Use of linezolid in infants and children: a retrospective multicentre study of the Italian Society for Paediatric Infectious Diseases
Use of linezolid in infants and children: a retrospective multicentre study of the Italian Society for Paediatric Infectious Diseases
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DOI：
10.1093/jac/dkr285
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发表时间：
2011-10-01
影响因子：
5.2
通讯作者：
Tovo, Pier-Angelo
中科院分区：
文献类型：
--
作者：
Garazzino, Silvia;Krzysztofiak, Andrzej;Tovo, Pier-Angelo
目的：由于耐药革兰氏阳性菌的传播，利奈唑胺用于治疗严重感染的使用正在增加。然而，儿科人群的临床经验仍然有限。我们进行了一项多中心研究，分析利奈唑胺在children.Methods中的使用：对疑似或确诊的革兰氏阳性菌或分枝杆菌感染的利奈唑胺治疗的住院儿童进行了回顾性分析。副作用进行了调查，专注于年幼的儿童和长期treatment.Results：75例（平均年龄6.8岁，范围7天至17岁）进行了研究。平均+/- SD利奈唑胺治疗持续时间为26.13 +/- 17天。临床治愈率为74.7%。最常见的不良事件是腹泻和呕吐。2例患者出现重度贫血、2例中性粒细胞减少和1例血小板减少。报告了2例3级肝功能检查结果升高和1例胰腺炎。不良事件的总体频率在治疗> 28天的患者和接受较短治疗的患者之间相似（30.8%对28.6%，P=0.84）。年龄< 2岁的儿童接受利奈唑胺的持续时间短于年龄较大的儿童（21.2天与28.4天，P=0.05），而不良事件的频率在两个年龄组相似。结论：在我们的儿科人群中，利奈唑胺似乎是安全和有效的治疗选定的革兰氏阳性菌和分枝杆菌感染。出现的不良反应是可逆的，似乎与儿科临床试验中报告的不良反应相当。然而，利奈唑胺在儿童中的潜在血液学毒性意味着治疗期间需要仔细监测。
Objectives: Because of the spread of drug-resistant Gram-positive bacteria, the use of linezolid for treating severe infections is increasing. However, clinical experience in the paediatric population is still limited. We undertook a multicentre study to analyse the use of linezolid in children.Methods: Hospitalized children treated with linezolid for a suspected or proven Gram-positive or mycobacterial infection were analysed retrospectively. Side effects were investigated, focusing on younger children and long-term treatments.Results: Seventy-five patients (mean age 6.8 years, range 7 days to 17 years) were studied. Mean +/- SD linezolid treatment duration was 26.13 +/- 17 days. Clinical cure was achieved in 74.7% of patients. The most frequent adverse events were diarrhoea and vomiting. Two patients had severe anaemia, two neutropenia and one thrombocytopenia. Two cases of grade 3 liver function test elevation and one case of pancreatitis were reported. The overall frequency of adverse events was similar between patients treated for > 28 days and those receiving shorter treatments (30.8% versus 28.6%, P=0.84). Children aged < 2 years received linezolid for a shorter duration than older children (21.2 days versus 28.4 days, P=0.05), whereas the frequency of adverse events was similar in the two age groups.Conclusions: In our paediatric population, linezolid appeared safe and effective for the treatment of selected Gram-positive and mycobacterial infections. The adverse reactions encountered were reversible and appeared comparable to those reported in paediatric clinical trials. Nevertheless, the potential for haematological toxicity of linezolid in children means that careful monitoring is required during treatment.