利奈唑胺致多重不良反应1例报道

Linezolid-induced multiple adverse reactions:a case report

1例69岁男性患者因颈椎间盘脓肿接受利奈唑胺治疗2个月后,白细胞计数、红细胞计数、血红蛋白和血小板计数均低于正常范围,血乳酸升高至2.6mmol·L^(-1),同时出现视物模糊和嗅觉异常加重等症状。停用利奈唑胺后,给予人促红素注射液和地榆升白片治疗,各项血液指标与血乳酸水平均恢复正常,视力和嗅觉障碍也有所改善。采用Naranjo’s评估量表进行关联性评价,结果为“很可能相关”,提示该病例的全血细胞减少、血乳酸升高、视力障碍和嗅觉异常加重等反应很可能为利奈唑胺导致。利奈唑胺的严重不良反应通常以单一形式出现,但临床应警惕同时出现多种不良反应的情况。用药时间、剂量和患者的基础健康状况与不良反应发生有关,治疗过程中监测血药浓度和相关指标有助于及早发现此类不良反应。

A 69-year-old male patient with cervical discitis received linezolid treatment for two months.The white blood cell count,red blood cell count,hemoglobin,and platelet count of the patient were all below normal ranges.Simultaneously,the blood lactate level increased to 2.6 mmol·L^(-1),and he experienced blurred vision and worsening olfactory dysfunction.After discontinuing linezolid,treatment with erythropoietin injections and Diyu Shengbai tablets was initiated.The blood parameters gradually returned to normal,as did the lactate level,and the vision and olfactory impairment of the patient were improved.Using Naranjo’s assessment scale indicated that the adverse drug reaction was"probably relevant"such as pancytopenia,elevated lactate,visual disturbances,and exacerbated olfactory dysfunction,were likely to be due to linezolid.While severe adverse reactions to linezolid typically manifest in isolation,clinicians and pharmacists should remain vigilant for the simultaneous occurrence of multiple adverse reactions.The onset of adverse reactions is associated with the duration of therapy,dosage,and the patient's baseline health.Monitoring of drug levels and relevant parameters during treatment can help in early detection of such adverse reactions.