Occurrence of linezolid induced thrombocytopenia and its association with the risk factors: a review article

ABSTRACT

Linezolid is the oxazolidinone group of antibiotic with wide range of activity against the gram positive bacteria including methicillin resistant staphylococcus aureus and penicillin resistant pneumococci and vancomycin resistant enterococci. Patients who are on linezolid were reported to have reversible myelosuppression especially thrombocytopenia and anaemia. Since there are less number of studies regarding the occurrence of thrombocytopenia and the risk factors associated with it, this study was undertaken to evaluate the occurrence of linezolid induced thrombocytopenia and its association with risk factors. It was a systematic review with synthesis of available literature in English language. Articles were retrieved using search terms included “linezolid”, “and”, “or”, “thrombocytopenia” from Clinical key and PubMed, published during 2000 - 2017. Out of 16 studies retrieved, only 7 studies were analysed based on inclusion and exclusion criteria; of them, 3 were found to be prospective and retrospective cohort each and only one was retrospective cross-sectional study. The occurrence of linezolid induced thrombocytopenia range from 18-50% with normal renal function and 57% of incidence associated with renal insufficiency patients. The risk factors were found to be dose of linezolid >18-27mg/kg, body weight of subjects <55kg, creatinine clearance <88.39 to 60ml/min/1.73m2 and baseline platelet count <200*103/mm3, serum albumin concentration, serum creatinine, concomitant caspofungin therapy and duration of linezolid therapy.