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Risk factors for thrombocytopenia in patients receiving linezolid therapy: a systematic review and meta-analysis

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Abstract

Purpose

The incidence of linezolid-induced thrombocytopenia (LIT) has been reported to vary widely across studies. We performed a meta-analysis to identify the risk factors for thrombocytopenia among patients who received linezolid treatment.

Methods

The PubMed, Embase and Cochrane Library databases were searched from inception to November 2022 to identify eligible studies. Data on the potential predictors of incidence in LIT were pooled using a random effects model. Sensitivity analyses were performed to determine the robustness of the results when significant heterogeneity was observed.

Results

Forty observational studies involving 6454 patients treated with linezolid were included in the analysis. LIT was estimated to occur in 37% of patients. The following important factors were associated with the incidence of LIT: advanced age, body mass index, concurrent renal impairment or liver disease, abnormal laboratory parameters (including white blood cell count, serum creatinine, baseline platelet count, albumin, creatinine clearance rate, and estimated glomerular filtration rate), treatment duration and renal replacement therapy.

Conclusions

A variety of risk factors related to the occurrence of LIT were revealed in our analysis. Early identification of these factors could help patients improve clinical outcomes.

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Data availability

The data that supports the findings of this study are available in the supplementary material of this article.

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Funding

This work was supported by the fund of Hangzhou Biological Medicine and Health Industry Development Support Project (grant number 2022WJC233).

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DZ: designed study, wrote paper. XW, LPH, and MYX: collected data; YSX, DZ, and RG: analysed data. SX: revised paper. YL: designed study, revised paper. All authors read and approved the final version.

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Correspondence to Ying Luo.

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Zhang, D., Xu, Y., Wang, X. et al. Risk factors for thrombocytopenia in patients receiving linezolid therapy: a systematic review and meta-analysis. Eur J Clin Pharmacol 79, 1303–1314 (2023). https://doi.org/10.1007/s00228-023-03542-z

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