Linezolid induced thrombocytopenia

Linezolid, an oxazolidinone antibiotic active against gram-positive bacteria is used in the treatment of vancomycin resistant Enterococci and MRSA. It is generally tolerated except for the 32% chance of thrombocytopenia on long term usage of linezolid. A 25-year-old male after renal transplantation was administered linezolid for antibiotic prophylaxis. His platelet count dropped from 1,68,000 cells to 74,000 on day 2. The platelet counts further dropped to 58,000 on day 3, followed which linezolid was withdrawn. His platelet improved to 88,000 on day 5 following withdrawal of linezolid. Though we are vigilant about thrombocytopenia on long term usage of linezolid, here we report a rare case of linezolid induced thrombocytopenia within 2 days of starting the antibiotic. This necessitates the increased vigilance on linezolid usage. Platelet count needs to be monitored as early as the start of treatment with linezolid.