Linezolid: Difference between revisions
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==General== | ==General== | ||
*Type: Oxazolidinone | *Type: Oxazolidinone [[antibiotic]] | ||
*Dosage Forms: PO/IV | *Dosage Forms: PO/IV | ||
*Common Trade Names: Zyvox | *Common Trade Names: Zyvox | ||
*Bacteriostatic, so prefer another agent in bacteremia | *Bacteriostatic, so prefer another agent in bacteremia, such as [[ceftaroline]] in [[vancomycin]] resistant MRSA | ||
==Adult Dosing== | ==Adult Dosing== | ||
*VRE infections: | *[[VRE]] infections: | ||
**600 mg PO/IV Q12H x 14-28 days | **600 mg PO/IV Q12H x 14-28 days | ||
*Pneumonia, community-acquired: | *[[Pneumonia]], community-acquired: | ||
**600 mg PO/IV Q12H x 5 days | **600 mg PO/IV Q12H x 5 days | ||
*Pneumonia, hospital-acquired or ventilator-associated: | *[[Pneumonia]], hospital-acquired or ventilator-associated: | ||
**600 mg PO/IV Q12H x 5 days | **600 mg PO/IV Q12H x 5 days | ||
*Uncomplicated skin infections: | *Uncomplicated [[skin infections]]: | ||
**400 mg PO Q12H x 10-14 days | **400 mg PO Q12H x 10-14 days | ||
*Complicated skin infections: | *Complicated [[skin infections]]: | ||
**600 mg PO/IV Q12H x 10-14 days | **600 mg PO/IV Q12H x 10-14 days | ||
*Endocarditis | *[[Endocarditis]] | ||
**600 mg PO/IV Q12H x 6 weeks | **600 mg PO/IV Q12H x 6 weeks | ||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
*>12 years old: 600mg IV/PO q12h | |||
*<12 years: 10mg/kg IV/PO q8-12h | |||
==Special Populations== | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C | ||
*Lactation: | *Lactation: Infant risk cannot be ruled out | ||
*Renal Dosing | *Renal Dosing | ||
** | **Renal impairment: no adjustment | ||
** | **Hemodialysis: give dose after HD | ||
Hepatic dosing: no adjustment for mild-moderate impairment (Child-Pugh Class A or B) | |||
==Contraindications== | ==Contraindications== | ||
*Allergy to class/drug | *Allergy to class/drug | ||
*Use of MAOIs, concomitantly or within past 14 days | |||
==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
*[[Serotonin syndrome]] can be caused with concomitant use with an SSRI or MAOI | *[[Serotonin syndrome]] can be caused with concomitant use with an SSRI or MAOI | ||
*Myelosuppression can occur after two | *Myelosuppression can occur after two weeks of use | ||
*[[Thrombocytopenia]]<ref>Natsumoto B, Yokota K, Omata F, Furukawa K. Risk factors for linezolid-associated thrombocytopenia in adult patients. Infection. 2014;42(6):1007-1012. doi:10.1007/s15010-014-0674-5</ref> | |||
*Peripheral and optic neuropathy | *Peripheral and optic neuropathy | ||
*[[Lactic acidosis]] | *[[Lactic acidosis]] | ||
*Clostridium difficile diarrhea | |||
*Liver injury | |||
*Seizure | |||
===Common=== | ===Common=== | ||
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==Pharmacology== | ==Pharmacology== | ||
*Half-life: | *Half-life: adults- 4.7-5.1h, pediatrics- 1.5-4.1 | ||
*Metabolism: | *Metabolism: | ||
*Excretion: | *Excretion: | ||
==Mechanism of Action== | |||
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>== | ==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>== | ||
| Line 173: | Line 180: | ||
===Key=== | ===Key=== | ||
{{Template:Antibacterial Spectra Key}} | {{Template:Antibacterial Spectra Key}} | ||
==See Also== | ==See Also== | ||
*[[Antibiotics (Main)]] | |||
== | ==References== | ||
<references/> | <references/> | ||
[[Category:ID]] | |||
[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
Latest revision as of 09:19, 3 January 2022
General
- Type: Oxazolidinone antibiotic
- Dosage Forms: PO/IV
- Common Trade Names: Zyvox
- Bacteriostatic, so prefer another agent in bacteremia, such as ceftaroline in vancomycin resistant MRSA
Adult Dosing
- VRE infections:
- 600 mg PO/IV Q12H x 14-28 days
- Pneumonia, community-acquired:
- 600 mg PO/IV Q12H x 5 days
- Pneumonia, hospital-acquired or ventilator-associated:
- 600 mg PO/IV Q12H x 5 days
- Uncomplicated skin infections:
- 400 mg PO Q12H x 10-14 days
- Complicated skin infections:
- 600 mg PO/IV Q12H x 10-14 days
- Endocarditis
- 600 mg PO/IV Q12H x 6 weeks
Pediatric Dosing
- >12 years old: 600mg IV/PO q12h
- <12 years: 10mg/kg IV/PO q8-12h
Special Populations
- Pregnancy Rating: C
- Lactation: Infant risk cannot be ruled out
- Renal Dosing
- Renal impairment: no adjustment
- Hemodialysis: give dose after HD
Hepatic dosing: no adjustment for mild-moderate impairment (Child-Pugh Class A or B)
Contraindications
- Allergy to class/drug
- Use of MAOIs, concomitantly or within past 14 days
Adverse Reactions
Serious
- Serotonin syndrome can be caused with concomitant use with an SSRI or MAOI
- Myelosuppression can occur after two weeks of use
- Thrombocytopenia[1]
- Peripheral and optic neuropathy
- Lactic acidosis
- Clostridium difficile diarrhea
- Liver injury
- Seizure
Common
- GI upset
- Headache
- Fever
Pharmacology
- Half-life: adults- 4.7-5.1h, pediatrics- 1.5-4.1
- Metabolism:
- Excretion:
Mechanism of Action
Antibiotic Sensitivities[2]
Key
- S susceptible/sensitive (usually)
- I intermediate (variably susceptible/resistant)
- R resistant (or not effective clinically)
- S+ synergistic with cell wall antibiotics
- U sensitive for UTI only (non systemic infection)
- X1 no data
- X2 active in vitro, but not used clinically
- X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
- X4 active in vitro, but not clinically effective for strep pneumonia