Initially Reduced Linezolid Dosing Regimen to Prevent Thrombocytopenia in Hemodialysis Patients
This retrospective cohort study investigated the effects of an initially reduced linezolid dosing regimen in hemodialysis patients through therapeutic drug monitoring (TDM). Patients were divided into two groups depending on their initial dose of linezolid (standard dose of 600 mg every 12 h or init...
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MDPI AG
2021-04-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/10/5/496 |
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| author | Hitoshi Kawasuji Yasuhiro Tsuji Chika Ogami Makito Kaneda Yushi Murai Kou Kimoto Akitoshi Ueno Yuki Miyajima Yasutaka Fukui Ippei Sakamaki Yoshihiro Yamamoto |
| author_facet | Hitoshi Kawasuji Yasuhiro Tsuji Chika Ogami Makito Kaneda Yushi Murai Kou Kimoto Akitoshi Ueno Yuki Miyajima Yasutaka Fukui Ippei Sakamaki Yoshihiro Yamamoto |
| author_sort | Hitoshi Kawasuji |
| collection | DOAJ |
| description | This retrospective cohort study investigated the effects of an initially reduced linezolid dosing regimen in hemodialysis patients through therapeutic drug monitoring (TDM). Patients were divided into two groups depending on their initial dose of linezolid (standard dose of 600 mg every 12 h or initially reduced dose of 300 mg every 12 h/600 mg every 24 h). The cumulative incidence rates of thrombocytopenia and severe thrombocytopenia were compared between both groups using the Kaplan–Meier method and log-rank test. Eleven episodes of 8 chronic hemodialysis patients were included; 5 were in the initially reduced-dose group. Thrombocytopenia developed in 81.8% of patients. The cumulative incidence rates of thrombocytopenia and severe thrombocytopenia in the initially reduced-dose group were significantly lower than in the standard-dose group (<i>p</i> < 0.05). At the standard dose, the median linezolid trough concentration (C<sub>min</sub>) just before hemodialysis was 49.5 mg/L, and C<sub>min</sub> at the reduced doses of 300 mg every 12 h and 600 mg every 24 h were 20.6 mg/L and 6.0 mg/L, respectively. All five episodes underwent TDM in the standard-dose group required dose reduction to 600 mg per day. Our findings indicate that initial dose reduction should be implemented to reduce the risk of linezolid-induced thrombocytopenia among hemodialysis patients. |
| first_indexed | 2024-03-10T11:56:52Z |
| format | Article |
| id | doaj.art-41331327c76842328692af7cc42ac7d1 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T11:56:52Z |
| publishDate | 2021-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-41331327c76842328692af7cc42ac7d12023-11-21T17:11:52ZengMDPI AGAntibiotics2079-63822021-04-0110549610.3390/antibiotics10050496Initially Reduced Linezolid Dosing Regimen to Prevent Thrombocytopenia in Hemodialysis PatientsHitoshi Kawasuji0Yasuhiro Tsuji1Chika Ogami2Makito Kaneda3Yushi Murai4Kou Kimoto5Akitoshi Ueno6Yuki Miyajima7Yasutaka Fukui8Ippei Sakamaki9Yoshihiro Yamamoto10Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama 930-0194, JapanCenter for Pharmacist Education, School of Pharmacy, Nihon University, 7-7-1 Narashinodai, Chiba 274-8555, JapanDepartment of Medical Pharmaceutics, Faculty of Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama 930-0194, JapanDepartment of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama 930-0194, JapanDepartment of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama 930-0194, JapanDepartment of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama 930-0194, JapanDepartment of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama 930-0194, JapanDepartment of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama 930-0194, JapanDepartment of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama 930-0194, JapanDepartment of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama 930-0194, JapanDepartment of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama 930-0194, JapanThis retrospective cohort study investigated the effects of an initially reduced linezolid dosing regimen in hemodialysis patients through therapeutic drug monitoring (TDM). Patients were divided into two groups depending on their initial dose of linezolid (standard dose of 600 mg every 12 h or initially reduced dose of 300 mg every 12 h/600 mg every 24 h). The cumulative incidence rates of thrombocytopenia and severe thrombocytopenia were compared between both groups using the Kaplan–Meier method and log-rank test. Eleven episodes of 8 chronic hemodialysis patients were included; 5 were in the initially reduced-dose group. Thrombocytopenia developed in 81.8% of patients. The cumulative incidence rates of thrombocytopenia and severe thrombocytopenia in the initially reduced-dose group were significantly lower than in the standard-dose group (<i>p</i> < 0.05). At the standard dose, the median linezolid trough concentration (C<sub>min</sub>) just before hemodialysis was 49.5 mg/L, and C<sub>min</sub> at the reduced doses of 300 mg every 12 h and 600 mg every 24 h were 20.6 mg/L and 6.0 mg/L, respectively. All five episodes underwent TDM in the standard-dose group required dose reduction to 600 mg per day. Our findings indicate that initial dose reduction should be implemented to reduce the risk of linezolid-induced thrombocytopenia among hemodialysis patients.https://www.mdpi.com/2079-6382/10/5/496linezolidhemodialysisthrombocytopeniatherapeutic drug monitoringdosing regimen |
| spellingShingle | Hitoshi Kawasuji Yasuhiro Tsuji Chika Ogami Makito Kaneda Yushi Murai Kou Kimoto Akitoshi Ueno Yuki Miyajima Yasutaka Fukui Ippei Sakamaki Yoshihiro Yamamoto Initially Reduced Linezolid Dosing Regimen to Prevent Thrombocytopenia in Hemodialysis Patients Antibiotics linezolid hemodialysis thrombocytopenia therapeutic drug monitoring dosing regimen |
| title | Initially Reduced Linezolid Dosing Regimen to Prevent Thrombocytopenia in Hemodialysis Patients |
| title_full | Initially Reduced Linezolid Dosing Regimen to Prevent Thrombocytopenia in Hemodialysis Patients |
| title_fullStr | Initially Reduced Linezolid Dosing Regimen to Prevent Thrombocytopenia in Hemodialysis Patients |
| title_full_unstemmed | Initially Reduced Linezolid Dosing Regimen to Prevent Thrombocytopenia in Hemodialysis Patients |
| title_short | Initially Reduced Linezolid Dosing Regimen to Prevent Thrombocytopenia in Hemodialysis Patients |
| title_sort | initially reduced linezolid dosing regimen to prevent thrombocytopenia in hemodialysis patients |
| topic | linezolid hemodialysis thrombocytopenia therapeutic drug monitoring dosing regimen |
| url | https://www.mdpi.com/2079-6382/10/5/496 |
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