The safety and efficacy of linezolid in orthopaedic practice for the treatment of infection due to antibiotic-resistant organisms.
Linezolid is the first of a new class of antibacterial agents, the oxazolidinones. It is particularly effective against Gram-positive infections and little resistance has been reported, even amongst methicillin- and vancomycin-resistant bacteria. The compound's excellent oral bioavailability and reasonable safety profile, along with the increasing incidence of resistant infections, means that linezolid offers a valuable alternative to more traditional therapies such as vancomycin. Although no large randomised trials have been carried out in patients with orthopaedic infections such as osteomyelitis and septic arthritis, early results are encouraging. However, the apparent increase in observed adverse events, particularly bone marrow suppression, seen with prolonged administration, means that treatment of such patients must be undertaken with careful surveillance, at least until these complications are better understood.
Harwood
P J
PJ
St. James's University Hospital, Chancellor Wing, Beckett Street, Leeds, West Yorkshire, LS9 7TF, UK.
Giannoudis
P V
PV
D000081:Acetamides / Q000009:adverse effects / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D001170:Arthritis, Infectious / Q000188:drug therapy; D001424:Bacterial Infections / Q000188:drug therapy*; D002648:Child; D002986:Clinical Trials as Topic; D015897:Comorbidity; D016527:Drug Costs; D004347:Drug Interactions; D024901:Drug Resistance, Multiple, Bacterial; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D006402:Hematologic Diseases / Q000139:chemically induced; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced / Q000150:complications; D000069349:Linezolid; D009140:Musculoskeletal Diseases / Q000188:drug therapy* / Q000382:microbiology; D009422:Nervous System Diseases / Q000139:chemically induced; D009901:Optic Nerve Diseases / Q000139:chemically induced; D010019:Osteomyelitis / Q000188:drug therapy; D023303:Oxazolidinones / Q000009:adverse effects / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D016459:Prosthesis-Related Infections / Q000188:drug therapy; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D000081:Acetamides; D000900:Anti-Bacterial Agents; D023303:Oxazolidinones; D000069349:Linezolid