J Pharmacoepidemiol Risk Manage.  2022 Sep;14(2):158-164. 10.56142/jperm.22.0015.

Incidence and Associated Factors of Linezolid Associated Lactic Acidosis

• Park SY
• Baek JU
• Kim KA
• Choi GW
• Baek JH
• Jo YH
• Cho YS
• Ryu HG
• Lee5 JY
• Kim AJ

• KMID: 2534687
• DOI: http://doi.org/10.56142/jperm.22.0015

Abstract

Objective
Incidence of linezolid-associated lactic acidosis (LALA) has been described as 5-7% in previous studies.However, limited studies have evaluated the association between linezolid and lactic acidosis, and there is a discordance of major risk factors among the existing studies. This study aimed to estimate the incidence of LALA and to identify its risk factors in a single hospital.
Methods
This study is a retrospective study, reviewing electronic medical records of adult patients who received 600 mg of intravenous linezolid twice daily from January 1, 2015 to June 30, 2020. LALA was defined as a serum lactate level above 5 mmol/L after the initiation of linezolid. Incidence proportion was estimated and the risk factors of LALA were analyzed with logistic regression.
Results
Among 586 patients, 10 patients were identified as LALA and the cumulative incidence was calculated as 2%. The onset of LALA was 8 days (median) after the initial linezolid treatment. Logistic regression analysis showed that body weight less than 60 kg (odds ratio [OR] 8.496; 95% confidence interval [CI] 1.011-71.377), total bilirubin higher than 5 mg/dL (OR 5.130; 95% CI 1.171-22.463), and renal replacement therapy (OR 5.555; 95% CI 1.401-22.021) are statistically significant factors. However, sensitivity analysis did not show consistent results.
Conclusion
This study shows that the cumulative incidence of LALA was 2%. However further studies are warranted to identify the risk factors.

Keyword

Linezolid; Lactic acidosis; Incidence