Population pharmacokinetic analysis of linezolid in low body weight patients with renal dysfunction

Yasuhiro Tsuji*, Eiji Yukawa, Yoichi Hiraki, Kana Matsumoto, Akiko Mizoguchi, Kunihiko Morita, Hidetoshi Kamimura, Yoshiharu Karube, Hideto To

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

42 Scopus citations

Abstract

Linezolid has antibacterial activity against aerobic Gram-positive cocci, including methicillin-resistant Staphylococcus aureus (MRSA). Adjustment of the dose of linezolid has been proposed to be unnecessary in patients with reduced renal function. However, platelet counts and hemoglobin levels were shown to be significantly lower in such patients than in patients with normal renal function. The population pharmacokinetic (PPK) of linezolid was investigated in MRSA infected patients with renal dysfunction. Linezolid concentrations in serum were measured by high-performance liquid chromatography. PPK analysis was performed in the nonlinear mixed effects model (NONMEM) computer program. In the final PPK model, total body weight (TBW), estimated glomerular filtration rate (eGFR), hemoglobin (HB), and alanine amino transferase (ALT) were influential covariates on total body clearance (CL), and the volume of distribution (Vd) was affected by TBW, which was expressed as CL (L/h) = 0.00327 × TBW × eGFR0.428 × HB0.502 × 0.283 (ALT ≥ 100 IU/L) and CL (L/h) = 0.00327 × TBW × eGFR0.428 × HB0.502 (ALT < 100 IU/L), Vd (L) = 1.310 × TBW. The PPK parameters of linezolid obtained here are useful for the optimal use of linezolid with similar patient population characteristics.

Original languageEnglish
Pages (from-to)967-973
Number of pages7
JournalJournal of Clinical Pharmacology
Volume53
Issue number9
DOIs
StatePublished - 2013/09

Keywords

  • Linezolid
  • Methicillin-resistant staphylococcus aureus
  • Nonlinear mixed effects modeling
  • Population pharmacokinetics
  • Renal dysfunction

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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