Linezolid

Restricted
Restricted

C. diff Risk

Low

Oral Bioavailability

Excellent

Approximate Cost

$190/day

Dosing

General Pediatric

30 mg/kg/24h IV/PO divided q8h
Maximum: 600 mg/dose
0 - 12 Years

20 mg/kg/24h IV/PO divided q12h
Maximum: 600 mg/dose
12+ Years

Renal

No dosage adjustment necessary in renal insufficiency, however inactive metabolites may accumulate in renal insufficiency.

General Information

Common Usage

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

  • Covers MRSA and VRE

Drug Monitoring

  • CBC at least once/week.

  • Visual testing for therapy greater than 3 months or if symptoms develop on therapy.

Adverse Effects

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

  • Peripheral/optic neuropathy with prolonged courses

  • Rash

  • Elevated liver enzymes

  • Lactic acidosis

Major Interactions

  • SSRI and other serotonergics/MAOIs- increased risk of serotonin syndrome

  • Rifampin decreases linezolid levels.

Pharmacology

Antimicrobial class: Oxazolidinone

Route of Elimination:

  • Urine (~30% of total dose as parent drug, ~50 of total dose as inactive metabolites), two metabolites may accumulate in patients with severe renal impairment

  • Feces (9% of total dose as metabolites)

Average serum half life:

  • Preterm neonates <1 week: 5.6 hours

  • Full-term neonates < 1 week : 3 hours

  • Full-term neonates ≥1 week to ≤ 28 days: 1.5 hours

  • Infants > 28 days to < 3 months: 1.8 hours

  • Infants and Children 3 months to 11 years: 2.9 hours

  • Adolescents: 4.1 hours

  • Adults: 4.9 hours