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To the Editor: Linezolid is the first oxazolidinone antibiotic with labeling approved to treat methicillin-resistant Staphylococcus aureus (MRSA) infection. We report 3 cases of myelosuppression with red cell hypoplasia that occurred following therapy with linezolid. Although reversible thrombocytopenia has been reported in patients receiving more than 2 weeks of therapy,¹ we found additional bone marrow changes that appear similar to those seen in reversible chloramphenicol toxicity.

Report of Cases

The first patient was a 70-year-old man who received linezolid, 600 mg twice daily for 4 months, for an MRSA infection in a femoral-popliteal Gore-Tex graft. During this period, the platelet count decreased from 215 x 10³/µL to 60 x 10³/µL, and hemoglobin decreased from 14.3 g/dL (143 g/L) to 7.0 g/dL (70 g/L), with a reticulocyte count of 0%. Vitamin B₁₂ and folate levels were normal, serum iron was 158 µg/dL (28.3 µmol/L) with a total iron binding capacity of 166 . . . [Full Text of this Article]

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RELATED LETTER

Linezolid and Reversible Myelosuppression
Pascale A. Abena, Valérie G. Mathieux, Jean-Marie Scheiff, Lucienne M. Michaux, Bernard C. Vandercam, Felix M. Arellano, Mathew C. Lawyer, Edward Z. Lawyer, Stephen L. Green, and John C. Maddox
JAMA. 2001;286(16):1973-1974.
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