title: Clinical experience with linezolid for the treatment of nocardia infection.
abstract: Linezolid is an oxazolidinone that has activity against most gram-positive bacteria, including in vitro activity against all Nocardia species and strains. We describe 6 clinical cases of nocardiosis that were successfully treated with linezolid. Two patients had underlying X-linked chronic granulomatous disease, and 2 patients were receiving chronic corticosteroid therapy. Four of 6 patients had disseminated disease, and 2 of these 4 patients had multiple brain abscesses. Four patients primarily received monotherapy; for the fifth patient, linezolid was added to a failing multiple-drug regimen, and, for the sixth patient, it was used as part of combination therapy. All 6 patients were successfully treated, although 1 patient had a presumed relapse of central nervous system infection after premature discontinuation of the drug. Linezolid appears to be an effective alternative for the treatment of nocardiosis.
authors.affiliation: Department of Pediatrics, Section of Allergy and Immunology, Texas Children's Hospital, Houston, TX 77030, USA. emoylett@bcm.tmc.edu
authors.forename: Edina H
authors.initials: EH
authors.lastname: Moylett
authors.forename: Susan E
authors.initials: SE
authors.lastname: Pacheco
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Brown-Elliott
authors.forename: Tracy R
authors.initials: TR
authors.lastname: Perry
authors.forename: E Stephen
authors.initials: ES
authors.lastname: Buescher
authors.forename: Mary C
authors.initials: MC
authors.lastname: Birmingham
authors.forename: Jerome J
authors.initials: JJ
authors.lastname: Schentag
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Gimbel
authors.forename: Aaron
authors.initials: A
authors.lastname: Apodaca
authors.forename: Margot A
authors.initials: MA
authors.lastname: Schwartz
authors.forename: Robert M
authors.initials: RM
authors.lastname: Rakita
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Wallace
mesh_terms: D000081:Acetamides / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D005260:Female; D006801:Humans; D000069349:Linezolid; D008297:Male; D008875:Middle Aged; D009615:Nocardia / Q000187:drug effects; D009617:Nocardia Infections / Q000188:drug therapy*; D023303:Oxazolidinones / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000081:Acetamides; D000900:Anti-Bacterial Agents; D023303:Oxazolidinones; D000069349:Linezolid