title: Linezolid: new preparation. In severe gram-positive infections.
abstract: (1) A variety of antibiotics can be used to treat community-acquired Gram-positive pneumonia. In contrast, for the treatment of nosocomial pneumonia and complicated skin and soft-tissue infections the choice of antibiotic must take into account the likely Gram positive species and the local resistance pattern. (2) Linezolid, a member of a new family of antibiotics, the oxazolidinones, has been authorized for all three indications. (3) Available clinical trials include two comparative studies in community-acquired pneumonia, one comparative study in nosocomial pneumonia, two comparative studies in complicated skin and soft-tissue infections, and one study in several of these situations. Linezolid was never superior to the comparator antibiotic. Cases of linezolid resistance have been reported. (4) Haematological disturbances are the main adverse effects, especially thrombocytopenia, the precise frequency of which remains unknown. (5) Linezolid is a non selective monoamine oxidase inhibitor (MAOI). It therefore has the potential to interact with several adrenergic and serotoninergic drugs and to cause hypertensive crisis and serotonin syndromes. (6) In practice, linezolid has no place in the treatment of community-acquired pneumonia, for which many antibiotics are already available. Linezolid may be an option, after the quinupristin + dalfopristin combination, for treating nosocomial pneumonia and complicated skin and soft-tissue infections due to multidrug-resistant bacteria, depending on the results of resistance tests.
mesh_terms: D000081:Acetamides / Q000009:adverse effects / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004341:Drug Evaluation; D024881:Drug Resistance, Bacterial; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D023303:Oxazolidinones / Q000009:adverse effects / Q000627:therapeutic use*; D018410:Pneumonia, Bacterial / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000081:Acetamides; D000900:Anti-Bacterial Agents; D023303:Oxazolidinones