Linezolid

C. diff Risk

Low

Oral Bioavailability

Excellent

Approximate Cost

$190/day

Dosing

Adult

600mg PO/IV q12h

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 >3mo or if symptoms develop on therapy.

Adverse Effects

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

  • Peripheral/optic neuropathy with prolonged courses

  • Serotonin syndrome

  • 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

Pregnancy category: C

Average serum half life: 5.0

CSF penetration: Therapeutic

Lung penetration: Therapeutic

Urine penetration: Therapeutic