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Predictive score of haematological toxicity in patients treated with linezolid

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European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

Objective

The aims of our study were to determine the factors associated with developing haematological toxicity (HT) in patients taking linezolid (LZD), to develop a predictive model of HT in these patients, and to evaluate factors associated with 30-day mortality.

Methods

This was an observational retrospective cohort study of patients treated for at least 5 days with LDZ in 2015. Demographic, clinical and analytical data were collected. Development of HT was defined as a 25% platelet count decrease between the basal count and the 1-week lab test.

Results

Five hundred forty-nine patients were finally included, mean age was 73.3 (SD 15.4) years, and 303 (55.2%) were men. One hundred seventy-five (30.1%) patients achieved HT criteria during treatment with LZD and 41 (7.5%) died. The final model included the presence of cerebrovascular disease (2 points), moderate or severe liver disease (2 points), renal failure (2 points) and basal platelet count less than 90,000/mm3 (8 points). This new model showed an AUC of 0.711 (IC 95% 0.664–0.757; p < 0.001) to predict the development of HT. The probability of HT based on this classification was 6.2, 29.9 and 76.5% for low (0–4 points), intermediate (5–10 points) and high risk (>10 points), respectively. The independent variables associated with 30-day mortality were metastatic solid tumor, lymphoma, age >75 years and HT.

Conclusion

This score could help in the identification of patients with high risk for HT and assess the use of an antibiotic other than LZD, an important issue considering its relation with 30-day mortality observed in our study.

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Acknowledgments

The authors wish to thank Juan González Núñez and Ana González Núñez for helping us with English text correction.

Author information

Authors and Affiliations

  1. Emergency Department, Hospital Universitario Clínico San Carlos, Calle Profesor Martín-Lagos s/n, 28040, Madrid, Spain

    J. González-Del Castillo, E. J. García-Lamberechts & F. J. Martín-Sánchez

  2. Health Research Institute, Hospital Universitario Clínico San Carlos, Madrid, Spain

    J. González-Del Castillo, F. J. Candel, E. J. García-Lamberechts & F. J. Martín-Sánchez

  3. Department of Clinical Microbiology, Hospital Universitario Clínico San Carlos, Madrid, Spain

    F. J. Candel

  4. Pharmacy Department, Hospital Universitario Clínico San Carlos, Madrid, Spain

    R. Manzano-Lorenzo & L. Arias

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  1. J. González-Del Castillo
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Consortia

Representatives of the Emergency Department Investigation Unit (addendum)

  • Fahd Beddar Chaib
  • , Flavia Chirella
  • , Sol Hernández
  • , Iván Larrosa-Espejo
  • , Laura Lopez-González
  • , Marta Gonzalvo Navarro
  • , Maria Isabel Perea Casado
  • , Alberto Pérez-Morales
  • , David Redondo-Domínguez
  • , Víctor Rodríguez-Neira
  • , José Carlos Tallón-Martínez
  •  & May Trujillo-Fox

Corresponding author

Correspondence to J. González-Del Castillo.

Ethics declarations

Funding

The study was not funded.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The Ethical Committee of the Clínico San Carlos Hospital approved the study.

Informed consent

Considering the characteristics of the study (observational retrospective cohort study), the ethical committee allowed us the exemption of obtaining informed consent.

Addendum

Addendum

Representatives of the Emergency Department Investigation Unit

Fahd Beddar Chaib (Emergency Department)

Flavia Chirella (Clinical Microbiology Department)

Sol Hernández (Emergency Department)

Iván Larrosa-Espejo (Pharmacy Department)

Laura Lopez-González (Clinical Microbiology Department)

Marta Gonzalvo Navarro (Emergency Department)

Maria Isabel Perea Casado (Emergency Department)

Alberto Pérez-Morales (Pharmacy Department)

David Redondo-Domínguez (Emergency Department)

Víctor Rodríguez-Neira (Emergency Department)

José Carlos Tallón-Martínez (Pharmacy Department)

May Trujillo-Fox (Emergency Department)

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González-Del Castillo, J., Candel, F.J., Manzano-Lorenzo, R. et al. Predictive score of haematological toxicity in patients treated with linezolid. Eur J Clin Microbiol Infect Dis 36, 1511–1517 (2017). https://doi.org/10.1007/s10096-017-2960-5

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  • DOI: https://doi.org/10.1007/s10096-017-2960-5

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