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Antimicrobial Agents and Chemotherapy, July 2007, p. 2559-2563, Vol. 51, No. 7
0066-4804/07/$08.00+0     doi:10.1128/AAC.00247-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Comparative Study of the Effects of Pyridoxine, Rifampin, and Renal Function on Hematological Adverse Events Induced by Linezolid

Alex Soriano,^1* Mar Ortega,¹ Sebastián García,² Georgina Peñarroja,¹ Albert Bové,³ Miguel Marcos,¹ Juan C. Martínez,² José A. Martínez,¹ and Josep Mensa¹

Department of Infectious Diseases, Hospital Clínic of Barcelona, C/Villarroel 170, Barcelona 08036, Spain,¹ Department of Orthopedics and Traumatology, Hospital Clínic of Barcelona, Barcelona, Spain,² Department of Internal Medicine, Hospital Clínic of Barcelona, Barcelona, Spain³

Received 18 February 2007/ Returned for modification 26 March 2007/ Accepted 19 April 2007

Hematological disturbances that develop during linezolid treatment are a major concern when linezolid is administered for prolonged periods of time. The aim of this study was to evaluate the influences of pyridoxine, rifampin, and renal function on hematological adverse events. From January 2002 to April 2006, 52 patients received a long-term course of linezolid. Blood cell counts were monitored weekly. Thrombocytopenia was defined as a decrease to <75% of the baseline platelet count, and anemia was defined when the hemoglobin concentration decreased by 2 g/liter from the baseline value. Twenty-four patients received linezolid alone, and 28 patients received linezolid plus 200 mg of pyridoxine. The Kaplan-Meier survival method, followed by the log-rank test, was used to estimate the cumulative probability of adverse events, and Cox regression analysis was performed to evaluate the independent predictors of toxicity. The baseline characteristics of the patients in both groups were similar. The cumulative probability of thrombocytopenia and anemia in patients who received pyridoxine was not different from that in patients who did not receive it. Hematological adverse events were less frequent in patients taking rifampin and were more frequent in patients with renal failure. However; the Cox regression analysis showed that rifampin was the only independent predictor associated with a lower risk of thrombocytopenia (hazard ratio, 0.37; 95% confidence interval, 0.14 to 0.98; P = 0.045). In conclusion, pyridoxine did not prevent linezolid-related hematological adverse events, and the coadministration of rifampin was associated with a lower risk of thrombocytopenia.

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* Corresponding author. Mailing address: Department of Infectious Diseases, Hospital Clínic of Barcelona, C/Villarroel 170, Barcelona 08036, Spain. Phone: 00 34 932275708. Fax: 00 34 934514438. E-mail: asoriano{at}clinic.ub.es

Published ahead of print on 30 April 2007.

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Antimicrobial Agents and Chemotherapy, July 2007, p. 2559-2563, Vol. 51, No. 7
0066-4804/07/$08.00+0     doi:10.1128/AAC.00247-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

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