Clinical experience with linezolid for the treatment of nocardia infection.
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.
Moylett
Edina H
EH
Department of Pediatrics, Section of Allergy and Immunology, Texas Children's Hospital, Houston, TX 77030, USA. emoylett@bcm.tmc.edu
Pacheco
Susan E
SE
Brown-Elliott
Barbara A
BA
Perry
Tracy R
TR
Buescher
E Stephen
ES
Birmingham
Mary C
MC
Schentag
Jerome J
JJ
Gimbel
Joseph F
JF
Apodaca
Aaron
A
Schwartz
Margot A
MA
Rakita
Robert M
RM
Wallace
Richard J
RJ
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
D000081:Acetamides; D000900:Anti-Bacterial Agents; D023303:Oxazolidinones; D000069349:Linezolid