Linezolid: Difference between revisions

(Text replacement - "vancomycin " to "vancomycin ")
(Restore original dosing content alongside dynamic SMW tables)
 
(3 intermediate revisions by 3 users not shown)
Line 18: Line 18:
*[[Endocarditis]]
*[[Endocarditis]]
**600 mg PO/IV Q12H x 6 weeks
**600 mg PO/IV Q12H x 6 weeks
===Indications by Disease===
{{#ask: [[Has DrugName::Linezolid]] [[Has Population::Adult]]
|?Treats disease=Disease
|?Has Dose=Dose
|?Has Context=Context
|format=table
|limit=50
|mainlabel=-
|headers=show
|sort=Treats disease
}}


==Pediatric Dosing==
==Pediatric Dosing==
*>12 years old: 600mg IV/PO q12h
*>12 years old: 600mg IV/PO q12h
*<12 years: 10mg/kg IV/PO q8-12h  
*<12 years: 10mg/kg IV/PO q8-12h  
===Indications by Disease===
{{#ask: [[Has DrugName::Linezolid]] [[Has Population::Pediatric]]
|?Treats disease=Disease
|?Has Dose=Dose
|?Has Context=Context
|format=table
|limit=50
|mainlabel=-
|headers=show
|sort=Treats disease
}}


==Special Populations==
==Special Populations==
Line 38: Line 64:
===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 week of use
*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
*Clostridium difficile diarrhea
*Liver injury
*Liver injury
*Seizure  
*Seizure
 
===Common===
===Common===
*GI upset
*GI upset
Line 184: Line 212:
==References==
==References==
<references/>
<references/>
 
[[Category:ID]]
[[Category:Pharmacology]]
[[Category:Pharmacology]]

Latest revision as of 02:38, 20 March 2026

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


Indications by Disease

DiseaseDoseContext
Cellulitis600mg IV q12hrsInpatient
Pneumonia (main)600 mg IV q12hICU, Risk of MRSA
Pneumonia (main)600mg IV q12hHAP, High Risk
Pneumonia (main)600 mg IV q12hVAP, High Risk
Septic bursitis600 mg IV BIDInpatient

Pediatric Dosing

  • >12 years old: 600mg IV/PO q12h
  • <12 years: 10mg/kg IV/PO q8-12h


Indications by Disease

DiseaseDoseContext
Cellulitis<12yr: 10mg/kg IV q8hrs; >12yr: 600mg IV q12hrsPediatric Inpatient
Septic bursitis10mg/kg Q8hrsInpatient

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

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]

Group Organism Sensitivity
Gram Positive Strep. Group A, B, C, G S
Strep. Pneumoniae S
Viridans strep X1
Strep. anginosus gp X1
Enterococcus faecalis S
Enterococcus faecium S
MSSA S
MRSA S
CA-MRSA S
Staph. Epidermidis S
C. jeikeium S
L. monocytogenes S
Gram Negatives N. gonorrhoeae X1
N. meningitidis R
Moraxella catarrhalis I
H. influenzae I
E. coli R
Klebsiella sp R
E. coli/Klebsiella ESBL+ R
E coli/Klebsiella KPC+ R
Enterobacter sp, AmpC neg R
Enterobacter sp, AmpC pos R
Serratia sp X1
Serratia marcescens R
Salmonella sp R
Shigella sp R
Proteus mirabilis X1
Proteus vulgaris R
Providencia sp. X1
Morganella sp. X1
Citrobacter freundii X1
Citrobacter diversus X1
Citrobacter sp. X1
Aeromonas sp X1
Acinetobacter sp. R
Pseudomonas aeruginosa R
Burkholderia cepacia R
Stenotrophomonas maltophilia R
Yersinia enterocolitica R
Francisella tularensis R
Brucella sp. R
Legionella sp. X1
Pasteurella multocida X1
Haemophilus ducreyi X1
Vibrio vulnificus X1
Misc Chlamydophila sp X2
Mycoplasm pneumoniae R
Rickettsia sp X1
Mycobacterium avium R
Anaerobes Actinomyces X1
Bacteroides fragilis I
Prevotella melaninogenica X1
Clostridium difficile I
Clostridium (not difficile) X2
Fusobacterium necrophorum X1
Peptostreptococcus sp. S

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

See Also

References

  1. ↑ 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
  2. ↑ Sanford Guide to Antimicrobial Therapy 2014
Retrieved from "https://www.wikem.org/w/index.php?title=Linezolid&oldid=386569"