LInezolid Monitoring to MInimise Toxicity (LIMMIT1): A multicentre retrospective review of patients receiving linezolid therapy and the impact of therapeutic drug monitoring.


Journal

International journal of antimicrobial agents
ISSN: 1872-7913
Titre abrégé: Int J Antimicrob Agents
Pays: Netherlands
ID NLM: 9111860

Informations de publication

Date de publication:
May 2023
Historique:
received: 09 11 2022
revised: 18 02 2023
accepted: 07 03 2023
medline: 5 5 2023
pubmed: 16 3 2023
entrez: 15 3 2023
Statut: ppublish

Résumé

Linezolid is a broad-spectrum antimicrobial with limited use due to toxicity. This study aimed to evaluate linezolid toxicity in a large multicentre cohort. Secondary objectives were to identify factors contributing to toxicity, including the impact of therapeutic drug monitoring (TDM). Patients administered linezolid between January 2017 and December 2019 were retrospectively reviewed. Data were collected on patient characteristics, linezolid therapy and outcomes. Descriptive statistics were performed on all patients, and statistical comparisons were undertaken between those who did and did not experience linezolid toxicity. A multivariable logistic regression model was constructed to identify any covariates that correlated with toxicity. Linezolid was administered to 1050 patients; of these, 381 did not meet the inclusion criteria and 47 were excluded as therapy ceased for non-toxicity reasons. There were 105 of 622 (16.9%) patients assessed to have linezolid toxicity. Patients who experienced toxicity displayed a higher baseline creatinine (96.5 µmol/L vs. 79 µmol/L; P = 0.025), lower baseline platelet count (225 × 10 This study confirmed that linezolid treatment-limiting toxicity remains a problem and suggests that TDM-guided dose optimisation may reduce the risk of toxicity and facilitate prolonged courses beyond 28 days.

Sections du résumé

BACKGROUND BACKGROUND
Linezolid is a broad-spectrum antimicrobial with limited use due to toxicity. This study aimed to evaluate linezolid toxicity in a large multicentre cohort. Secondary objectives were to identify factors contributing to toxicity, including the impact of therapeutic drug monitoring (TDM).
METHODS METHODS
Patients administered linezolid between January 2017 and December 2019 were retrospectively reviewed. Data were collected on patient characteristics, linezolid therapy and outcomes. Descriptive statistics were performed on all patients, and statistical comparisons were undertaken between those who did and did not experience linezolid toxicity. A multivariable logistic regression model was constructed to identify any covariates that correlated with toxicity.
RESULTS RESULTS
Linezolid was administered to 1050 patients; of these, 381 did not meet the inclusion criteria and 47 were excluded as therapy ceased for non-toxicity reasons. There were 105 of 622 (16.9%) patients assessed to have linezolid toxicity. Patients who experienced toxicity displayed a higher baseline creatinine (96.5 µmol/L vs. 79 µmol/L; P = 0.025), lower baseline platelet count (225 × 10
CONCLUSIONS CONCLUSIONS
This study confirmed that linezolid treatment-limiting toxicity remains a problem and suggests that TDM-guided dose optimisation may reduce the risk of toxicity and facilitate prolonged courses beyond 28 days.

Identifiants

pubmed: 36921808
pii: S0924-8579(23)00068-7
doi: 10.1016/j.ijantimicag.2023.106783
pii:
doi:

Substances chimiques

Linezolid ISQ9I6J12J
Anti-Bacterial Agents 0

Types de publication

Multicenter Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

106783

Informations de copyright

Crown Copyright © 2023. Published by Elsevier Ltd. All rights reserved.

Auteurs

Cindy Lau (C)

Department of Pharmacy, St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia; School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia. Electronic address: Cindy.lau@svha.org.au.

Deborah Marriott (D)

Department of Clinical Microbiology and Infectious Diseases, St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia; School of Medicine, The University of New South Wales, Sydney, NSW, Australia.

Jessica Bui (J)

Department of Pharmacy, Royal North Shore Hospital, St Leonards, NSW, Australia.

Melanie Figtree (M)

Department of Clinical Microbiology and Infectious Diseases, Royal North Shore Hospital, St Leonards, NSW, Australia; School of Medicine, University of Sydney, Sydney, NSW, Australia.

Michael Gould (M)

School of Medicine, University of Notre Dame Australia, Sydney, NSW, Australia; Department of Intensive Care, Royal North Shore Hospital, St Leonards, NSW, Australia.

Adriana Chubaty (A)

Department of Pharmacy, Prince of Wales Hospital, Randwick, NSW, Australia.

Yuen Su (Y)

Department of Infectious Diseases, Prince of Wales Hospital, Randwick, NSW, Australia.

Suman Adhikari (S)

Department of Pharmacy, St George Hospital, Kogarah, NSW, Australia; School of Clinical Medicine, The University of New South Wales, Sydney, Australia.

Pam Konecny (P)

School of Clinical Medicine, The University of New South Wales, Sydney, Australia; Department of Infectious Diseases, Immunology and Sexual Health, St George Hospital, Kogarah, NSW, Australia.

Kristi Kozierowski (K)

Department of Pharmacy, John Hunter Hospital, New Lambton Heights, NSW, Australia.

Taylor Holland (T)

Department of Pharmacy, John Hunter Hospital, New Lambton Heights, NSW, Australia.

Eliza Milliken (E)

Department of Immunology and Infectious Diseases, John Hunter Hospital, New Lambton Heights, NSW, Australia.

Ayesha Akram (A)

Department of Immunology and Infectious Diseases, John Hunter Hospital, New Lambton Heights, NSW, Australia.

Alexander Mcnamara (A)

Department of Pharmacy, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.

Yihui Sun (Y)

School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Pharmacy, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.

Sebastiaan Van Hal (S)

School of Medicine, University of Sydney, Sydney, NSW, Australia; Department of Infectious Diseases and Microbiology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.

Asad E Patanwala (AE)

School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Pharmacy, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.

Aryan Shahabi-Sirjani (A)

Department of Pharmacy, Concord Repatriation General Hospital, Concord, NSW, Australia; Department of Microbiology and Infectious Diseases, Concord Repatriation General Hospital, Concord, NSW, Australia.

Timothy Gray (T)

School of Medicine, University of Sydney, Sydney, NSW, Australia; Department of Microbiology and Infectious Diseases, Concord Repatriation General Hospital, Concord, NSW, Australia.

Chin Yen Yeo (CY)

Department of Pharmacy, Blacktown Hospital, Blacktown, NSW, Australia.

Angela Netluch (A)

Department of Pharmacy, Westmead Hospital, Westmead, NSW, Australia.

Stephanie Halena (S)

Department of Pharmacy, Westmead Hospital, Westmead, NSW, Australia.

Marcelle Appay (M)

Department of Pharmacy, Westmead Hospital, Westmead, NSW, Australia.

Rozanna Alameddine (R)

Department of Pharmacy, Westmead Hospital, Westmead, NSW, Australia.

Fiona Yin (F)

Department of Pharmacy, Westmead Hospital, Westmead, NSW, Australia.

Quoc Nguyen (Q)

Department of Pharmacy, Westmead Hospital, Westmead, NSW, Australia.

Mei-Yi So (MY)

Department of Pharmacy, Westmead Hospital, Westmead, NSW, Australia.

Indy Sandaradura (I)

School of Medicine, University of Sydney, Sydney, NSW, Australia; Centre for Infectious Diseases and Microbiology, Westmead Hospital, Westmead, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Camperdown, NSW, Australia.

Hannah Yejin Kim (HY)

School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Pharmacy, Westmead Hospital, Westmead, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Camperdown, NSW, Australia.

Semun Galimam (S)

Department of Pharmacy, Gosford and Wyong Hospitals, Gosford, NSW, Australia.

Nicole Cerruto (N)

Department of Pharmacy, Gosford and Wyong Hospitals, Gosford, NSW, Australia.

Tony Lai (T)

Sydney Institute for Infectious Diseases, University of Sydney, Camperdown, NSW, Australia; Department of Pharmacy, Children's Hospital Westmead, Westmead, NSW, Australia.

Timothy Gilbey (T)

Department of Infectious Diseases, Wagga Wagga Base Hospital, Wagga Wagga, NSW, Australia.

Kathryn Daveson (K)

Department of Infectious Diseases, The Canberra Hospital, Canberra, ACT, Australia.

Stephanie E Reuter (SE)

UniSA Clinical and Medical Sciences, University of South Australia, Adelaide, SA, Australia.

Jonathan Penm (J)

School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Pharmacy, Prince of Wales Hospital, Randwick, NSW, Australia.

Jan-Willem Alffenaar (JW)

School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Pharmacy, Westmead Hospital, Westmead, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Camperdown, NSW, Australia.

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Classifications MeSH