{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T05:54:04Z","timestamp":1781589244542,"version":"3.54.5"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Thrombocytopenia is a common adverse reaction of linezolid, often leading to severe complications. It is challenging to externally validate directly apply developed in other countries. We aim to develop and validate a risk prediction model of linezolid-associated thrombocytopenia (LAT) tailored to Vietnamese setting and to construct a simplified risk score calculation to support clinical decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Data was collected retrospectively from three large hospitals in Northern Vietnam. We selected inpatients treated with linezolid from November 2019 to March 2023. Potential predictors were chosen based on literature review and clinical experts\u2019 opinions. Final predictors were selected using Bayesian model selection. Thrombocytopenia was defined as platelet count value \u2264112.5\u00a0G\/L and a decrease more than 25% from the baseline. A multivariable logistic regression model was constructed to predict the occurrence of LAT. The final model was further validated using internal-external cross-validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 776 patients included, 247 patients (31.8%) developed LAT. Logistic regression model selection indicated that the risk predictors were age, duration of linezolid \u226514 days, baseline platelet count, creatinine clearance, sepsis, cirrhosis, continuous renal replacement therapy (CRRT) and heparin use. The model had moderate discrimination, with area under the curve (AUC) of 0.77 (95% confidence interval (CI): 0.72\u20130.83). Model calibration was good, with calibration-in-the-large and calibration slope of 0.00 (\u22120.38 to 0.38), and 0.92 (0.59\u20131.26) respectively. A risk score scale was established, with the optimal cut-off value being 23 points. Patients were categorised based on this score into three groups: low risk (\u22121 to 13 points), moderate risk (14\u201322 points) and high risk (\u226523 points).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our newly developed risk prediction model demonstrated moderate discriminatory ability in predicting the occurrence of LAT. From there, a simplified risk score was constructed to facilitate its applicability in clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2026.1802397","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T05:38:03Z","timestamp":1781588283000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prediction model of thrombocytopenia on patients using linezolid: a ranked-based covariate selection with multi-center data"],"prefix":"10.3389","volume":"17","author":[{"given":"Nhi H.","family":"Nguyen","sequence":"first","affiliation":[{"name":"National Centre for Drug Information and Adverse Drug Reactions Monitoring, Hanoi University of Pharmacy","place":["Hanoi, Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hieu","family":"Le","sequence":"additional","affiliation":[{"name":"National Centre for Drug Information and Adverse Drug Reactions Monitoring, Hanoi University of Pharmacy","place":["Hanoi, Vietnam"]},{"name":"Administration of Science Technology and Training, Ministry of Health","place":["Hanoi, Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"An Q.","family":"Tang","sequence":"additional","affiliation":[{"name":"National Centre for Drug Information and Adverse Drug Reactions Monitoring, Hanoi University of Pharmacy","place":["Hanoi, Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hang T. H.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"National Centre for Drug Information and Adverse Drug Reactions Monitoring, Hanoi University of Pharmacy","place":["Hanoi, Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ha N.","family":"Tran","sequence":"additional","affiliation":[{"name":"National Centre for Drug Information and Adverse Drug Reactions Monitoring, Hanoi University of Pharmacy","place":["Hanoi, Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuyen T.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"National Centre for Drug Information and Adverse Drug Reactions Monitoring, Hanoi University of Pharmacy","place":["Hanoi, Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thuc T. N.","family":"Bui","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Clinical Pharmacy and Drug Information Unit, Bach Mai Hospital","place":["Hanoi, Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anh T. L.","family":"Dang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Thanh Nhan Hospital","place":["Hanoi, Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oanh T.","family":"Khuat","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, National Hospital for Tropical Diseases","place":["Hanoi, Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoa D.","family":"Vu","sequence":"additional","affiliation":[{"name":"National Centre for Drug Information and Adverse Drug Reactions Monitoring, Hanoi University of Pharmacy","place":["Hanoi, Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nhung T. H.","family":"Trinh","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy and Pharmacoepidemiology Research Group, UiT - The Arctic University of Norway","place":["Troms\u00f8, Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anh H.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"National Centre for Drug Information and Adverse Drug Reactions Monitoring, Hanoi University of Pharmacy","place":["Hanoi, Vietnam"]},{"name":"Department of Pharmacy, Clinical Pharmacy and Drug Information Unit, Bach Mai Hospital","place":["Hanoi, Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1016\/j.curtheres.2012.07.002","article-title":"Risk factors for thrombocytopenia in adult Chinese patients receiving linezolid therapy","volume":"73","author":"Chen","year":"2012","journal-title":"Curr. Ther. Res. Clin. Exp."},{"key":"B2","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1111\/bcpt.13123","article-title":"Risk factors for linezolid-induced thrombocytopenia in patients without haemato-oncologic diseases","volume":"124","author":"Choi","year":"2019","journal-title":"Basic Clin. Pharmacol. Toxicol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"e074819","DOI":"10.1136\/bmj-2023-074819","article-title":"Evaluation of clinical prediction models (part 1): from development to external validation","volume":"384","author":"Collins","year":"","journal-title":"BMJ"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e078378","DOI":"10.1136\/bmj-2023-078378","article-title":"TRIPOD+AI statement: updated guidance for reporting clinical prediction models that use regression or machine learning methods","volume":"385","author":"Collins","year":"","journal-title":"BMJ"},{"key":"B5","doi-asserted-by":"publisher","first-page":"807","DOI":"10.1111\/jcpt.13359","article-title":"Analysis of the risk factors of linezolid-related haematological toxicity in Chinese patients","volume":"46","author":"Dai","year":"2021","journal-title":"J. Clin. Pharm. Ther. 20210208th Ed"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1029","DOI":"10.1007\/s10096-013-2041-3","article-title":"Therapeutic drug monitoring and receiver operating characteristic curve prediction may reduce the development of linezolid-associated thrombocytopenia in critically ill patients","volume":"33","author":"Dong","year":"2014","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"B7","doi-asserted-by":"publisher","first-page":"710099","DOI":"10.3389\/fphar.2022.710099","article-title":"A regression model to predict linezolid induced thrombocytopenia in neonatal sepsis patients: a ten-year retrospective cohort study","volume":"13","author":"Duan","year":"2022","journal-title":"Front. Pharmacol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1008","DOI":"10.1046\/j.1365-2648.2000.t01-1-01567.x","article-title":"Research guidelines for the Delphi survey technique","volume":"32","author":"Hasson","year":"2000","journal-title":"J. Adv. Nurs."},{"key":"B9","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1007\/s11096-014-9961-6","article-title":"Retrospective analysis of the risk factors for linezolid-induced thrombocytopenia in adult Japanese patients","volume":"36","author":"Hirano","year":"2014","journal-title":"Int. J. Clin. Pharm."},{"key":"B10","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1007\/s10156-010-0188-8","article-title":"Chronic liver disease increases the risk of linezolid-related thrombocytopenia in methicillin-resistant staphylococcus aureus-infected patients after digestive surgery","volume":"17","author":"Ikuta","year":"2011","journal-title":"J. Infect. Chemother."},{"key":"B11","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1186\/s40360-021-00479-w","article-title":"Proposal of initial and maintenance dosing regimens with linezolid for renal impairment patients","volume":"22","author":"Kawasuji","year":"2021","journal-title":"BMC Pharmacol. Toxicol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1111\/j.1749-6632.2011.05962.x","article-title":"Linezolid, the first oxazolidinone antibacterial agent","volume":"1222","author":"Leach","year":"2011","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"B13","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1016\/j.jointm.2022.12.003","article-title":"Nomogram prediction model called \u201cADPLCP\u201d for predicting linezolid-associated thrombocytopenia in elderly individuals","volume":"3","author":"Liu","year":"2023","journal-title":"J. Intensive Med."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1249","DOI":"10.1016\/j.jiac.2022.05.004","article-title":"Linezolid induced thrombocytopenia in critically ill patients: risk factors and development of a machine learning-based prediction model","volume":"28","author":"Maray","year":"2022","journal-title":"J. Infect. Chemother."},{"key":"B15","doi-asserted-by":"publisher","first-page":"2126","DOI":"10.1016\/j.clinthera.2009.10.017","article-title":"Retrospective cohort chart review study of factors associated with the development of thrombocytopenia in adult Japanese patients who received intravenous linezolid therapy","volume":"31","author":"Niwa","year":"2009","journal-title":"Clin. Ther."},{"key":"B16","doi-asserted-by":"publisher","first-page":"2128","DOI":"10.1093\/jac\/dkt133","article-title":"High plasma linezolid concentration and impaired renal function affect development of linezolid-induced thrombocytopenia","volume":"68","author":"Nukui","year":"2013","journal-title":"J. Antimicrob. Chemother."},{"key":"B17","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1136\/ejhpharm-2022-003258","article-title":"Development and validation of a risk prediction model for linezolid-induced thrombocytopenia in elderly patients","volume":"31","author":"Qin","year":"2021","journal-title":"Eur. J. Hosp. Pharm"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1276","DOI":"10.1002\/sim.7992","article-title":"Minimum sample size for developing a multivariable prediction model: PART II - binary and time-to-event outcomes","volume":"38","author":"Riley","year":"2019","journal-title":"Statistics Med."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1631","DOI":"10.1002\/sim.1742","article-title":"RB. Presentation of multivariate data for clinical use: the framingham study risk score functions","volume":"23","author":"Sullivan","year":"2004","journal-title":"Statistics Med."},{"key":"B20","doi-asserted-by":"publisher","first-page":"2295","DOI":"10.1016\/j.xphs.2021.02.014","article-title":"Classification tree analysis based on machine learning for predicting linezolid-induced thrombocytopenia","volume":"110","author":"Takahashi","year":"2021","journal-title":"J. Pharm. Sci."},{"key":"B21","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1177\/1937586719887709","article-title":"We agree, don\u2019t we? The Delphi method for health environments research","volume":"13","author":"Taylor","year":"2020","journal-title":"HERD"},{"key":"B22","unstructured":"Zyvox 2 mg\/ml solution for infusion\n          \n          \n          2017"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1335","DOI":"10.1007\/s00228-017-2303-6","article-title":"Is it time to revise linezolid dose in elderly patients?","volume":"73","author":"Tinelli","year":"2017","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1974","DOI":"10.1093\/jac\/dkad191","article-title":"Establishment and validation of a risk prediction model incorporating concentrations of linezolid and its metabolite PNU142300 for linezolid-induced thrombocytopenia","volume":"78","author":"Xu","year":"2023","journal-title":"J. Antimicrob. Chemother."},{"key":"B25","doi-asserted-by":"publisher","first-page":"290","DOI":"10.2471\/blt.22.288614","article-title":"The WHO AWaRe (access, watch, reserve) antibiotic book and prevention of antimicrobial resistance","volume":"101","author":"Zanichelli","year":"2023","journal-title":"Bull. World Health Organ"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1303","DOI":"10.1007\/s00228-023-03542-z","article-title":"Risk factors for thrombocytopenia in patients receiving linezolid therapy: a systematic review and meta-analysis","volume":"79","author":"Zhang","year":"2023","journal-title":"Eur. J. Clin. Pharmacol."}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2026.1802397\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T05:38:06Z","timestamp":1781588286000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2026.1802397\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,16]]},"references-count":26,"alternative-id":["10.3389\/fphar.2026.1802397"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2026.1802397","relation":{},"ISSN":["1663-9812"],"issn-type":[{"value":"1663-9812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,16]]},"article-number":"1802397"}}