Use of linezolid in pediatrics: a critical review.
BACKGROUND
Linezolid, an oxazolidinone antibacterial agent, is available for intravenous/oral administration, with activity against Gram-positive bacteria including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and penicillin-resistant Streptococcus pneumoniae (PRSP). These pathogens are important causes of hospital- and community-associated infections in children.


METHODS
PubMed was searched for all English language articles on patients younger than 18 years of age treated with linezolid, and an analysis of these articles was performed.


RESULTS
From the 133 articles retrieved, a total of 30 were studied (18 case reports, nine case series, and three clinical trials) based on the inclusion criteria preset for this review. In these articles, a total of 597 children received linezolid. MRSA was the most common pathogen, followed by VRE, PRSP, other bacteria and less common mycobacterial species. Linezolid was reported to be safe and effective for the treatment of pneumonia and endocarditis, as well as skin and soft tissue, central nervous system and osteoarticular infections.


CONCLUSIONS
Linezolid is promising as a safe and efficacious agent for the treatment of infections due to mainly resistant Gram-positive organisms in children who are unable to tolerate conventional agents or after treatment failure.
Dotis
John
J
Laboratory of Infectious Diseases, 3(rd) Department of Pediatrics, Aristotle University, School of Medicine, Hippokration Hospital, Konstantinoupoleos 49, Thessaloniki, Greece.
Iosifidis
Elias
E
Ioannidou
Maria
M
Roilides
Emmanuel
E
D000081:Acetamides / Q000009:adverse effects / Q000627:therapeutic use*; D000293:Adolescent; D000890:Anti-Infective Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D006095:Gram-Positive Cocci / Q000187:drug effects*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D000069349:Linezolid; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects; D023303:Oxazolidinones / Q000009:adverse effects / Q000627:therapeutic use*; D013203:Staphylococcal Infections / Q000188:drug therapy; D016896:Treatment Outcome
D000081:Acetamides; D000890:Anti-Infective Agents; D023303:Oxazolidinones; D000069349:Linezolid