High accumulation of linezolid and its major metabolite in the serum of patients with hepatic and renal dysfunction is significantly associated with thrombocytopenia and anemia

• Published in: Microbiology spectrum Vol. 13; no. 7; p. e0249324
• Main Authors: Gou, Junqiang, Li, Qian, Fan, Ning, Zhang, Chen, Tang, Haiwen, Wang, Xiaofeng, Yin, Dongfeng
• Format: Journal Article
• Language: English
• Published: United States American Society for Microbiology 01.07.2025
• Subjects: Adult; adverse reactions; Aged; Aged, 80 and over; Anemia - blood; Anemia - chemically induced; Anti-Bacterial Agents - adverse effects; Anti-Bacterial Agents - blood; Anti-Bacterial Agents - pharmacokinetics; Antimicrobial Chemotherapy; Female; Humans; Kidney Diseases; linezolid; Linezolid - adverse effects; Linezolid - blood; Linezolid - metabolism; Linezolid - pharmacokinetics; Liver Diseases; Male; Middle Aged; Platelet Count; Prospective Studies; relationship analysis; Research Article; therapeutic drug monitoring; threshold; Thrombocytopenia - blood; Thrombocytopenia - chemically induced; linezolid; threshold; relationship analysis; adverse reactions; therapeutic drug monitoring
• ISSN: 2165-0497; 2165-0497
• DOI: 10.1128/spectrum.02493-24

The accumulation of plasma linezolid and its metabolites increased with the degree of liver and kidney injury. High plasma linezolid and its metabolite accumulation is significantly associated with thrombocytopenia and anemia. Linezolid and its metabolite concentration threshold can warn the clinical prevention of hematological adverse reactions. Individual therapy guided by therapeutic drug monitoring (TDM) can improve the efficacy of linezolid and reduce toxic reactions. Patients with severe hepatic and renal dysfunction should actively monitor the blood routine and linezolid concentration and adjust the dosage in time.