Antimicrobials
Linezolid

Linezolid

Low
Excellent
$190/day

Spectrum of Activity

General Information

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

  • Covers MRSA and VRE

  • CBC with differential at least once/week.

  • Visual testing for therapy greater than 1 month or if symptoms develop on therapy.

  • Myelosuppression (usually with >2weeks therapy)- reversible, most common thrombocytopenia and neutropenia

  • Peripheral/optic neuropathy with prolonged courses (> 28 days). Any symptoms of visual change or impairment warrant immediate ophthalmic evaluation and possible discontinuation of therapy

  • Rash

  • Elevated liver enzymes

  • Lactic acidosis

  • SSRI and other serotonergics/MAOIs- increased risk of serotonin syndrome (agitation, confusion, hallucinations, hyperreflexia, myoclonus, shivering, sweating and tachycardia)

  • Rifampin decreases linezolid levels.

Antimicrobial class: Oxazolidinone

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

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)