

Soriano

Ortega

García

et al. 2007

Antimicrob Agents Chemother

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“…Severe anemia may occur in adult patients receiving prolonged linezolid therapy, making linezolid therapy cessation necessary [15,18,19]. One report suggests that pyridoxine may prevent myelosuppression [19]; however, a recent article concluded that treatment with pyridoxine is unlikely to benefit patients who have been receiving linezolid [16]. Our patient did not develop myelotoxicity during treatment with linezolid.…”

mentioning

confidence: 62%

“…Long-term linezolid administration complications include anemia and thrombocytopenia [15][16][17]. Severe anemia may occur in adult patients receiving prolonged linezolid therapy, making linezolid therapy cessation necessary [15,18,19].…”

mentioning

confidence: 99%

Successful Long-Term Treatment with Linezolid for Disseminated Infection with Multiresistant Nocardia farcinica

et al. 2008

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“…5 Spellberg et al 6 associated the reversal of anaemia in two patients with Mycobacterium abscessus infections treated with linezolid for 9 months with the subsequent administration of vitamin B 6 . However, Plachouras et al 7 retrospectively assessed the effects of administration of vitamin B 6 in 24 patients who received linezolid for bone infections and did not find a significant benefit of vitamin B 6 in reducing linezolid-related haematological toxicities.…”

Section: Introductionmentioning

confidence: 99%

The role of vitamin B6 in the prevention of haematological toxic effects of linezolid in patients with cancer

Youssef

Hachem

Chemaly

et al. 2007

Journal of Antimicrobial Chemotherapy

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Background: Linezolid is the first approved synthetic oxazolidinone with activity against multidrugresistant Gram-positive pathogens. However, haematological toxic effects of linezolid frequently limit its prolonged use, especially in patients with poor marrow reserves such as those with cancer receiving chemotherapy. Previous authors have reported that administration of vitamin B 6 with linezolid reversed pancytopenia in two patients. Methods:This is an open-label study of 31 patients with cancer who received linezolid at 600 mg twice daily and vitamin B 6 at 50 mg/day for at least 2 weeks mean therapy duration and they were matched to 62 control patients who received linezolid without vitamin B 6 to determine whether the concomitant use of vitamin B 6 attenuates the haematological toxicity of linezolid in patients with cancer.Results: Patients were matched according to age, underlying disease, duration of therapy, creatinine level and use of chemotherapy. We found no significant differences in the rate of haematological toxic effects between the two patient groups. The rate of thrombocytopenia was 13% in the vitamin B 6 group and 15% in the control group (P 5 0.82). Also, the rate of leucopenia was 7% versus 5%, respectively (P 5 0.75). None of the patients in the vitamin B 6 group had anaemia compared with 5% in the control group.Conclusions: Vitamin B 6 given at 50 mg/day may have an impact on anaemia but did not prevent linezolid-induced thrombocytopenia or leucopenia in cancer patients.

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No Effect of Pyridoxine on the Incidence of Myelosuppression during Prolonged Linezolid Treatment

Cited by 27 publications

References 13 publications

Comparative Study of the Effects of Pyridoxine, Rifampin, and Renal Function on Hematological Adverse Events Induced by Linezolid

Comparative Study of the Effects of Pyridoxine, Rifampin, and Renal Function on Hematological Adverse Events Induced by Linezolid

Successful Long-Term Treatment with Linezolid for Disseminated Infection with Multiresistant Nocardia farcinica

The role of vitamin B6 in the prevention of haematological toxic effects of linezolid in patients with cancer

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