PDF(Pubmed)
Abstract：
Linezolid is an oxazolidinone antibiotic. Linezolid-associated lactic acidosis has been reported in 6.8% of linezolid-treated patients. Lactic acidosis is associated with poor clinical outcomes, with high blood lactate levels resulting in organ dysfunction and mortality. This case report describes the development of lactic acidosis in a 64-year-old Chinese woman who had received 33 days of treatment with antituberculosis drugs and 28 days of treatment with oral linezolid for tuberculous meningitis. Severe lactic acidosis was reversed by withdrawing antituberculosis drugs and using continuous venovenous hemodiafiltration (CVVH). When the patient\'s condition was stable, she was transferred to the infectious disease department, and antituberculosis drugs, with the exception of linezolid, were reintroduced. This did not result in recurrence of lactic acidosis. The causal relationship between lactic acidosis and linezolid was categorized as \'probable\' on the Adverse Drug Reaction Probability Scale. This case demonstrates that CVVH has potential as an alternative to discontinuation of linezolid alone for rapid reversal of linezolid-associated severe lactic acidosis.
摘要：
利奈唑胺是一种恶唑烷酮抗生素。据报道，有6.8％的利奈唑胺治疗的患者与利奈唑胺相关的乳酸性酸中毒。乳酸性酸中毒与不良临床结局相关，高血乳酸水平导致器官功能障碍和死亡。该病例报告描述了一名64岁的中国女性乳酸性酸中毒的发展，该女性接受了33天的抗结核药物治疗和28天的口服利奈唑胺治疗结核性脑膜炎。通过停用抗结核药物并使用连续静脉静脉血液透析滤过（CVVH）可以逆转严重的乳酸性酸中毒。当病人病情稳定时,她被转移到传染病科，和抗结核药物，除了利奈唑胺,被重新引入。这并未导致乳酸性酸中毒的复发。乳酸性酸中毒和利奈唑胺之间的因果关系在药物不良反应概率量表上被归类为“可能”。该病例表明，CVVH有可能替代单独停用利奈唑胺，以快速逆转利奈唑胺相关的严重乳酸性酸中毒。
