利奈唑胺是否需要血药浓度监测?

Abstract

利奈唑胺非肝药酶代谢,约35%以原型经肾排泄,说明书提示其浓度受其他药物影响轻微,肾功能不全患者无需调整剂量,但临床研究表明肾功能不全患者利奈唑胺所致血小板减少症或贫血发生率增高与利奈唑胺高暴露相关,且利奈唑胺与某些药物存在的相互作用可显著影响其血药浓度、利奈唑胺的血药浓度在危重症患者中个体差异大,应进行血药浓度监测。

Linezolid is not metabolized by CYP450 s and only approximately 35% of the prototype was excreted via the kidney, and its label suggests that its concentration is affected by other drugs slightly and no dose adjustment is recommended to patients with renal impairment. Nevertheless, clinic studies showed that the development of linezolid- induced thrombocytopenia and anemia was related to the high linezolid exposure in patients with impaired renal function, and the interaction between linezolid and other drugs may significantly affect its concentration. Considering these factors and the significant variability of linezolid concentration in critically ill patients, the therapeutic drug monitoring is necessary for linezolid to ensure its efficiency and safety.