Clinical trial results with linezolid, an oxazolidinone, in the treatment of soft tissue and postoperative gram-positive infections.
BACKGROUND
Infectious complications encountered after major surgery include operative site infections and nosocomial pneumonia. Recent infection surveillance programs have identified the increasing pathogenic role of gram-positive bacteria in these infections and the high prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in the United States and abroad. Surgical site infections and nosocomial pneumonia, often serious infections, are associated with adverse clinical outcomes including bacteremia and its resultant complications, as well as the socioeconomic consequences of excess hospitalization and discharge to nursing care.


METHODS
The essential triad for management of postoperative soft tissue infection consists of thorough appraisal of the infection site for reintervention, culture of drainage or infected tissue, and prompt initiation of empiric antimicrobial therapy designed to cover the most probable causative pathogens. Broad-spectrum antimicrobial regimens are often necessary for empiric therapy of skin and soft tissue infections or nosocomial pneumonia; however, regimens should be tailored to the most effective and clinically appropriate agent based on results of susceptibility testing.


RESULTS
Results of the clinical trial experience with the first United States Food and Drug Administration (FDA)-approved antimicrobial in the new class of oxazolidinones, linezolid, are reviewed.


CONCLUSIONS
In randomized, controlled trials, linezolid 600 mg twice daily (intravenously or orally) provided effective antimicrobial therapy for gram-positive soft tissue infections, including MRSA, and nosocomial pneumonia in which S. aureus was a causative pathogen.
Wilson
S E
SE
Department of Surgery, University of California Irvine, Orange, California 92868, USA. sewilson@uci.edu
D000081:Acetamides / Q000627:therapeutic use*; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003428:Cross Infection / Q000188:drug therapy; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D000069349:Linezolid; D016106:Methicillin Resistance; D023303:Oxazolidinones / Q000627:therapeutic use*; D018461:Soft Tissue Infections / Q000188:drug therapy*; D013203:Staphylococcal Infections / Q000188:drug therapy; D013530:Surgical Wound Infection / Q000188:drug therapy*
D000081:Acetamides; D000890:Anti-Infective Agents; D023303:Oxazolidinones; D000069349:Linezolid