Therapeutic drug monitoring may improve safety outcomes of long-term treatment with linezolid in adult patients

被引:213
|
作者
Pea, Federico [1 ]
Viale, Pierluigi [2 ]
Cojutti, Piergiorgio [1 ]
Del Pin, Barbara [2 ]
Zamparini, Eleonora [2 ]
Furlanut, Mario [1 ]
机构
[1] Univ Udine, Azienda Osped Univ Santa Maria della Misericordia, Dept Expt & Clin Med, Inst Clin Pharmacol,Med Sch, I-33100 Udine, Italy
[2] Univ Bologna, Dept Internal Med Geriatr & Nephrol Dis, Clin Infect Dis, Bologna, Italy
关键词
thrombocytopenia; therapy; TDM; PROSTHETIC JOINT INFECTIONS; CHRONIC OSTEOMYELITIS; ILL PATIENTS; RIFAMPIN; SERUM; TOLERABILITY; PENETRATION; RESISTANT; EXPOSURE; EFFICACY;
D O I
10.1093/jac/dks153
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Prolonged treatment with linezolid may cause toxicity. The purpose of this study was to define pharmacodynamic thresholds for improving safety outcomes of linezolid. We performed a retrospective study of patients who had trough (C-min) and peak (C-max) plasma levels measured during prolonged linezolid treatment. Dosage adjustments were performed when C-min epsilon 10 mg/L and/or AUC(24) epsilon 400 mg/Lh. Patients were divided into two subgroups according to the absence or presence of co-treatment with rifampicin (the linezolid group and the linezolidrifampicin group, respectively). Data on demographic characteristics, disease, microbiology and haematochemical parameters were collected and outcomes in relation to drug exposure were compared between groups. A total of 45 patients were included. Dosage adjustments were needed in 40 versus 0 of patients in the linezolid group (n35) versus the linezolidrifampicin group (n10), respectively. Patients in the linezolid group had either significantly higher C-min [3.71 mg/L (1.436.38) versus 1.37 mg/L (0.672.55), P0.001] or AUC(24) [212.77 mg/Lh (166.67278.42) versus 123.33 mg/Lh (97.36187.94), P0.001]. Thrombocytopenia appeared in 51.4 versus 0 of cases in the linezolid group versus the linezolidrifampicin group, respectively. In 33.3 of those patients who were experiencing thrombocytopenia, therapeutic drug monitoring (TDM)-guided dosage reductions allowed recovery from toxicity and prosecution of therapy with good outcome. A logistic regression model for thrombocytopenia estimated a probability of 50 in the presence of C-min of 6.53 mg/L and/or of AUC(24) of 280.74 mg/Lh. Maintenance over time of C-min between 2 and 7 mg/L and/or of AUC(24) between 160 and 300 mg/Lh may be helpful in improving safety outcomes while retaining appropriate efficacy in adult patients receiving prolonged linezolid treatment.
引用
收藏
页码:2034 / 2042
页数:9
相关论文
共 50 条
  • [21] Therapeutic Drug Monitoring of Golimumab for the Prediction of Long-Term Clinical Remission in Patients with Ulcerative Colitis
    Tawa, Hideki
    Kakimoto, Kazuki
    Numa, Keijiro
    Kinoshita, Naohiko
    Kawasaki, Yuka
    Tatsumi, Yoshihiro
    Koshiba, Ryoji
    Nakata, Satoshi
    Hirata, Yuki
    Ota, Kazuhiro
    Sakiyama, Naokuni
    Kojima, Yuichi
    Koubayashi, Eiko
    Nishikawa, Hiroki
    Takeuchi, Toshihisa
    Inoue, Takuya
    Fukunishi, Shinya
    Miyazaki, Takako
    Nakamura, Shiro
    Higuchi, Kazuhide
    DIGESTION, 2022, 103 (05) : 329 - 338
  • [22] Long-term impact of therapeutic drug monitoring on the risk of hypoglycemia in HOCM patients on cibenzoline therapy
    Mukai, Yutaro
    Wada, Kyoichi
    Fujimoto, Mai
    Hosomi, Kouichi
    Kuwahara, Takeshi
    Takada, Mitsutaka
    INTERNATIONAL JOURNAL OF CLINICAL PHARMACOLOGY AND THERAPEUTICS, 2016, 54 (10) : 795 - 803
  • [23] LINEZOLID AND LACTIC ACIDOSIS A ROLE FOR LACTATE MONITORING WITH LONG-TERM LINEZOLID USE IN CHILDREN
    Su, Erik
    Crowley, Kelli
    Carcillo, Joseph A.
    Michaels, Marian G.
    PEDIATRIC INFECTIOUS DISEASE JOURNAL, 2011, 30 (09) : 804 - 806
  • [24] Stenting in acute myocardial infarction may improve procedural and long-term outcomes
    Siegel, RM
    Underwood, P
    Barker, B
    Bhaskaran, A
    Nuttall, A
    Chuang, MY
    Swanson, D
    Vermillion, J
    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1997, 29 (02) : 7156 - 7156
  • [25] Impact of high plasma concentrations of linezolid in Taiwanese adult patients - therapeutic drug monitoring in improving adverse drug reactions
    Cheng, Chih-Ning
    Wu, Chien-Chih
    Kuo, Ching-Hua
    Wang, Chi-Chuan
    Wang, Jann-Tay
    Lin, Ya-Ting
    Jhang, Ren-Shiang
    Lin, Shu-Wen
    JOURNAL OF THE FORMOSAN MEDICAL ASSOCIATION, 2021, 120 (01) : 466 - 475
  • [26] Therapeutic Drug Monitoring for Patients With Alzheimer Dementia to Improve Treatment With Donepezil
    Hefner, Gudrun
    Brueckner, Anne
    Hiemke, Christoph
    Fellgiebel, Andreas
    THERAPEUTIC DRUG MONITORING, 2015, 37 (03) : 353 - 361
  • [27] Safety of long-term antithyroid drug treatment? A systematic review
    F. Azizi
    R. Malboosbaf
    Journal of Endocrinological Investigation, 2019, 42 : 1273 - 1283
  • [28] Safety of long-term antithyroid drug treatment? A systematic review
    Azizi, F.
    Malboosbaf, R.
    JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION, 2019, 42 (11) : 1273 - 1283
  • [29] Long-Term Visual Safety of Voriconazole in Adult Patients With Paracoccidioidomycosis
    Laties, Alan M.
    Fraunfelder, Frederick T.
    Tomaszewski, Konrad
    Goodrich, James
    Moreira, Ana Tereza
    Sato, Mario T.
    de Queiroz-Telles, Flavio
    CLINICAL THERAPEUTICS, 2010, 32 (13) : 2207 - 2217
  • [30] Treatment Outcomes and Long-term Survival in Patients with Extensively Drug-resistant Tuberculosis
    Kim, Doh Hyung
    Kim, Hee Jin
    Park, Seung-Kyu
    Kong, Suck-Jun
    Kim, Young Sam
    Kim, Tae-Hyung
    Kim, Eun Kyung
    Lees, Ki Man
    Lee, Sung Soon
    Park, Jae Seuk
    Koh, Won-Jung
    Lee, Chang-Hoon
    Kim, Ji Yeon
    Shim, Tae Sun
    AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2008, 178 (10) : 1075 - 1082