Background: Linezolid-induced thrombocytopenia incidence varies considerably. Linezolid-related thrombocytopenia in patients has received few studies which have investigated risk factors including platelet parameters except for platelet counts. The study aims to analyze the effect of platelet parameters, including mean platelet volume and platelet large cell ratio, on linezolid-related thrombocytopenia in patients.
Methods: The effect of platelet parameters on linezolid-related thrombocytopenia was identified by univariate and multivariate logistic regressions. A Kaplan–Meier survival analysis was carried out to compare the survival of patients who developed linezolid-related thrombocytopenia with patients who did not.
Results: Thrombocytopenia occurred at a rate of 41.5% (66/159) after linezolid therapy in hospitalized patients. Platelet parameters, including the difference in mean platelet volume (MPV/fL=0.08 (− 1.2– 0.9)vs-0.5 (− 1.5– 0.3), (OR , 0.459; P = 0.001), the difference in platelet large cell ratio (PLCR/fL=0.9 (− 5.1– 6.2)vs-3.8 (− 8.6– 2.4), (OR , 1.156; P = 0.001), baseline platelet counts (OR , 0.995; P = 0.006) and duration of linezolid therapy≥ 10d (OR , 1.346; P = 0.007), were significantly associated with linezolid-related thrombocytopenia in hospitalized patients. In addition, other risk factors which also are associated with linezolid-related thrombocytopenia include baseline red blood cells, co-medication with parecoxib and co-medication with caspofungin. Accumulated in-hospital mortality of patients with thrombocytopenia was significantly higher than that of patients without thrombocytopenia during linezolid treatment (19.7% vs 8.6%, P = 0.003).
Conclusion: The difference in mean platelet volume, the difference in large platelet ratio, baseline platelet counts and duration of linezolid therapy≥ 10d significantly affected the development of linezolid-related thrombocytopenia in hospitalized patients.
Keywords: linezolid, platelet parameters, thrombocytopenia, risk factors