Compassionate Use of Linezolid for Adult Taiwanese Patients with Bone and Joint Infections

BACKGROUND: Compassionate use of linezolid for bone and joint infections has been reported and hematological adverse reactions are a cause for concern. A similar experience in Asian people has not been reported. METHODS: Adult cases that received linezolid for bone and joint infections at 3 Taiwanese medical centers from 2002 to 2006 were analyzed. We investigated factors associated with treatment outcome and hematological adverse reactions. RESULTS: Of the 51 cases that received linezolid for more than 3 days, 41 (80.4%) had a favorable outcome and 10 had a failed outcome. Based on univariate analysis, patients with renal/urinary tract diseases, gastrointestinal diseases, higher WBC counts, a higher alanine aminotransferase level, or a higher creatinine level prior to linezolid treatment were significantly associated with a failed outcome. Based on multivariate analysis, underlying gastrointestinal disease was the only significant factor for a failed outcome. Six patients stopped linezolid use due to adverse reactions. A failed outcome was significantly associated with anemia caused by linezolid. CONCLUSION: Linezolid is an effective salvage agent for bone and joint infections. However, adverse effects, especially hematological reactions, may cause drug discontinuation.