title: Use of linezolid in infants and children: a retrospective multicentre study of the Italian Society for Paediatric Infectious Diseases.
abstract: OBJECTIVE
  Because of the spread of drug-resistant Gram-positive bacteria, the use of linezolid for treating severe infections is increasing. However, clinical experience in the paediatric population is still limited. We undertook a multicentre study to analyse the use of linezolid in children.
  
  
  METHODS
  Hospitalized children treated with linezolid for a suspected or proven Gram-positive or mycobacterial infection were analysed retrospectively. Side effects were investigated, focusing on younger children and long-term treatments.
  
  
  RESULTS
  Seventy-five patients (mean age 6.8 years, range 7 days to 17 years) were studied. Mean ± SD linezolid treatment duration was 26.13 ± 17 days. Clinical cure was achieved in 74.7% of patients. The most frequent adverse events were diarrhoea and vomiting. Two patients had severe anaemia, two neutropenia and one thrombocytopenia. Two cases of grade 3 liver function test elevation and one case of pancreatitis were reported. The overall frequency of adverse events was similar between patients treated for >28 days and those receiving shorter treatments (30.8% versus 28.6%, P = 0.84). Children aged <2 years received linezolid for a shorter duration than older children (21.2 days versus 28.4 days, P = 0.05), whereas the frequency of adverse events was similar in the two age groups.
  
  
  CONCLUSIONS
  In our paediatric population, linezolid appeared safe and effective for the treatment of selected Gram-positive and mycobacterial infections. The adverse reactions encountered were reversible and appeared comparable to those reported in paediatric clinical trials. Nevertheless, the potential for haematological toxicity of linezolid in children means that careful monitoring is required during treatment.
authors.affiliation: Department of Paediatrics, Infectious Diseases Unit, University of Turin, Regina Margherita Children's Hospital, Turin, Italy. silvia.garazzino@unito.it
authors.forename: Silvia
authors.initials: S
authors.lastname: Garazzino
authors.forename: Andrzej
authors.initials: A
authors.lastname: Krzysztofiak
authors.forename: Susanna
authors.initials: S
authors.lastname: Esposito
authors.forename: Elio
authors.initials: E
authors.lastname: Castagnola
authors.forename: Alessandro
authors.initials: A
authors.lastname: Plebani
authors.forename: Luisa
authors.initials: L
authors.lastname: Galli
authors.forename: Monica
authors.initials: M
authors.lastname: Cellini
authors.forename: Rita
authors.initials: R
authors.lastname: Lipreri
authors.forename: Carlo
authors.initials: C
authors.lastname: Scolfaro
authors.forename: Chiara
authors.initials: C
authors.lastname: Bertaina
authors.forename: Carmelina
authors.initials: C
authors.lastname: Calitri
authors.forename: Elena
authors.initials: E
authors.lastname: Bozzola
authors.forename: Laura
authors.initials: L
authors.lastname: Lancella
authors.forename: Anna
authors.initials: A
authors.lastname: Quondamcarlo
authors.forename: Samantha
authors.initials: S
authors.lastname: Bosis
authors.forename: Lorenza
authors.initials: L
authors.lastname: Pugni
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Losurdo
authors.forename: Annarosa
authors.initials: A
authors.lastname: Soresina
authors.forename: Marina
authors.initials: M
authors.lastname: De Gaudio
authors.forename: Ilaria
authors.initials: I
authors.lastname: Mariotti
authors.forename: Luca
authors.initials: L
authors.lastname: Mancini
authors.forename: Clara
authors.initials: C
authors.lastname: Gabiano
authors.forename: Pier-Angelo
authors.initials: PA
authors.lastname: Tovo
mesh_terms: D000081:Acetamides / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D006094:Gram-Positive Bacteria / Q000187:drug effects / Q000472:pathogenicity; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy; D000069349:Linezolid; D008297:Male; D009161:Mycobacterium / Q000187:drug effects; D009164:Mycobacterium Infections / Q000188:drug therapy* / Q000382:microbiology; D023303:Oxazolidinones / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000081:Acetamides; D023303:Oxazolidinones; D000069349:Linezolid