title: Linezolid in late-chronic prosthetic joint infection caused by gram-positive bacteria.
abstract: Linezolid may be an interesting alternative for prosthetic joint infection (PJI) due to its bioavailability and its antimicrobial spectrum. However, experience in this setting is scarce. The aim of the study was to assess linezolid's clinical and microbiological efficacy, and also its tolerance. This was a prospective, multicenter, open-label, non-comparative study of 25 patients with late-chronic PJI caused by Gram-positive bacteria managed with a two-step exchange procedure plus 6 weeks of linezolid. Twenty-two (88%) patients tolerated linezolid without major adverse effects, although a global decrease in the platelet count was observed. Three patients were withdrawn because of major toxicity, which reversed after linezolid stoppage. Among patients who completed treatment, 19 (86%) demonstrated clinical and microbiological cure. Two patients presented with clinical and microbiological failure, and one showed clinical cure and microbiological failure. In conclusion, linezolid showed good results in chronic PJI managed with a two-step exchange procedure. Tolerance seems acceptable, though close surveillance is required.
authors.affiliation: Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain. jcobo.hrc@salud.madrid.org
authors.forename: Javier
authors.initials: J
authors.lastname: Cobo
authors.forename: Jaime
authors.initials: J
authors.lastname: Lora-Tamayo
authors.forename: Gorane
authors.initials: G
authors.lastname: Euba
authors.forename: Alfredo
authors.initials: A
authors.lastname: Jover-Sáenz
authors.forename: Julián
authors.initials: J
authors.lastname: Palomino
authors.forename: Ma Dolores
authors.initials: MD
authors.lastname: del Toro
authors.forename: Dolors
authors.initials: D
authors.lastname: Rodríguez-Pardo
authors.forename: Melchor
authors.initials: M
authors.lastname: Riera
authors.forename: Javier
authors.initials: J
authors.lastname: Ariza
mesh_terms: D000081:Acetamides / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001168:Arthritis / Q000382:microbiology* / Q000601:surgery; D005260:Female; D006094:Gram-Positive Bacteria / Q000187:drug effects / Q000302:isolation & purification*; D006801:Humans; D000069349:Linezolid; D008297:Male; D008875:Middle Aged; D023303:Oxazolidinones / Q000493:pharmacokinetics / Q000627:therapeutic use*; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000382:microbiology; D016896:Treatment Outcome
chemical_list: D000081:Acetamides; D000900:Anti-Bacterial Agents; D023303:Oxazolidinones; D000069349:Linezolid