摘要
利奈唑胺为恶唑烷酮类抗生素,主要用于革兰阳性细菌引起的呼吸道和皮肤感染以及耐万古霉素肠球菌引起的感染.利奈唑胺的常见不良反应为腹泻、恶心、呕吐、头痛、皮疹等.利奈唑胺可致血小板减少,其危险因素为长时间治疗、高龄以及肾功能不全.利奈唑胺所致血小板减少的机制可能与骨髓抑制或免疫介导致血小板减少有关.防治血小板减少的措施:避免大剂量和长时间应用利奈唑胺;用药期间严密监测血小板水平;避免将利奈唑胺与抑制骨髓的药物联用;患者出现血小板减少应立即停药,严重患者可考虑输注血小板.
Abstract
Linezolid is an oxazolidinone antibacterial used for the treatment of Gram-positive infection of the respiratory tract and skin, including those due to vancomycin resistant enterocooci. The common adverse reactions are diarrhea, nausea, vomiting, headache, and rash. Linezolid may cause thrombocytopenia, and the risk factors for thrombocytopenia are prolonged use of linezolid, advanced age, and renal insufficiency. The mechanism of thrombocytopenia induced by linezolid might be linked to bone marrow suppression or immune-mediated platelet decrease. The measures for prevention and treatment of thrombocytopenia are as follows: high-dose and prolonged use of linezolid should be avoided; platelet count should be closely monitored during linezolid therapy; linezolid combined with drugs that produce bone marrow suppression should be avoided; linezolid therapy should be discontinued in patients who developed thrombocytopenia, and transfusion of platelets should be considered in patients having severe thrombocytopenia.