Drug Discov Ther. 2022;16(3):142-144. (DOI: 10.5582/ddt.2022.01038)

Safety of linezolid, rifampicin, and clindamycin combination therapy in patients with prosthetic joint infection

Kobayashi S, Tagawa S, Ogura T, Kitaoka A, Yasu T


We investigated adverse events in patients with prosthetic joint infections receiving combination therapy with linezolid, rifampicin, and clindamycin for ≥ 7 days. Twenty-two patients were evaluated. The combination therapy was administered for 15.5 (7–29) days at dosages of 1200, 450, and 450–1200 mg/day for linezolid, rifampicin, and clindamycin, respectively. Adverse events (gastrointestinal, eye, and skin disorders; liver damage; myelosuppression; hyponatremia, and others) were recorded. The incidence rates of leukopenia, neutropenia, anemia, thrombocytopenia, and hyponatremia were 36.4%, 31.8%, 40.9%, 18.2%, and 18.2%, respectively. Common Terminology Criteria for Adverse Events version 5.0 Grade 3 neutropenia, anemia, and hyponatremia were observed. The incidence rate of myelosuppression was higher following combination therapy compared with that previously reported following single-drug administration. All patients were discharged after the infection was under control. It is important to monitor these adverse events during combination therapy with the aforementioned agents; these conditions may be relieved by discontinuing linezolid.

KEYWORDS: Myelosuppression, toxicity, hyponatremia, anemia

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