Initial trough concentration may be beneficial in preventing linezolid-induced thrombocytopenia

Abstract

We assessed whether prospective therapeutic drug monitoring to optimise the therapeutic range could prevent linezolid-induced thrombocytopenia. This prospective interventional study was conducted from September 2017 to October 2020 among 37 adult patients receiving linezolid. Patients were administered one of the following two initial dosages: 600 mg twice or once daily for patients with a creatinine clearance rate of ≥50 or <50 mL/min, respectively. Linezolid dosage adjustment was performed on days 3–5 based on the trough concentration. The serum linezolid levels in 22 and 15 patients were within and above the therapeutic range (2–7 µg/mL), respectively. The incidence of thrombocytopenia was significantly lower among patients whose linezolid levels were within the therapeutic range (4.5%;1/22) than in those whose levels were above the therapeutic range (80%; 12/15). It is important to maintain the linezolid level within the therapeutic range at the first therapeutic drug monitoring to prevent thrombocytopenia.

Keywords:

• Linezolid
• therapeutic drug monitoring
• dose adjustment
• thrombocytopenia
• concentration
• therapeutic range

Acknowledgements

We would like to thank all staffs of Kitasato University Hospital who were involved in this study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors

Data availability statement

Data available on request from the authors.