TABLE 1.
Clinical features, outcomes, and adverse reactions associated with prolonged linezolid therapy
| Parameter | Total | No. of patients with treatment duration (days) of:
|
No. of patients cured
|
||||
|---|---|---|---|---|---|---|---|
| 7-14 | 15-28 | >28 | Medical treatment alone | Medical and surgical treatment | Total | ||
| No. (%) of patients | 44 | 12 (27) | 16 (36) | 16 (36) | 17 (39) | 15 (34) | 32 (73) |
| Clinical indications | |||||||
| Osteomyelitis/septic arthritis | 22 | 5 | 7 | 10 | 5 | 11 | 16 |
| Skin and soft tissue infection | 5 | 2 | 1 | 2 | 3 | 3 | |
| Deep abscess | 4 | 1 | 3 | 2 | 1 | 3 | |
| Bacterial endocarditis | 4 | 1 | 3 | 2 | 2 | 4 | |
| Prosthetic graft | 4 | 2 | 2 | 2 | 1 | 3 | |
| Othera | 5 | 2 | 2 | 1 | 3 | 3 | |
| Pathogens | |||||||
| MRSAj | 16 | 6 | 5 | 5 | 6 | 7 | 13 |
| hVISA/VISA | 18 | 2 | 7 | 9 | 5 | 6 | 11 |
| VREn | 2 | 1 | 1 | 2 | 2 | ||
| Otherb | 8 | 4 | 3 | 1 | 4 | 2 | 6 |
| Adverse reactions | |||||||
| Required drug cessation | 7 | 2 | 4 | 1 | |||
| GITk/hepaticc | |||||||
| Nausea/vomiting | 10 | 4 | 6 | ||||
| Taste disturbance | 1 | 1 | |||||
| Diarrhea | 2 | 2 | |||||
| Increased ALTl | 3 | 1 | 2 | ||||
| Thrombocytopeniam | |||||||
| Mild | 8 | 3 | 5 | ||||
| Moderate | 3 | 2 | 1 | ||||
| Severed | 2 | 1 | 1e | ||||
| Anemiaf | |||||||
| Mild | 1 | 1 | |||||
| Moderateg | 2 | 1 | 1 | ||||
| Severeg | 4 | 2 | 2 | ||||
| Pancytopenia (including leukopenia)h | 2 | 1 | 1 | ||||
| Otheri | 4 | 1 | 2 | 1 | |||
Central venous cannula sepsis (n = 2) and persistent bacteremia of unknown source (n = 3).
Methicillin-susceptible S. aureus (n = 1), S. haemolyticus (n = 1), methicillin-resistant S. epidermidis (n = 3), and coagulase-negative staphylococci (n = 3).
Twelve patients experienced 16 ARs.
Both patients had preexisting mild or moderate thrombocytopenia. Platelet counts decreased by >50% from the baseline.
One patient required a platelet transfusion 40 days after commencing linezolid.
Six patients required red cell transfusion after a mean of 29 ± 9.1 (SD) days (range, 19 to 39 days; median, 26.5 days).
All patients had preexisting mild anemia.
Leukocyte counts in these two patients were 2.8 × 109/liter (neutrophils, 1.6 × 109/liter) and 1.7 × 109/liter (neutrophils, 1.0 × 109/liter).
See text for details.
MRSA, methicillin-resistant S. aureus.
GIT, gastrointestinal tract.
ALT, alanine transaminase.
For definitions of levels of thrombocytopenia and anemia, see the text.
VRE, vancomycin-resistant enterococci.