Journal Article

Risk factors for anaemia in patients on prolonged linezolid therapy for chronic osteomyelitis: a case–control study

Eric Senneville, Laurence Legout, Michel Valette, Yazdan Yazdanpanah, François Giraud, Eric Beltrand, Guillaume Obert, Luc Dubreuil, Henri Migaud and Yves Mouton

in Journal of Antimicrobial Chemotherapy

Published on behalf of British Society for Antimicrobial Chemotherapy

Volume 54, issue 4, pages 798-802
Published in print October 2004 | ISSN: 0305-7453
Published online October 2004 | e-ISSN: 1460-2091 | DOI:
Risk factors for anaemia in patients on prolonged linezolid therapy for chronic osteomyelitis: a case–control study

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  • Medical Oncology
  • Critical Care


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Objectives: The intrinsic properties of the new antibiotic linezolid make it an attractive candidate for the treatment of chronic osteomyelitis. However, data regarding the tolerance of long-term linezolid administration are still lacking.

Methods: The medical charts of patients given linezolid for >4 weeks were retrospectively analysed, especially their haematology. In a case–control study, we compared the respective characteristics of patients who developed anaemia during linezolid therapy and those who did not.

Results: Forty-five adults with chronic osteomyelitis received 600 mg linezolid intravenously twice daily for 7 days, and then orally, for a mean total duration of 15.9 weeks (range, 6–36). Anaemia episodes requiring blood transfusion occurred in 13/45 patients (28.9%). Median time from treatment initiation to anaemia onset was 7.4 weeks (range, 4–16). Anaemia was significantly associated with premature linezolid therapy cessation (P=0.0012). No linezolid-related thrombocytopenia was observed. By univariate analysis, four variables were associated with the occurrence of anaemia: age >58 years, alcohol abuse, diabetes mellitus and low haemoglobin before linezolid treatment. Logistic regression analysis revealed two independent risk factors for anaemia: age >58 years (OR = 20.5, 95% CI 0.69–599; P=0.0001) and pre-treatment haemoglobin <10.5 g/dL (OR = 16.49, 95% CI 1.06–255; P=0.04).

Conclusions: Profound anaemia may occur in adult patients with chronic osteomyelitis on prolonged linezolid therapy, and often necessitates linezolid cessation. These patients are likely to be aged >58 years and to have low pre-treatment haemoglobin. The results for the present series might help physicians to identify patients who should not be given long-term linezolid treatment for chronic osteomyelitis.

Keywords: oxazolidinones; toxicity; myelosuppression

Journal Article.  3263 words.  Illustrated.

Subjects: Medical Oncology ; Critical Care

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