Linezolid-induced pancytopenia

BMJ Case Rep. 2018 Jul 26:2018:bcr2018225480. doi: 10.1136/bcr-2018-225480.


Linezolid is a bacteriostatic antibiotic of the Oxazolidinone class; it works by inhibiting the initiation of protein synthesis on bacterial ribosomes. Due to its excellent bioavailability after oral dosing, it has become an important tool in combating multi-drug-resistant bacteria including glycopeptide-resistant enterococci and methicillin-resistant Staphylococcus aureus Side effects are multiple and potentially serious. We report the case of an 87-year-old man who developed pancytopenia secondary to a 6-week course of linezolid. Withdrawal of the antibiotic was decided as the treatment and resolution of the pancytopenia was evident within 2 weeks. Clinicians should be aware of this side effect of linezolid therapy and that weekly full blood count monitoring is paramount.

Keywords: drug therapy related to surgery; safety; unwanted effects / adverse reactions.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / adverse effects*
  • Arthroplasty, Replacement, Knee*
  • Diagnosis, Differential
  • Humans
  • Linezolid / administration & dosage
  • Linezolid / adverse effects*
  • Male
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification
  • Pancytopenia / blood
  • Pancytopenia / chemically induced
  • Pancytopenia / diagnosis*
  • Staphylococcal Infections / drug therapy
  • Surgical Wound Infection / drug therapy


  • Anti-Bacterial Agents
  • Linezolid