Clinical results of linezolid in arthroplasty and trauma MRSA related infections.
OBJECTIVE
To analyse the management of patients treated with linezolid for orthopaedic infections.


METHODS
Twenty-two patients with orthopaedic related infections receiving a course of linezolid were reviewed retrospectively. Patients were classified into either post trauma, post arthroplasty and non trauma related infections. A diagnosis of infection was based on clinical findings, positive microbiological specimens, and positive signs of infection on radiological imaging and raised inflammatory markers. Pathogens isolated, inflammatory markers both at presentation and at final follow up, length of linezolid treatment, adverse drug reactions, concomitant anti-microbial therapy, length of hospital stay and any surgical interventions were recorded.


RESULTS
Infections were classified as post arthroplasty (n = 10), post trauma surgery (n = 8) or non-trauma related infections (n = 4). Twenty patients (91%) underwent surgical intervention as part of their treatment. The number of required surgical procedures ranged from 1 to 6 (mean = 2.56). Mean total length of stay per admission was 28.5 d (range 1-160 d). Furthermore, the mean duration of treatment with linezolid of patients who had resolution of symptoms was 31 d (range 10-84 d). All patients within this group were discharged on oral linezolid. Pathogens isolated included methicillin resistant Staphylococcus aureus, coagulase negative staphylococci, coliforms, enterococcus, Staphylococcus epidermidis, streptococcus viridans, Escherichia coli, group B streptococcus and pseudomonas. An overall 77% of patients demonstrated resolution of infections at follow-up, with mean C-reactive protein reducing from 123 mg/L to 13.2 mg/L.


CONCLUSIONS
This study demonstrates that the use of linezolid offers excellent efficacy in orthopaedic related infections when used alongside appropriate surgical management.
James Joel, Adam Peckham-Cooper, Academic Orthopaedic and Trauma Unit, Leeds Teaching Hospitals, Leeds School of Medicine, Leeds LS1 3EX, United Kingdom.
James
J
Joel
James Joel, Adam Peckham-Cooper, Academic Orthopaedic and Trauma Unit, Leeds Teaching Hospitals, Leeds School of Medicine, Leeds LS1 3EX, United Kingdom.
Simon Matthew
SM
Graham
James Joel, Adam Peckham-Cooper, Academic Orthopaedic and Trauma Unit, Leeds Teaching Hospitals, Leeds School of Medicine, Leeds LS1 3EX, United Kingdom.
Adam
A
Peckham-Cooper
James Joel, Adam Peckham-Cooper, Academic Orthopaedic and Trauma Unit, Leeds Teaching Hospitals, Leeds School of Medicine, Leeds LS1 3EX, United Kingdom.
Nectarios
N
Korres
James Joel, Adam Peckham-Cooper, Academic Orthopaedic and Trauma Unit, Leeds Teaching Hospitals, Leeds School of Medicine, Leeds LS1 3EX, United Kingdom.
Helen
H
Tsouchnica
James Joel, Adam Peckham-Cooper, Academic Orthopaedic and Trauma Unit, Leeds Teaching Hospitals, Leeds School of Medicine, Leeds LS1 3EX, United Kingdom.
Eleftherios
E
Tsiridis
Antibiotic resistance; Linezolid; Orthopaedic infections; Osteomyelitis; Periprosthetic joint infection