Evaluation of the relationship between linezolid exposure and hyponatremia |
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| Authors: | Yoshifumi Nishi Chika Ogami Yasuhiro Tsuji Hitoshi Kawasuji Harumi Yamada Shin Kawai Ippei Sakamaki Hideto To Yoshihiro Yamamoto |
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| Institution: | 1. Department of Infectious Diseases, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan;2. Department of Medical Pharmaceutics, Graduate School of Medical and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan;3. Center for Pharmacist Education, School of Pharmacy, Nihon University, 7-7-1 Narashinodai, Funabashi, Chiba, 274-8555, Japan;4. Department of Clinical Infectious Diseases, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan;5. Department of Pharmaceutical Sciences, International University of Health and Welfare, 2600-1 Kita-kanemaru, Ohtawara, Tochigi, 324-8501, Japan;1. Department of Nephrology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan;2. Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan;3. Division of Infection Control and Prevention, University of Fukui Hospital, Fukui, Japan;4. Department of Internal Medicine, National Hospital Organization Awara Hospital, Fukui, Japan;5. Department of Infection Control and Prevention, Kyoto Prefectural University Medicine, Kyoto, Japan;1. Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou, China;2. School of Population Health, The University of New South Wales, Sydney, Australia;3. Department of Infectious Diseases, Guangzhou Eighth People''s Hospital, Guangzhou Medical University, Guangzhou, China;1. Department of Infectious Diseases, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan;2. Department of Infection Control and Prevention, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan;1. Division of Infectious Diseases and Immunology, Saitama Children''s Medical Center, Saitama, Japan;2. Division of Otorhinolaryngology, Kawagoe Otology Institute, Saitama, Japan;3. Division of Otolaryngology, Saitama Children''s Medical Center, Saitama, Japan;4. Department of Pharmacy, Saitama Children''s Medical Center, Saitama, Japan;5. MicroSKY Lab, Inc., Tokyo, Japan;6. The Medical and Nursing Institution of Akitsu Ryoiku-En for Children/Adults with Severe Motor and Intellectual Disabilities, Tokyo, Japan;1. Department of Neonatology, Kanagawa Children''s Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama, Kanagawa, 232-8555, Japan;2. Division of Infectious Diseases, The Hospital for Sick Children, 555 University Ave, Toronto, M5G 1X8, ON, Canada;3. Department of Laboratory Medicine, Nara Prefecture General Medical Center, 2-897-5 Shichijonishimachi, Nara, Nara, 630-8581, Japan;1. Department of Infectious Diseases, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan;2. Department of Laboratory Medicine, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan;3. Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan;4. Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan |
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| Abstract: | IntroductionAims of this study were (a) to assess the development ratio of hyponatremia during treatment with linezolid and (b) to evaluate the relationship between the risk of hyponatremia and linezolid exposure and patient background.MethodClinical data including linezolid serum concentrations and serum sodium values were collected at Toyama University Hospital and Kyorin University Hospital. Data from 89 patients were used for the analysis, and a nadir serum sodium level ≤130 mmol/L during the treatment with linezolid was defined as hyponatremia. Mann-Whitney's U test was used to evaluate the effects of the area under the time-concentration curve (AUC) of linezolid at the nadir sodium level, clinical characteristics (e.g. laboratory data), and baseline serum sodium levels on the development of hyponatremia.ResultsThe hyponatremia was occurred in 21 of 89 patients (23.6%). Data are compared for baseline and nadir serum sodium levels of patients with and without hyponatremia. In both groups, nadir serum sodium levels were significantly different from those of the baseline values (P < 0.05). The values of AUC0-12, accumulated AUC, baseline serum sodium levels and age were significantly different between patients with and without hyponatremia (P < 0.05).ConclusionsLinezolid exposure, age, and baseline sodium levels were detected as the risk factors for linezolid-related hyponatremia. Our findings suggest that regular monitoring of serum sodium levels is desirable during treatment with linezolid, especially for the elderly and patients with low serum sodium levels before the start of linezolid administration. |
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| Keywords: | Drug exposure response Hyponatremia Linezolid Pharmacokinetics |
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