title: Good practice in antibiotic use: what about linezolid in a French university hospital?
abstract: OBJECTIVE
  Linezolid represents an important advance in the treatment of methicillinresistant staphylococci. Its effectiveness should be preserved by appropriate uses. The aims of this survey were to describe the use of linezolid in clinical practice and to assess its overall safety.
  
  
  METHODS
  This retrospective observational study included patients treated with linezolid in 2008 in all departments at the CHU Nantes. A data-collection card was completed using the patients' medical files.
  
  
  RESULTS
  A total of 179 patients from 23 different departments were included. Fifty-four per cent of indications were outside the Marketing Authorization criteria, and were mainly osteoarticular infections and septicaemia (22% and 8% of total prescriptions, respectively). Inefficacy of first-line antibiotic treatment (23%) and alterations in renal function (23%) were the main reasons for using linezolid, which was prescribed as a first-line therapy in 28% of patients. Fifty-three per cent of infections were documented microbiologically, of which 58% were due to a methicillin-resistant Staphylococcus.
  
  
  CONCLUSIONS
  Linezolid seems to be a possible therapeutic strategy in case of multiresistant bacteria and/or complex clinical situations. Because many prescriptions fall outside the Marketing Authorization criteria, this study highlights the need to have clinical data available for such situations.
authors: Service de Bactériologie-Hygiène, CHU de NANTES, 9 Quai Moncousu, 44093, Nantes Cedex 1, France. aubin.guillaume@yahoo.com
authors: Guillaume
authors: G
authors: Aubin
authors: Christine
authors: C
authors: Lebland
authors: Stéphane
authors: S
authors: Corvec
authors: Patrick
authors: P
authors: Thomaré
authors: Gilles
authors: G
authors: Potel
authors: Jocelyne
authors: J
authors: Caillon
authors: Dominique
authors: D
authors: Navas
mesh_terms: D000081:Acetamides / Q000009:adverse effects / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003625:Data Collection; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D005602:France; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D000069349:Linezolid; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D008875:Middle Aged; D023303:Oxazolidinones / Q000009:adverse effects / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000382:microbiology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000081:Acetamides; D000900:Anti-Bacterial Agents; D023303:Oxazolidinones; D000069349:Linezolid