1例利奈唑胺注射液致乳酸酸中毒的药学监护

doi:10.19803/j.1672-8629.20240893

中国药物警戒 ›› 2025, Vol. 22 ›› Issue (11): 1292-1295.
DOI: 10.19803/j.1672-8629.20240893

1例利奈唑胺注射液致乳酸酸中毒的药学监护

李鹃¹, 王恒¹, 彭曦², 袁勇², 杨新惠², 李永乐³, 张选明⁴, 张志刚⁴, 阳静^2*

¹石河子大学药学院,新疆石河子 832002;
²石河子大学第一附属医院药学部,新疆石河子 832008;
³石河子大学第一附属医院泌尿外科,新疆石河子 832008;
⁴石河子大学第一附属医院中医科,新疆石河子 832008

收稿日期:2024-11-18 出版日期:2025-11-15 发布日期:2025-11-14
通讯作者: ^*阳静,女,硕士,主管药师,个体化给药监测。E-mail: 1438029725@qq.com
作者简介:李鹃,女,在读硕士,临床药学。
基金资助:
石河子大学项目（ZZZC2023066）

Pharmacological Care of a Patient with Lactic Acidosis Caused by Linezolid Injection

LI Juan¹, WANG Heng¹, PENG Xi², YUAN Yong², YANG Xinhui², LI Yongle³, ZHANG Xuanming⁴, ZHANG Zhigang⁴, YANG Jing^2*

¹College of Pharmacy, Shihezi University, Shihezi Xinjiang 832002, China;
²Department of Pharmacy, the First Affiliated Hospital of Shihezi University, Shihezi Xinjiang 832008, China;
³Department of Urinary Surgery, the First Affiliated Hospital of Shihezi University, Shihezi Xinjiang 832008, China;
⁴Department of Traditional Chinese Medicine, the First Affiliated Hospital of Shihezi University, Shihezi Xinjiang 832008, China

Received:2024-11-18 Online:2025-11-15 Published:2025-11-14

摘要/Abstract

摘要： 目的对利奈唑胺注射液治疗屎肠球菌感染患者致乳酸酸中毒的病例进行探讨,为临床用药提供参考。方法 1例肾功能不全患者使用利奈唑胺注射液治疗后,出现乳酸酸中毒,临床药师通过治疗药物监测（TDM）,结合利奈唑胺的药动学特点及文献分析,为临床提供治疗建议。结果利奈唑胺致乳酸酸中毒为很可能,后调整患者治疗方案,不良反应消失、病情好转出院。结论肾功能不全患者使用利奈唑胺需要给予个体化初始剂量,然后再根据TDM动态调整;警惕利奈唑胺致乳酸酸中毒,除了常规监测乳酸,还应监测非特异性临床表现。

关键词: 利奈唑胺注射液, 肾功能不全, 屎肠球菌, 乳酸酸中毒, 治疗药物监测

Abstract: Objective To study one case of lactic acidosis caused by Enterococcus faecium infection following treatment with linezolid. Methods One patient with renal insufficiency developed lactic acidosis after treatment with linezolid. Clinical pharmacists gave the clinicians advice on the treatment regimen via therapeutic drug monitoring(TDM) and based on the pharmacokinetics of linezolid as well as literature review. Results Lactic acidosis was believed to have been caused by linezolid,so a new treatment was adopted. The patient was cured of the infection, adverse reactions resolved, and the patient was discharged. Conclusion The use of linezolid in patients with renal insufficiency should start with an individualized dose, which is then dynamically adjusted according to TDM. Clinicians need to be alert to linezolid-induced lactic acidosis. Both non-specific clinical manifestations and levels of lactate have to be monitored.

Key words: Linezolid Injection, Renal Insufficiency, Enterococcus Faecium, Lactic Acidosis, Therapeutic Drug Monitoring

中图分类号:

李鹃, 王恒, 彭曦, 袁勇, 杨新惠, 李永乐, 张选明, 张志刚, 阳静. 1例利奈唑胺注射液致乳酸酸中毒的药学监护[J]. 中国药物警戒, 2025, 22(11): 1292-1295.

LI Juan, WANG Heng, PENG Xi, YUAN Yong, YANG Xinhui, LI Yongle, ZHANG Xuanming, ZHANG Zhigang, YANG Jing. Pharmacological Care of a Patient with Lactic Acidosis Caused by Linezolid Injection[J]. Chinese Journal of Pharmacovigilance, 2025, 22(11): 1292-1295.

导出引用管理器 EndNote|Ris|BibTeX

链接本文: https://zgywjj.magtechjournal.com/CN/10.19803/j.1672-8629.20240893

https://zgywjj.magtechjournal.com/CN/Y2025/V22/I11/1292

参考文献

[1] LAARHUIS SRE, KERSKES CHM, NIJZIEL MR, et al.Linezolid-Induced Thrombocytopenia in Patients with Renal Impairment: a Case Series, Review and Dose Advice[J]. Drugs in R&D, 2024, 24(1): 109-115.
[2] SETHI Y, PADDA I, FULTON M, et al.Linezolid-Induced Black Hairy Tongue in a Patient Treated for Idiopathic Granulomatous Mastitis: a Case Report[J]. Annals of Medicine and Surgery, 2023, 85(6): 3090-3093.
[3] XU YC, YU XX, WANG Y, et al.Effect of Rifampicin Pretreatment on the Pharmacokinetics of Linezolid[J]. The Chinese Journal of Clinical Pharmacology(中国临床药理学杂志), 2024, 40(10): 1492-1496.
[4] FERREIRA A, SOBROSA P, COSTA M, et al.Linezolid Toxicity: a Clinical Case Report[J]. Cureus, 2024, 16(3): e55672.
[5] APODACA AA, RAKITA RM.Linezolid-Induced Lactic Acidosis[J]. The New England Journal of Medicine, 2003, 348(1): 86-87.
[6] ZHANG NJ, CHEN TP, HUANG R, et al.Progress of Research on Lactic Acidosis Caused by Linezolid[J]. Chinese Journal of Clinical Pharmacology and Therapeutics(中国临床药理学与治疗学), 2020, 25(12): 1408-1413.
[7] Expert Committee on Rational Use of Drugs, National Health and Health Commission. National Guidelines for Antimicrobial Therapy(国家抗微生物治疗指南) [M]. 3rd Edition. Beijing: People's Health Publishing House, 2023.
[8] WANG D, LIN ZQ, RUAN YC, et al.Clinical Distribution and Drug Resistance Variability of 2396 Bacterial Strains of Enterococcus Species Pluralis[J]. Chinese Journal of Antibiotics(中国抗生素杂志), 2022, 47(8): 823-828.
[9] BI P, XU JS.Efficacy and Safety of Linezolid and Vancomycin in the Treatment of Infective Endocarditis in the Elderly[J]. Chinese Journal of Gerontology(中国老年学杂志), 2023, 43(18): 4365-4368.
[10] WAGENLEHNER FM, WYDRA S, ONDA H, et al.Concentrations in Plasma, Urinary Excretion, and Bactericidal Activity of Linezolid (600 Milligrams) Versus those of Ciprofloxacin (500 Milligrams) in Healthy Volunteers Receiving a Single Oral Dose[J]. Antimicrobial Agents and Chemotherapy, 2003, 47(12): 3789-3794.
[11] MALINOWSKI L, ZAYET S, CHIARUZZI M, et al.Linezolid in Enterococcal Urinary Tract Infection: a Multicentre Study[J]. European Journal of Clinical Microbiology & Infectious Diseases, 2024, 43(11): 2107-2115.
[12] LIN B, HU Y, XU P, et al.Expert Consensus Statement on Therapeutic Drug Monitoring and Individualization of Linezolid[J]. Frontiers in Public Health, 2022, 10: 967311.
[13] CRASS RL, COJUTTI PG, PAI MP, et al.Reappraisal of Linezolid Dosing in Renal Impairment to Improve Safety[J]. Antimicrobial Agents and Chemotherapy, 2019, 63(8): e00605-e00619.
[14] SASAKI T, TAKANE H, OGAWA K, et al.Population Pharmacokinetic and Pharmacodynamic Analysis of Linezolid and a Hematologic Side Effect, Thrombocytopenia, in Japanese Patients[J]. Antimicrobial Agents and Chemotherapy, 2011, 55(5): 1867-1873.
[15] DJIBRE M, PHAM T, DENIS M, et al.Fatal Lactic Acidosis Associated with Linezolid Therapy[J]. Infection, 2015, 43(1): 125-126.
[16] PROTTI A, RONCHI D, BASSI G, et al.Changes in Whole-Body Oxygen Consumption and Skeletal Muscle Mitochondria During Linezolid-Induced Lactic Acidosis[J]. Critical Care Medicine, 2016, 44(7): e579-e582.
[17] CARSON J, CERDA J, CHAE JH, et al.Severe Lactic Acidosis Associated with Linezolid Use in a Patient with the Mitochondrial DNA A2706G Polymorphism[J]. Pharmacotherapy, 2007, 27: 2771-2774.
[18] SORIANO A, MIRO O, MENSA J.Mitochondrial Toxicity Associated with Linezolid[J]. The New England Journal of Medicine, 2005, 353(21): 2305-2306.
[19] BIRMINGHAM MC, RAYNER CR, MEAGHER AK, et al.Linezolid for the Treatment of Multidrug-Resistant, Gram-Positive Infections: Experience from a Compassionate-Use Program[J]. Clinical Infectious Diseases, 2003, 36(2): 159-168.
[20] BOUTOILLE D, GROSSI O, DEPATUREAUX A, et al.Fatal Lactic Acidosis after Prolonged Linezolid Exposure for Treatment of Multidrug-Resistant Tuberculosis[J]. European Journal of Internal Medicine, 2009, 20(6): e134-e135.
[21] KRONEN T, AGRAWAL A, REDDY P.Acute Onset Lactic Acidosis Secondary to Linezolid[J]. Cureus, 2023, 15(3): e35891.
[22] XU H, XU BP, WANG XT.A Case of Severe Lactic Acidosis Caused by Xylitol Injection[J]. Herald of Medicine(医药导报), 2024, 43(10): 1684-1687.
[23] ZHU R, YANG SW, TIAN XH, et al.Induction of Fatal Lactic Acidosis by Linezolid: an Adverse Reaction that is Highly Likely to be Confused with Septic Shock[J]. Chinese Journal of Infection Control(中国感染控制杂志), 2024, 23(7): 897-900.
[24] GOU JQ, LI Q, YIN DF, et al.Progress in the Study of Linezolid-Related Adverse Reactions in Blood and Metabolic System[J]. Medical Journal of Chinese People's Liberation Army(解放军医学杂志), 2024, 49(8): 965-972.

1例利奈唑胺注射液致乳酸酸中毒的药学监护

Pharmacological Care of a Patient with Lactic Acidosis Caused by Linezolid Injection

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 13

编辑推荐

Metrics

[1]	兰晓倩, 果伟. 舒必利稳态谷浓度/剂量比及常见不良反应的影响因素分析[J]. 中国药物警戒, 2025, 22(4): 420-423.
[2]	伍诗琪, 苏甦, 闫素英, 张青霞. 非瓣膜性房颤合并肾功能不全患者利伐沙班联用药代动力学相互作用致出血的回顾性队列研究[J]. 中国药物警戒, 2025, 22(4): 415-419.
[3]	王佳庆, 汪祺, 刘彤彤, 张冬婕, 陈启, 梅升辉, 宁霄. 高效液相色谱质谱联用法测定血浆中利奈唑胺浓度[J]. 中国药物警戒, 2025, 22(4): 377-380.
[4]	刘彤彤, 郭星辰, 张冬婕, 陈启, 赵志刚, 梅升辉, 宁霄, 袁晶华. 人血浆中头孢他啶和阿维巴坦浓度测定的液相色谱串联质谱法建立[J]. 中国药物警戒, 2025, 22(10): 1109-1113.
[5]	曹银, 周旋, 戴彪, 邓逸芸, 闫春宇, 单锋, 夏清荣, 梁俊. UPLC-MS/MS法测定人血清中曲唑酮浓度及其临床个体化用药[J]. 中国药物警戒, 2024, 21(9): 991-997.
[6]	张渊, 贺梅. 1例盐酸曲美他嗪片致合并肾功能不全老年患者帕金森综合征的药学监护[J]. 中国药物警戒, 2023, 20(3): 343-345.
[7]	朱旭婷, 任佳, 杭永付. 头孢曲松钠注射液致透析患者抗生素脑病3例分析[J]. 中国药物警戒, 2022, 19(3): 336-338.
[8]	陈浩然, 张利丹, 谢雁鸣, 高阳, 刘浩, 杨云云. 真实世界丹参川芎嗪注射液治疗肾功能不全患者的复杂网络分析[J]. 中国药物警戒, 2021, 18(6): 547-551.
[9]	赵敏, 黄振光. 巴氯芬致肾功能不全者不良反应文献分析[J]. 中国药物警戒, 2020, 17(5): 296-299.
[10]	周俊, 刘元, 吕小会, 赵嫄, 熊朝刚, 雷倩, 王皓. 异烟肼、利福平和吡嗪酰胺血药浓度的稳定性及差异分析[J]. 中国药物警戒, 2019, 16(11): 678-682.
[11]	滕玲，覃建阳. 应用抗生素治疗老年慢性肾功能不全并细菌感染60例疗效分析[J]. 中国药物警戒, 2012, 9(6): 325-326.
[12]	陈超，郭代红，曹秀堂，蔡云，王芝林，徐元杰，朱曼，马亮，赵鹏芝. 住院患者使用利奈唑胺致相关性血小板减少症的危险因素分析[J]. 中国药物警戒, 2012, 9(2): 71-76.
[13]	闫颖,张顺利,钟,任思楣,马嵘,王冬环,张传宝 . 2010～2012年度治疗药物监测室间质评结果分析[J]. 中国药物警戒, 2011, 8(12): 755-759.