Two cases of serious rhabdomyolysis during linezolid treatment

Lechner, A; Past, Eva; Porsche, U.; Kern, Jan Marco; Hoppe, Uta C.; Pretsch, Ingrid

doi:10.1007/s15010-016-0978-8

Cited by 5 publications

(5 citation statements)

References 9 publications

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“…Our results demonstrated significant rhabdomyolysis associations (from strongest to weakest) with daptomycin, cefditoren, cefaclor, erythromycin, norfloxacin, clarithromycin, meropenem, azithromycin, cefdinir, piperacillintazobactam, trimethoprim-sulfamethoxazole, linezolid, and ciprofloxacin. Our results confirmed previously known rhabdomyolysis associations with daptomycin, macrolides, trimethoprimsulfamethoxazole, linezolid, fluoroquinolones, and cefdinir [2][3][4][5][6][7][8][9][10][11][12][13][14]. Meropenem, cefditoren, cefaclor, and piperacillin-tazobactam were found to be associated with rhabdomyolysis, which were not reported in the literature.…”

Section: Discussionsupporting

confidence: 91%

“…Additionally, case reports indicated that trimethoprim-sulfamethoxazole induced rhabdomyolysis occurred in both immunocompetent and immunocompromised patients [8,9]. There have been case reports linking the use of linezolid to serious cases of rhabdomyolysis [10,11]. Fluoroquinolones have also been shown to be associated with rhabdomyolysis in case reports when fluoroquinolones were used alone or in combination with statins [12,13].…”

Section: Ivyspringmentioning

confidence: 99%

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Rhabdomyolysis Associations with Antibiotics: A Pharmacovigilance Study of the FDA Adverse Event Reporting System (FAERS)

Teng¹,

Baus²,

Wilson³

et al. 2019

Int. J. Med. Sci.

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Introduction: Daptomycin, macrolides, trimethoprim-sulfamethoxazole, linezolid, fluoroquinolones, and cefdinir are known to be associated with rhabdomyolysis. Other antibiotics may also lead to rhabdomyolysis, but no study has systemically compared rhabdomyolysis associations for many available antibiotics. Objectives: The objective of this study was to evaluate the association between rhabdomyolysis and many available antibiotics using the FDA Adverse Event Report System (FAERS). Methods: FAERS reports from January 1, 2004 to December 31, 2017 were included in the study. The Medical Dictionary for Regulatory Activities (MedDRA) was used to identify rhabdomyolysis cases. Reporting Odds Ratios (RORs) and corresponding 95% confidence intervals (95%CI) for the association between antibiotics and rhabdomyolysis were calculated. An association was considered statistically significant when the lower limit of the 95%CI was greater than 1.0. Results: A total of 2,334,959 reports (including 7,685 rhabdomyolysis reports) were considered, after inclusion criteria were applied. Daptomycin had the greatest proportion of rhabdomyolysis reports, representing 5.5% of all daptomycin reports. Statistically significant rhabdomyolysis RORs (95% CI) for antibiotics were (in descending order):

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Section: Discussionsupporting

confidence: 91%

Section: Ivyspringmentioning

confidence: 99%

Rhabdomyolysis Associations with Antibiotics: A Pharmacovigilance Study of the FDA Adverse Event Reporting System (FAERS)

Teng¹,

Baus²,

Wilson³

et al. 2019

Int. J. Med. Sci.

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“…There are two reported cases of linezolid induced rhabdomyolysis [ 5 , 8 ]. Rhabdomyolysis has been associated with drugs that inhibit mitochondrial function [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the patient’s fever recurred and he became more haemodynamically unstable, requiring escalated inotropic support. As there were reported cases of linezolid induced rhabdomyolysis, we considered linezolid as the offending agent [ 5 ]. Withdrawal of linezolid resulted in the recovery of AKI and rhabdomyolysis.…”

Section: Case Presentationmentioning

confidence: 99%

Staphylococcal endocarditis in a quadricuspid aortic valve following uncomplicated dengue infection: a case report

et al. 2020

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Background Dengue fever is endemic and a leading health problem in Sri Lanka. Increased incidence of concurrent bacteremia in patients with dengue infection is a recognized complication. However, Staphylococcal endocarditis following dengue fever is uncommon. Quadricuspid aortic valve (QAV) is a rare congenital anomaly and few cases of infective endocarditis have been reported in QAV. Case presentation A 32-year-old Sri Lankan male presented to the National Hospital of Sri Lanka with recurrence of fever and acute left hemiplegia following an uncomplicated recovery of dengue fever. He was diagnosed to have Staphylococcal infective endocarditis of quadricuspid aortic valve, with septic emboli to brain and spleen. He was managed with intravenous vancomycin initially, however, due to inadequate response, intravenous linezolid was added. He developed rhabdomyolysis with very high creatine phosphokinase leading to acute kidney injury, which settled with the cessation of linezolid. The patient succumbed to his illness despite aggressive antimicrobial therapy and maximum supportive care while being assessed for aortic valve replacement. Conclusions This case illustrates three clinical issues that a clinician should be aware of. Firstly, the possibility of a serious secondary bacterial infection as a cause for recurrence of fever following dengue infection. Secondly, this case highlights the importance of identifying QAV as a cause for complicated infective endocarditis of increased severity. The report also denotes the value of being vigilant of linezolid induced rhabdomyolysis which had a causal relationship with the commencement of the drug and its cessation.

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“…Rhabdomyolysis is a potentially lifethreatening disease caused by damage to muscle cells and the subsequent release of cellular components into the bloodstream (Stahl et al, 2020). Four cases of rhabdomyolysis associated with linezolid have been reported (Allison et al, 2009;Carroll et al, 2012;Lechner et al, 2017). Moreover, a FAERS-based study identified an association between linezolid and prolongation of the QT interval along with a higher incidence in TB patients (Shao et al, 2023).…”

Section: Ades At Other Soc Levelsmentioning

confidence: 99%

Adverse drug events associated with linezolid administration: a real-world pharmacovigilance study from 2004 to 2023 using the FAERS database

Zou,

Cui,

Lou

et al. 2024

Front. Pharmacol.

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Introduction: Linezolid is an oxazolidinone antibiotic that is active against drug-resistant Gram-positive bacteria and multidrug-resistant Mycobacterium tuberculosis. Real-world studies on the safety of linezolid in large populations are lacking. This study aimed to determine the adverse events associated with linezolid in real-world settings by analyzing data from the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS).Methods: We retrospectively extracted reports on adverse drug events (ADEs) from the FAERS database from the first quarter of 2004 to that of 2023. By using disproportionality analysis including reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), along with the multi-item gamma Poisson shrinker (MGPS), we evaluated whether there was a significant association between linezolid and ADE. The time to onset of ADE was further analyzed in the general population and within each age, weight, reporting population, and weight subgroups.Results: A total of 11,176 reports of linezolid as the “primary suspected” drug and 263 significant adverse events of linezolid were identified, including some common adverse events such as thrombocytopenia (n = 1,139, ROR 21.98), anaemia (n = 704, ROR 7.39), and unexpected signals that were not listed on the drug label such as rhabdomyolysis (n = 90, ROR 4.33), and electrocardiogram QT prolonged (n = 73, ROR 4.07). Linezolid-induced adverse reactions involved 27 System Organ Class (SOC). Gender differences existed in ADE signals related to linezolid. The median onset time of all ADEs was 6 days, and most ADEs (n = 3,778) occurred within the first month of linezolid use but some may continue to occur even after a year of treatment (n = 46).Conclusion: This study reports the time to onset of adverse effects in detail at the levels of SOC and specific preferred term (PT). The results of our study provide valuable insights for optimizing the use of linezolid and reducing potential side effects, expected to facilitate the safe use of linezolid in clinical settings.

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Two cases of serious rhabdomyolysis during linezolid treatment

Cited by 5 publications

References 9 publications

Rhabdomyolysis Associations with Antibiotics: A Pharmacovigilance Study of the FDA Adverse Event Reporting System (FAERS)

Rhabdomyolysis Associations with Antibiotics: A Pharmacovigilance Study of the FDA Adverse Event Reporting System (FAERS)

Staphylococcal endocarditis in a quadricuspid aortic valve following uncomplicated dengue infection: a case report

Adverse drug events associated with linezolid administration: a real-world pharmacovigilance study from 2004 to 2023 using the FAERS database

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