Linezolid in the treatment of severe intraabdominal infection: A STROBE-compliant retrospective study
Deyuan You1, Yuexiang Su2, Xuri Sun1
1Department of Respiratory and Critical Care Medicine, Fujian Respiratory Medical Center, The Second Affiliated Hospital of Fujian Medical University, Quanzhou City, Fujian Province, China.
Abstract:
Safety concerns over bone marrow suppression and thrombocytopenia may inhibit the use of linezolid to treat intraabdominal infection (IAI). To evaluate the effectiveness, safety, and prognosis of linezolid in the treatment of severe IAI (SIAI). Patients were divided into a linezolid group and nonlinezolid group according to whether linezolid was prescribed. Subgroup analysis (thrombocytopenia treated with linezolid group (I), and thrombocytopenia treated with nonlinezolid group (II) also was performed. We evaluated the effectiveness of linezolid by analyzing the changes in white blood cells (WBC) and procalcitonin, evaluated safety by analyzing the changes in platelet counts, and evaluated patient outcomes by analyzing the length of hospital stay, the length of ICU stay, and the rates of clinical improvement. Sixty-six adult SIAI patients were treated with anti-gram-positive (G+) bacteria drugs for more than 7 days from January 1, 2014, to December 31, 2020. The length of hospital stay, the length of ICU stay, and the rates of clinical improvement were not significantly different between the linezolid group and nonlinezolid group. On the 15th day after anti-G + bacteria treatment, the WBC of the linezolid group was significantly lower than in the nonlinezolid group (9.00 ± 4.30 vs 13.1 ± 6.19, P < .05). The time for a statistical difference in the decrease of procalcitonin in the linezolid group was earlier than in the nonlinezolid group (day 6 vs day 7, P < .05). There was no statistically significant difference in the changes of platelet counts in the subgroup I (P > .05), but compared with the baseline data (day 0), the time for the statistical difference in the increase of platelets in thrombocytopenia treated with linezolid group was earlier (day 5 vs day 6, P < .05). There was no statistical difference in the changes of platelets in subgroup II (P > .05). In the treatment of severe intraabdominal infection in a single-center, retrospective study, linezolid was not inferior to other antibiotics in patient clinical outcomes or seral WBC and procalcitonin values. Linezolid also induced no evident bone marrow suppression or thrombocytopenia. Linezolid is a good choice for treatment of SIAI.
Insights
Linezolid is effective for treating severe intraabdominal infections (SIAI) without causing significant bone marrow suppression or thrombocytopenia. This study found linezolid comparable to other antibiotics in patient outcomes and inflammatory markers.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Pharmacology
Background:
- Bone marrow suppression and thrombocytopenia are safety concerns limiting linezolid use in intraabdominal infections (IAI).
- Evaluating linezolid's efficacy and safety in severe IAI (SIAI) is crucial for clinical decision-making.
Purpose of the Study:
- To assess the effectiveness and safety of linezolid in treating severe intraabdominal infections (SIAI).
- To compare linezolid with other antibiotics regarding clinical outcomes and laboratory markers.
Main Methods:
- A retrospective study comparing 66 adult SIAI patients treated with linezolid versus non-linezolid regimens.
- Analysis included white blood cell (WBC) counts, procalcitonin levels, platelet counts, hospital/ICU stay, and clinical improvement rates.
- Subgroup analysis focused on patients with thrombocytopenia.
Main Results:
- No significant differences in hospital stay, ICU stay, or clinical improvement rates between groups.
- Linezolid group showed significantly lower WBC counts on day 15 and earlier decrease in procalcitonin.
- No evident bone marrow suppression or thrombocytopenia observed; platelet counts improved earlier in the linezolid subgroup with thrombocytopenia.
Conclusions:
- Linezolid is a viable option for SIAI treatment, demonstrating comparable clinical outcomes to other antibiotics.
- Linezolid does not appear to cause significant bone marrow suppression or thrombocytopenia in SIAI patients.
- Linezolid offers an effective and safe treatment choice for severe intraabdominal infections.
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