Linezolid‐Induced Anemia and Thrombocytopenia

Linezolid, a fluorinated oxazolidinone, is the first of a new class of antimicrobials designed to target resistant gram‐positive cocci. Hematologic adverse effects, including reversible thrombocytopenia, were reported during phase III comparator‐controlled trials. A 66‐year‐old man developed sternal osteomyelitis due to methicillin‐resistant Staphylococcus aureus after undergoing coronary artery bypass graft surgery. Methicillin‐resistant S. aureus bacteremia developed after several surgical debridements and courses of vancomycin failed to improve the patient's condition. Oral linezolid 600 mg twice/day was begun; 17 days later, a complete blood count revealed that his hematocrit had decreased from 37.4% to 24.8%, and his platelet count had decreased from 234 times 103/mm3 to 149 times 103/mm3. Both values returned to normal after linezolid was discontinued. Complete blood counts should be monitored closely in patients taking linezolid, especially if therapy continues for more than 14 days.