Linezolid for treatment of subdural empyema due to Streptococcus: case reports.
BACKGROUND
Recurring subdural empyema despite adequate surgical drainage and antibiotic treatment is still a life-threatening disease. This is mainly due to poor diffusion of the antibiotic into the subdural space.


METHODS
We report 2 cases of recurring subdural empyema due to Streptococcus, after repeat surgery and high-dose antibiotic treatment including beta-lactamines and vancomycin. Both patients showed marked clinical and radiologic improvement after introduction of linezolid. There was no drug-related adverse effect despite 36 and 90 days of treatment.


CONCLUSIONS
Off-label use of linezolid for treatment of subdural empyema due to gram-positive bacteria should be considered after failure of conventional antibiotic treatment.
Lefebvre
Laurent
L
Department of Anesthesiology and Intensive Care, CHU Timone, Université de la Méditerranée, Marseille, France.
Metellus
Philippe
P
Dufour
Henry
H
Bruder
Nicolas
N
D000081:Acetamides / Q000009:adverse effects / Q000627:therapeutic use*; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000150:complications; D004322:Drainage; D013354:Empyema, Subdural / Q000188:drug therapy* / Q000382:microbiology* / Q000601:surgery; D005151:Facial Injuries / Q000150:complications; D005260:Female; D006801:Humans; D000069349:Linezolid; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015878:Mydriasis / Q000209:etiology; D019635:Neurosurgical Procedures; D023303:Oxazolidinones / Q000009:adverse effects / Q000627:therapeutic use*; D010291:Paresis / Q000209:etiology; D012640:Seizures / Q000209:etiology; D013290:Streptococcal Infections / Q000188:drug therapy* / Q000382:microbiology*; D013355:Subdural Space / Q000378:metabolism; D014640:Vancomycin / Q000627:therapeutic use
D000081:Acetamides; D000900:Anti-Bacterial Agents; D023303:Oxazolidinones; D014640:Vancomycin; D000069349:Linezolid