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Lactic acidosis associated with standard dose linezolid in a kidney recipient with impaired renal function
Chen, Chien-Chou; Liu, Wei-Ting; Lin, Shih-Hua.
Affiliation
  • Chen, Chien-Chou; Tri-Service General Hospital Songshan Branch. Department of Internal Medicine. Taipei. TW
  • Liu, Wei-Ting; Tri-Service General Hospital. Department of Medicine. Division of Nephrology. Taipei. TW
  • Lin, Shih-Hua; Tri-Service General Hospital. Department of Medicine. Division of Nephrology. Taipei. TW
Braz. j. infect. dis ; Braz. j. infect. dis;26(1): 101701, 2022. graf
Article in En | LILACS-Express | LILACS | ID: biblio-1364542
Responsible library: BR1.1
ABSTRACT
Abstract Severe lactic acidosis, a mitochondrial toxicity caused by the recommended standard dosage of linezolid (LZD), may occur in patients with impaired renal function. We describe an adult male who underwent kidney transplantation with stably impaired renal function, severe dyspnea, and abdominal discomfort. He received a standard oral dose of LZD (600 mg twice daily) and azithromycin for three weeks with a reduced immunosuppressant dose due to pulmonary non-tuberculosis mycobacterial infection. He was alert and afebrile, with a blood pressure of 140/60 mmHg. Pertinent laboratory data showed pH 7.12, PaCO2 13.6 mmHg; HCO3- 4.3 mmol/L and serum lactate 18.4 mmol/L. His trough serum LZD concentration reached toxic levels (21.4 μg/mL). With hemodialysis, his clinical symptoms improved, with a decline in serum LZD (9.8μg/mL) and lactate (3.2 mmol/L). Chronic standard dose LZD in patients with impaired renal function can lead to life-threatening lactic acidosis, especially in coexisting conditions that reduce LZD metabolism.
Key words

Full text: 1 Collection: 01-internacional Database: LILACS Type of study: Risk_factors_studies Language: En Journal: Braz. j. infect. dis Journal subject: DOENCAS TRANSMISSIVEIS Year: 2022 Document type: Article Affiliation country: Taiwan Country of publication: Brazil

Full text: 1 Collection: 01-internacional Database: LILACS Type of study: Risk_factors_studies Language: En Journal: Braz. j. infect. dis Journal subject: DOENCAS TRANSMISSIVEIS Year: 2022 Document type: Article Affiliation country: Taiwan Country of publication: Brazil