Use of Linezolid, an Oxazolidinone, in the Treatment of Multidrug-Resistant Gram-Positive Bacterial Infections

Abstract

We report our experience with linezolid in an investigation of its use against resistant gram-positive bacterial infections. Fifteen patients who had renal failure (n=6), recent liver transplantation (n=5) or surgery (n=6), cancer (n=3), endocarditis (n=2), or human immunodeficiency virus infection (n=1), along with infections due to vancomycin-resistant enterococcus (VRE), and 2 patients with infections due to methicillin-resistant Staphylococcus species who had adverse reactions to vancomycin were treated with linezolid (600 mg every 12 h for 5-42 days (mean+/-SD, 20.5+/-3.5 days). Abscess drainage or prosthetic device removal was undertaken. Microbiological cure occurred in all 10 patients who completed therapy, and all 7 patients alive at follow-up were free of infection. No deaths were attributable to the index infection. Adverse events associated with linezolid use were mild leukopenia in 1 patient and nausea in another. It appears that administration of linezolid, in conjunction with surgical intervention or device removal, is an effective treatment option for serious resistant gram-positive bacterial infections.

Evolving trends in multiple-antibiotic-resistant bacteria in liver transplant recipients: A longitudinal study of antimicrobial susceptibility patterns

“…Not only have staphylococci and enterococci emerged as the foremost causes of nosocomially acquired bloodstream infections, but 32% to 75% of the Staphylococcus aureus isolates are currently methicillin resistant, and 12% to 47% of the enterococcal isolates are vancomycin resistant. [1][2][3][4][5] Although trends in the emergence of antimicrobial resistance are most notable among gram-positive bacteria, resistance to multiple antibiotics is also widely recognized in gram-negative bacteria. In a study from Europe, 65% of the Pseudomonas aeruginosa strains were multiple-antibiotic resistant.…”

In-vitro susceptibility of linezolid against methicillin resistant Staphylococcus aureus at a tertiary care hospital in Pakistan

“…This has given the cause for alarm in the health care community. 16,17 In addition to that, vancomycin-resistant Staphylococcal strains (VRSA) have been reported from Brazil, Jordan and India.…”

Successful treatment of meningoencephalitis caused by methicillin-resistant Staphylococcus aureus with intrathecal vancomycin in an allogeneic peripheral blood stem cell transplant recipient

“…and oral administration and has proven effective in the treatment of infections caused by methicillin-resistant staphylococcal species in critically ill patients. 12 Intravenous linezolid also appears to be a safe and effective therapy for vancomycin-resistant enterococcus meningitis [13][14][15] and linezolid achieved sufficient CSF concentrations to bring about clinical and bacteriological cure. 16,17 Based on our experience and the data reported to date, i.t.…”