To demonstrate the influence of the linezolid′s adverse events, especially the thrombocytopenia, and compare the safety and efficacy of linezolid and vancomycin in patients after liver transplantation.

One prospective, randomized, comparative-controlled clinical study was conducted. Eighty-five patients who did the liver transplantation were enrolled between September 2007 and June 2009. Palates counts, cumulative incidence of substantially low platelet counts among patients, two drugs′ efficacy were measured and compared on day 3, day 5, day 7, at the end of treatment, or at follow-up for 44 linezolid and 40 vancomycin recipients.

There was no relationship between thrombocytopenia and duration of treatment. When prolonged the treatment, the decrease trend with the platelet was not distinct and also has no significant difference between the two groups. Before the therapy and at the end of treatment the platelet counts in linezolid group were (71.25±11.01)×10⁹/L vs (86.74±11.60)×10⁹/L respectively, whereas in vancomycin group there were (62.0±19.11) ×10⁹/L vs (85.2±12.73)×10⁹/L. Percentage of patients treated for ≥5 days who had ≥1 substantially low platelet count during the study was similar between treatment groups, 1(2.3%) of 44 linezolid recipients and 1(2.5%) of 40 vancomycin recipients, whereas one-half of all patients experienced increases or no change of percentage change in platelet count, including 20 linezolid recipients(45%) and 19 vancomycin recipients (47%). Besides, the efficacy and safety between this two groups didn’t have significant difference.

Clinically significant thrombocytopenia is uncommon in our analysis, and linezolid is not associated with a greater risk of thrombocytopenia in liver transplantation patients than is vancomycin.