title: Drug monitoring and individual dose optimization of antimicrobial drugs: oxazolidinones.
abstract: BACKGROUND
  Oxazolidinones are synthetic antibiotics with bacteriostatic activity against Gram-positive pathogens. Linezolid, the first marketed oxazolidinone, has shown also activity against Mycobaterium tuberculosis, including multidrug-resistant and extensively drug-resistant strains. Recently, a second agent of this class (tedizolid) has been approved for the treatment of acute bacterial skin and skin structure infections, and other oxazolidinones are under active investigation in clinical trials.
  
  
  METHODS
  In the present review, we consider factors that affect oxazolidinones pharmacokinetics and their role in reducing the effectiveness of these drugs and increasing the risk of drug-related adverse events. Furthermore, we review the potential role of strategies aimed at individualizing drug doses. A MEDLINE PubMed search for articles published from January 1990 to November 2015 was completed matching the terms oxazolidinones, linezolid, or tedizolid with pharmacokinetics, therapeutic drug monitoring, pharmacology or clinical trials. Moreover, additional studies were identified from the reference list of retrieved papers.
  
  
  CONCLUSIONS
  Consistent evidence is now available showing that therapeutic drug monitoring and guided individual dose optimization of linezolid is justified and feasible in clinical practice to improve tolerability and possibly response to therapy. The role of individualized drug dosing regimens for other oxazolidinones remains to be proven.
authors.affiliation: a Unit of Clinical Pharmacology, Department of Laboratory Medicine , Luigi Sacco University Hospital , Milan , Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Cattaneo
authors.affiliation: b Department of Clinical Pharmacy and Pharmacology , University of Groningen, University Medical Center Groningen , Groningen , the Netherlands.
authors.forename: Jan-Willem
authors.initials: JW
authors.lastname: Alffenaar
authors.affiliation: c Laboratory of Applied Pharmacokinetics and Bioinformatics , The Saban Research Institute, Children's Hospital Los Angeles , Los Angels , CA , USA.|d Department of Pediatrics , Keck School of Medicine, University of Southern California , Los Angels , CA , USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Neely
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology; D004305:Dose-Response Relationship, Drug; D016903:Drug Monitoring / Q000379:methods*; D006801:Humans; D000069349:Linezolid / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D023303:Oxazolidinones / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D057285:Precision Medicine; D013777:Tetrazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics
chemical_list: D000900:Anti-Bacterial Agents; D023303:Oxazolidinones; D013777:Tetrazoles; C546016:tedizolid; D000069349:Linezolid
keywords: Dose optimization; linezolid; oxazolidinones; pharmacokinetics; tedizolid; therapeutic drug monitoring