ABSTRACT
Objective:To analyze and summarize adverse reactions such as hypoglycemia, lactic acidosis and pancytopenia caused by Linezolid in elderly patients, in order to enhance clinicians' awareness of adverse reactions of Linezolid.Methods:One case with Linezolid-induced lactic acidosis, pancytopenia and hypoglycemia was reported in a patient receiving long-term and repeated use of Linezolid for recurrent urinary tract infections(RUTI)in Beijing Hospital.National and international literature on the three severe and rare adverse reactions caused by Linezolid before December 2018 was reviewed, and the risk factors, clinical characteristics and prognosis of the three severe adverse reactions caused by Linezolid were summarized and analyzed.Results:A total of 86 cases with Linezolid-induced adverse reactions such as hypoglycemia, lactic acidosis and pancytopenia were analyzed.Among them, the ratio of males to females was 1.8∶1.0, the median age was 64.5 years, and 44 cases were over 65 years, accounting for 51.2%.Among the 57 patients with lactic acidosis, 25 lactic acidosis cases were combined with liver and kidney diseases, which were the most commonly involved organs(43.9%, 25/57). The time of onset for lactic acidosis was 4 h-109 d, with a median value of 32 d, and the peak values of blood lactate were 2.6-38.1 mmol/L, with a median value of 13.3 mol/L.Pancytopenia occurred 4 h-120 days after the treatment, and the median value was 21 days.The time of onset for hypoglycemia was 8 h-26, and the median time was 10.3 days.The lowest value of blood glucose was 0.2 mmol/L.Of the 86 cases, 61(70.9%)patients improved, and 12 cases of 51 patients with lactic acidosis died, with a mortality rate of 23.5%.Conclusions:Clinicians should be aware of serious adverse reactions including hypoglycemia, lactic acidosis and pancytopenia during Linezolid treatment in elderly patients.It is recommended to monitor changes in blood glucose, blood lactate and blood cell count during Linezolid treatment, and to avoid long-term use of Linezolid, so as to maximize the benefits for patients.