Linezolid

Restricted
Restricted

C. diff Risk

Low

Oral Bioavailability

Excellent

Approximate Cost

Dosing

Requires Infectious Disease consultation for use OR completion of the Restricted Antimicrobial order form for approved indications 600 mg PO/IV every 12 hr Note: No restriction on oral therpy when being used to prepare patient for discharge

General Information

Acceptable Uses

  • Documented VRE infection (not colonization)

  • Documented MRSA or methicillin-resistant coagulase-negative staphylococcal infection in a patient with a severe allergy to vancomycin

  • Documented vancomycin resistant Staphylococcus aures (VRSA) infection (MIC ≥ 2 mcg/ml)

  • Documented MRSA or methicillin-resistant coagulase-negative staphylococcal infection in a patient failing treatment with vancomycin despite adeqaute trough levels

Unacceptable Uses

  • Convenience (patients with renal dysfunction)

  • Empiric therapy for suspected staphylococcal infection

  • VRE colonization of the stool, urine, respiratory tract, wounds, or drains

Common Usage

Targeted or empiric therapy for gram positive infections including skin and soft tissue, and pneumonia.

Covers MRSA and VRE.

Drug Monitoring

Lab

  • CBC at least once/week

Clinical

  • Hypersensitivity

  • GI effects

  • Neuropathy

  • Visual changes/function with therapy ≥ 3 months

Adverse Effects

  • Serotonin syndrome

  • Rash

  • Elevated liver enzymes

  • Lactic acidosis

  • Myelosuppression (usually with >2weeks therapy)- reversible

Major Interactions

SSRI and other serotonergics/MAOIs - Increased risk of serotonin syndrome.

Rifampin decreases linezolid levels.

Pharmacology

Antimicrobial class: Oxazolidinone

Pregnancy category: C

Average serum half life: 5 hours

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Therapeutic