{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:06:39Z","timestamp":1785420399129,"version":"3.56.0"},"reference-count":33,"publisher":"American Society for Microbiology","issue":"9","license":[{"start":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T00:00:00Z","timestamp":1756857600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T00:00:00Z","timestamp":1756857600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82073561"],"award-info":[{"award-number":["82073561"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2025,9,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Despite the widespread pediatric use of linezolid, data on its hematologic toxicity\u2014particularly among children exposed to anticancer chemotherapy\u2014remain limited and inconsistent. This study aimed to evaluate linezolid-induced hematotoxicity through pharmacokinetic analysis, with an emphasis on chemotherapy-exposed pediatric patients. This dual-center prospective study assessed linezolid pharmacokinetics and clinical profiles in chemotherapy-stratified pediatric cohorts, examining associations with hematologic toxicity. Among 229 pediatric patients (65 with cancer), hematologic toxicity occurred in 43.2%, with significantly higher risks of leukopenia (hazard ratio [HR] 20.29, 95% confidence interval [CI]: 3.98\u2013103.38), neutropenia (HR 2.60, 95% CI: 1.00\u20136.77), and thrombocytopenia events (HR 7.08, 95% CI: 2.19\u201322.92) in cancer patients. Median linezolid trough and peak concentrations were 2.60 mg\/L (interquartile range [IQR] 1.42\u20134.06) and 12.00 mg\/L (IQR 9.5\u201314.19), respectively. Among cancer patients, trough concentrations above 7 mg\/L elevated leukopenia (HR 6.33, 95% CI: 1.36\u201329.42) and anemia event (HR 8.72, 95% CI: 1.98\u201338.37) risk. Prolonged therapy exceeding 14 days elevated the risk of anemia events (HR 2.17; 95% CI: 1.08\u20134.35), while durations beyond 28 days also increased the risk of neutropenia events (HR 3.58; 95% CI, 1.37\u20139.32). At equivalent daily doses, twice-daily dosing resulted in higher peak concentrations (19.65 vs 13.67 mg\/L;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.020) and a greater incidence of anemia events (62.50% vs 25.00%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.033) compared to thrice-daily regimens. Linezolid frequently causes hematologic toxicity in children, particularly in chemotherapy recipients. Risk is also driven by high concentrations (peak &gt; 15 mg\/L, trough &gt; 7 mg\/L in cancer patients), prolonged therapy, and twice-daily dosing, necessitating careful monitoring and dose optimization.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/aac.00294-25","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T12:00:50Z","timestamp":1753272050000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":1,"title":["Pharmacokinetics and hematologic toxicity of linezolid in children: a prospective, two-center cohort study"],"prefix":"10.1128","volume":"69","author":[{"given":"Lvchang","family":"Zhu","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03wa2q724","id-type":"ROR","asserted-by":"publisher"}],"name":"Pediatric Intensive Care Unit, Children\u2019s Hospital, Zhejiang University School of Medicine, National Clinical Research Center 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