Use of linezolid, an oxazolidinone, in the treatment of multidrug-resistant gram-positive bacterial infections.
We report our experience with linezolid in an investigation of its use against resistant gram-positive bacterial infections. Fifteen patients who had renal failure (n=6), recent liver transplantation (n=5) or surgery (n=6), cancer (n=3), endocarditis (n=2), or human immunodeficiency virus infection (n=1), along with infections due to vancomycin-resistant enterococcus (VRE), and 2 patients with infections due to methicillin-resistant Staphylococcus species who had adverse reactions to vancomycin were treated with linezolid (600 mg every 12 h for 5-42 days (mean+/-SD, 20.5+/-3.5 days). Abscess drainage or prosthetic device removal was undertaken. Microbiological cure occurred in all 10 patients who completed therapy, and all 7 patients alive at follow-up were free of infection. No deaths were attributable to the index infection. Adverse events associated with linezolid use were mild leukopenia in 1 patient and nausea in another. It appears that administration of linezolid, in conjunction with surgical intervention or device removal, is an effective treatment option for serious resistant gram-positive bacterial infections.
Chien
J W
JW
Division of Infectious Diseases, Case Western Reserve University School of Medicine, University Hospitals of Cleveland, OH 44106-5083, USA.
Kucia
M L
ML
Salata
R A
RA
D000081:Acetamides / Q000494:pharmacology / Q000627:therapeutic use*; D000328:Adult; D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents / Q000494:pharmacology / Q000627:therapeutic use*; D004352:Drug Resistance, Microbial; D018432:Drug Resistance, Multiple; D016983:Enterococcus / Q000187:drug effects; D020802:Epidural Abscess / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D006094:Gram-Positive Bacteria / Q000187:drug effects*; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D000069349:Linezolid; D008297:Male; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010080:Oxazoles / Q000494:pharmacology / Q000627:therapeutic use*; D023303:Oxazolidinones; D010309:Parotitis / Q000188:drug therapy / Q000382:microbiology; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects; D020713:Vancomycin Resistance
D000081:Acetamides; D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D010080:Oxazoles; D023303:Oxazolidinones; D000069349:Linezolid