High plasma concentration of linezolid in patients undergoing continuous venovenous hemodiafiltration

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  • Ide Takeshi
    Division of Intensive Care Unit, Hyogo College of Medicine
  • Takeda Kenta
    Division of Intensive Care Unit, Hyogo College of Medicine
  • Nishi Shinichi
    Division of Intensive Care Unit, Hyogo College of Medicine
  • Takahashi Keiko
    Department of Infection Control and Prevention, Hyogo College of Medicine
  • Takesue Yoshio
    Department of Infection Control and Prevention, Hyogo College of Medicine
  • Ikawa Kazuro
    Department of Clinical Pharmacotherapy, Graduate School of Biomedical Sciences, Hiroshima University
  • Morikawa Norifumi
    Department of Clinical Pharmacotherapy, Graduate School of Biomedical Sciences, Hiroshima University

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Other Title
  • Continuous hemodiafiltration（CHDF）施行中にリネゾリド血中濃度が予想以上に上昇した3症例
  • 症例報告 Continuous hemodiafiltration (CHDF)施行中にリネゾリド血中濃度が予想以上に上昇した3症例
  • ショウレイ ホウコク Continuous hemodiafiltration (CHDF)シコウ チュウ ニ リネゾリド ケッチュウ ノウド ガ ヨソウ イジョウ ニ ジョウショウ シタ 3 ショウレイ

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Abstract

<p>The oxazolidinone linezolid is an antibacterial drug used for treating infections caused by methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus spp. Linezolid clearance is known to occur via non-enzymatic reactions and non-renal elimination and can also be achieved by renal replacement therapy involving the metabolites of linezolid. Therefore, the adjustment of linezolid dosage is not needed in patients with renal dysfunction and in those undergoing renal replacement therapy. However, information on linezolid clearance in patients undergoing continuous renal replacement therapy is limited. Hence, we measured linezolid clearance in patients undergoing continuous venovenous hemodiafiltration (CVVH). We found that the plasma concentration of linezolid was high in 3 patients. The elimination half-life and total clearance of linezolid were 13.0h, 11.0h, and 11.0h and 4.2L/h, 3.6L/h, and 4.5L/h, respectively, in the 3 patients. These results suggested that linezolid was not always removed by CVVH. Furthermore, 2 patients developed thrombocytopenia as a frequent side effect of linezolid. The high plasma concentration of linezolid might have induced the thrombocytopenia. Hence, clinicians should be aware of the side effect of linezolid in patients undergoing CVVH. </p>

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