Risk factors for linezolid-associated hyponatremia focused on differences between intravenous and oral administration: a single-center, retrospective study

Abstract Background Linezolid (LZD)-associated hyponatremia is a rare side effect, and no reports have compared intravenous and oral administration in relation to the development of hyponatremia. This study aimed to identify risk factors for LZD-associated hyponatremia and to evaluate whether there...

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Main Authors: Ryoji Takata, Masatoshi Taga, Hirofumi Nagai, Yoshihiro Nishita, Hironori Kobayashi, Nozomi Arakawa, Toru Imai, Yoshitsugu Iinuma, Togen Masauji
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Journal of Pharmaceutical Health Care and Sciences
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Online Access:https://doi.org/10.1186/s40780-025-00463-0
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author Ryoji Takata
Masatoshi Taga
Hirofumi Nagai
Yoshihiro Nishita
Hironori Kobayashi
Nozomi Arakawa
Toru Imai
Yoshitsugu Iinuma
Togen Masauji
author_facet Ryoji Takata
Masatoshi Taga
Hirofumi Nagai
Yoshihiro Nishita
Hironori Kobayashi
Nozomi Arakawa
Toru Imai
Yoshitsugu Iinuma
Togen Masauji
author_sort Ryoji Takata
collection DOAJ
description Abstract Background Linezolid (LZD)-associated hyponatremia is a rare side effect, and no reports have compared intravenous and oral administration in relation to the development of hyponatremia. This study aimed to identify risk factors for LZD-associated hyponatremia and to evaluate whether there are differences in the development of hyponatremia between intravenous and oral administration. Methods We conducted a retrospective study that included patients aged ≥ 20 years who received LZD of 1200 mg/day intravenously or orally at Kanazawa Medical University Hospital from January 2011 to December 2023. Patient information was retrospectively examined, and multiple logistic regression analysis was used to assess the risk of intravenous administration for hyponatremia. Additionally, propensity scores were calculated for the intravenous and oral administration groups, and these scores were subsequently used in a propensity score matching analysis. Results This retrospective study revealed hyponatremia in 32 of 240 (13.3%) patients. Intravenous administration (OR = 17.137, 95% CI = 2.029–144.712, P = 0.009), serum sodium level before administration (OR = 0.626, 95% CI = 0.528–0.744, P < 0.001), and creatinine clearance (OR = 0.987, 95% CI = 0.975–0.999, P = 0.040) were identified as independent variables associated with hyponatremia. After propensity score matching, the incidence of LZD-associated hyponatremia was higher with intravenous administration than with oral administration (OR = 9.697, 95% CI = 1.153–81.545, P = 0.029). Conclusions This study identified intravenous administration as an independent risk factor for LZD-associated hyponatremia, and that the risk of hyponatremia was significantly higher with the intravenous administration compared with the oral administration. Patients with the identified risk factors should be administered intravenous LZD more cautiously and carefully monitored for serum sodium levels.
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spelling doaj-art-9c9d3373eb304f0fa0065edbdb1141492025-08-20T02:10:31ZengBMCJournal of Pharmaceutical Health Care and Sciences2055-02942025-06-011111910.1186/s40780-025-00463-0Risk factors for linezolid-associated hyponatremia focused on differences between intravenous and oral administration: a single-center, retrospective studyRyoji Takata0Masatoshi Taga1Hirofumi Nagai2Yoshihiro Nishita3Hironori Kobayashi4Nozomi Arakawa5Toru Imai6Yoshitsugu Iinuma7Togen Masauji8Department of Pharmacy, Kanazawa Medical University HospitalDepartment of Pharmacy, Kanazawa Medical University HospitalDepartment of Pharmacy, Kanazawa Medical University HospitalDepartment of Pharmacy, Kanazawa Medical University HospitalDepartment of Pharmacy, Kanazawa Medical University HospitalDepartment of Pharmacy, Kanazawa Medical University HospitalDepartment of Pharmacy, Nihon University Itabashi HospitalDepartment of Infectious Disease, Kanazawa Medical UniversityDepartment of Pharmacy, Kanazawa Medical University HospitalAbstract Background Linezolid (LZD)-associated hyponatremia is a rare side effect, and no reports have compared intravenous and oral administration in relation to the development of hyponatremia. This study aimed to identify risk factors for LZD-associated hyponatremia and to evaluate whether there are differences in the development of hyponatremia between intravenous and oral administration. Methods We conducted a retrospective study that included patients aged ≥ 20 years who received LZD of 1200 mg/day intravenously or orally at Kanazawa Medical University Hospital from January 2011 to December 2023. Patient information was retrospectively examined, and multiple logistic regression analysis was used to assess the risk of intravenous administration for hyponatremia. Additionally, propensity scores were calculated for the intravenous and oral administration groups, and these scores were subsequently used in a propensity score matching analysis. Results This retrospective study revealed hyponatremia in 32 of 240 (13.3%) patients. Intravenous administration (OR = 17.137, 95% CI = 2.029–144.712, P = 0.009), serum sodium level before administration (OR = 0.626, 95% CI = 0.528–0.744, P < 0.001), and creatinine clearance (OR = 0.987, 95% CI = 0.975–0.999, P = 0.040) were identified as independent variables associated with hyponatremia. After propensity score matching, the incidence of LZD-associated hyponatremia was higher with intravenous administration than with oral administration (OR = 9.697, 95% CI = 1.153–81.545, P = 0.029). Conclusions This study identified intravenous administration as an independent risk factor for LZD-associated hyponatremia, and that the risk of hyponatremia was significantly higher with the intravenous administration compared with the oral administration. Patients with the identified risk factors should be administered intravenous LZD more cautiously and carefully monitored for serum sodium levels.https://doi.org/10.1186/s40780-025-00463-0LinezolidHyponatremiaAdministration routePropensity score matching
spellingShingle Ryoji Takata
Masatoshi Taga
Hirofumi Nagai
Yoshihiro Nishita
Hironori Kobayashi
Nozomi Arakawa
Toru Imai
Yoshitsugu Iinuma
Togen Masauji
Risk factors for linezolid-associated hyponatremia focused on differences between intravenous and oral administration: a single-center, retrospective study
Journal of Pharmaceutical Health Care and Sciences
Linezolid
Hyponatremia
Administration route
Propensity score matching
title Risk factors for linezolid-associated hyponatremia focused on differences between intravenous and oral administration: a single-center, retrospective study
title_full Risk factors for linezolid-associated hyponatremia focused on differences between intravenous and oral administration: a single-center, retrospective study
title_fullStr Risk factors for linezolid-associated hyponatremia focused on differences between intravenous and oral administration: a single-center, retrospective study
title_full_unstemmed Risk factors for linezolid-associated hyponatremia focused on differences between intravenous and oral administration: a single-center, retrospective study
title_short Risk factors for linezolid-associated hyponatremia focused on differences between intravenous and oral administration: a single-center, retrospective study
title_sort risk factors for linezolid associated hyponatremia focused on differences between intravenous and oral administration a single center retrospective study
topic Linezolid
Hyponatremia
Administration route
Propensity score matching
url https://doi.org/10.1186/s40780-025-00463-0
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