Clinical efficacy of linezolid in treatment of neonatal septicemia and its influence on platelets
10.3760/cma.j.issn.1008-5734.2016.02.005
- VernacularTitle:利奈唑胺治疗新生儿败血症的疗效及对血小板的影响
- Author:
Lian TANG
1
;
Sannan WANG
;
Xiaohong WENG
;
Erning SHANG
Author Information
1. 215002,苏州市立医院药学部
- Publication Type:Journal Article
- Keywords:
Linezolid;
Infant,newborn;
sepsis;
ThrombocYtopenia;
RisK factors
- From:
Adverse Drug Reactions Journal
2016;18(2):99-104
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analYze the clinical efficacY of linezolid,the influence of linezolid on PLT and risK factors for treatment of neonatal septicemia. Methods The medical record data of neonates,who received the treatment with linezolid,diagnosed as late onset gram positive bacterial sepsis,and hospitalized in Department of neonatologY,suzhou Municipal Hospital from June 2009 to MaY 2015,were collected. The infants'sex,age in daYs when medication was applied,bodY weight when theY were born,gestational weeKs at birth, diagnosis and complications, course of treatment, combined antimicrobial agents, results of pathogenic bacterial culture and laboratorY examination before and after treatment,and the prognosis were recorded. Linezolidˊs clinical efficacY,bacteriological efficacY,and the influence on PLT in infants were analYzed. The risK factors of linezolid related thrombocYtopenia were analYzed bY single and multi factor Logistics regression analYsis. Results A total of 195 infants were enrolled in the studY. Of them,109 were boYs and 86 were girls with age in daYs when medication from 8 to 28 daYs and an average age in daYs was(16 ± 8)daYs,gestational weeKs at birth from 27 to 42 weeKs and average gestational weeKs was(33 ± 3)weeKs,time of medication from 7 to 23 daYs and an average time was(12 ± 4)daYs. Of the 195 infants, 133(68. 21%)were premature babies and 96(49. 23%)were used of other antimicrobial agents at the same time. The results of evaluation of clinical efficacY showed the recoverY were 117 cases(60. 00%), excellence were 58 cases(29. 74%). The total effective rate was 89. 74%. There were 208 bacterial strain of gram-positive bacteria and 18 of gram-negative bacteria in 195 infants. The results of bacteriological efficacY showed the bacteria eradication were 178 cases(91. 28%),partial removal of bacteria were 11 cases (5. 64%),bacteria not cleared were 3(1. 54%)cases,and bacterial substitution were 3(1. 54%)cases. The bacterial eradication rate was 96. 92%. There were 27 cases appeared PLT decreasing on 5 to 15 daYs of medication[an average daYs of(9 ± 5)d]in 195 infants. Of them,22 cases(81. 48%)were premature, 19 infants with normal PLT baseline developed thrombocYtopenia inⅠ,Ⅱ,Ⅲ andⅣdegree were 8,7,4 and 0 cases,respectivelY. six cases appeared the decreasing of hemoglobin( ﹥50% of baseline). Eight infants with thrombocYtopeniaⅠdegree baseline developed to Ⅱ,Ⅲ and Ⅳdegree were 5,1,and 2 cases, respectivelY. Two cases appeared the decreasing of hemoglobin( ﹥ 50% of baseline ). Linezolid was withdrawn immediatelY in 27 infants who developed thrombocYtopenia. Of them,19 cases’ PLT returned to normal bY themselves on 3 to 13 daY[an average time was(5 ± 4)daYs]of drug withdrawal ,and two cases discharged according to their parents,PLT in 6 cases returned to normal after receiving the sYmptomatic treatment. The results of Logistics regression analYsis showed that bodY weight when theY were born, gestational weeKs at birth, baseline levels of PLT, albumin and total bilirubin were related to thrombocYtopenia due to linezolid,gestational weeKs at birth,baseline levels of PLT,albumin and total bilirubin were independent risK factors of thrombocYtopenia due to linezolid. Conclusions Linezolid has a good efficacY in treatment of neonatal gram-positive bacterial sepsis. The risK of thrombocYtopenia due to linezolid maY be increased when the infants receiving linezolid who with premature birth,or lower PLT baseline,or hYpoproteinemia or hYperbilirubinemia.
