To explore the high-risk factors for linezolid-induced thrombocytopenia in patients with postoperative surgical infections, and to provide a basis for the safety of clinical medication.

A retrospective analysis was conducted on the data of 164 patients who received linezolid for postoperative surgical infections from January 2021 to December 2021. Univariate and multivariate Logistic regression analyses were used to identify the high-risk factors for linezolid-induced thrombocytopenia in these patients.

The incidence of thrombocytopenia was 13.4% (22/164). In the 22 patients with thrombocytopenia, the platelet count decreased from (184.0±54.1)×10⁹/L before medication to (75.2±19.1)×10⁹/L after medication, with a statistically significant difference (P<0.05). Multivariate analysis showed that age ≥65 years (OR=3.432, 95%CI: 1.234-9.654), medication duration >14 days (OR=4.798, 95%CI: 1.321-17.456), combined use of ≥2 antimicrobial agents (OR=3.072, 95%CI: 1.178-8.032), glomerular filtration rate (GFR) <30ml/min (OR=6.623, 95%CI: 1.478-29.876), and Charlson Comorbidity Index (CCI) ≥4 (OR=5.998, 95%CI: 1.654-21.789) were high-risk factors for linezolid-induced thrombocytopenia in patients with postoperative surgical infections (all P<0.05).

In clinical practice, for patients with postoperative surgical infections who have characteristics such as advanced age, long-term medication, severe renal impairment, high CCI, and combined use of multiple drugs, high vigilance is required when using linezolid. Strengthened monitoring and intervention should be implemented to reduce the risk of thrombocytopenia and improve the safety and effectiveness of clinical treatment.