linezolid


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linezolid

 [lĭ-nez´o-lid]
a synthetic antibacterial of the oxazolidinone class, effective against gram-positive organisms; used for the treatment of community-acquired and nosocomial pneumonia, skin and soft tissue infections, and bacteremia, administered orally or intravenously.

linezolid

Zyvox, Zyvoxam (CA)

Pharmacologic class: Oxazolidinone

Therapeutic class: Anti-infective

Pregnancy risk category C

Action

Selectively binds to bacterial 23S ribosomal RNA of 50S subunit, preventing formation of essential component of bacterial protein synthesis. Bacteriostatic or bactericidal against gram-positive and some gram-negative bacteria.

Availability

Injection: 2 mg/ml

Powder for oral suspension: 100 mg/5 ml

Tablets: 400 mg, 600 mg

Indications and dosages

Vancomycin-resistant Enterococcus faecium infections

Adults and children ages 12 and older: 600 mg P.O. or I.V. infusion q 12 hours for 14 to 28 days

Children from birth to age 11: 10 mg/kg I.V. q 8 hours for 14 to 28 days

Nosocomial pneumonia; community-acquired pneumonia; complicated skin and skin-structure infections

Adults and children ages 12 and older: 600 mg P.O. or I.V. infusion q 12 hours for 10 to 14 days

Children from birth to age 11: 10 mg/kg P.O. or I.V. q 8 hours for 10 to 14 days

Uncomplicated skin and soft-tissue infections

Adults: 400 mg P.O. q 12 hours for 10 to 14 days

Adolescents: 600 mg P.O. or I.V. q 12 hours for 10 to 14 days

Children ages 5 to 11: 10 mg/kg P.O. or I.V. q 12 hours for 10 to 14 days

Children younger than age 5: 10 mg/kg P.O. or I.V. q 8 hours for 10 to 14 days

Contraindications

• Hypersensitivity to drug or its components

Precautions

Use cautiously in:
• hepatic dysfunction, hypertension, hyperthyroidism, pheochromocytoma, bone marrow depression, pseudomembranous colitis
• phenylketonuria (oral suspension only)
• pregnant or breastfeeding patients.

Administration

• Give oral drug with or without food.
• For I.V. injection, use single-use, ready-to-use infusion bag. Check for particulate matter before giving. Infuse over 30 minutes to 2 hours.
• For I.V. infusion, mix with dextrose 5% in water, normal saline solution, or lactated Ringer's injection.
• Flush I.V. line before and after administering, to avoid incompatibilities.

Adverse reactions

CNS: anxiety, confusion, difficulty speaking, dizziness, hallucinations, lethargy, paresthesia, light-headedness, fatigue, drowsiness, headache, seizures

GI: nausea, vomiting, diarrhea, gastritis, anorexia, dry mouth, pseudomembranous colitis

Hematologic: thrombocytopenia

Skin: rash, photosensitivity, diaphoresis

Other: fever, fungal infections

Interactions

Drug-drug.Antiplatelet drugs (such as aspirin, dipyridamole, nonsteroidal anti-inflammatory drugs): increased bleeding risk

MAO inhibitors, pseudoephedrine: increased risk of hypertension and associated adverse effects

Serotonergics: serotonin syndrome

Drug-diagnostic tests.Prothrombin time: altered

Drug-food.Tyramine-containing foods and beverages (such as beer; Chianti and certain other red wines; aged cheese; bananas; aged, cured, or spoiled meats; salted herring and other dried fish; avocado; bean curd; red plums; soy sauce; spinach; tofu, tomatoes; yeast): hypertension

Patient monitoring

• Monitor neurologic status. Institute safety measures as needed to prevent injury.
• Check I.V. site for infiltration.

Watch for bleeding and signs and symptoms of other adverse reactions (especially pseudomembranous colitis).
• Monitor CBC, coagulation studies, and culture and sensitivity tests.

Patient teaching

• Tell patient he may take with or without food, but should avoid foods containing tyramine.

Tell patient to promptly report bleeding or severe diarrhea.
• Instruct patient to minimize adverse GI effects by eating small, frequent servings of healthy food.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and foods mentioned above.

linezolid

/li·nez·o·lid/ (lĭ-nez´o-lid) a synthetic oxazolidinoneantibacterial, effective against gram-positive organisms.

linezolid

[lĭnez′olid]
a synthetic antibacterial of the oxazolidinone class, effective against gram-positive organisms and used for the treatment of community-acquired and nosocomial pneumonia, skin and soft tissue infections, and bacteremia. It is administered orally or intravenously.

linezolid

Infectious disease An oxazolidinone antimicrobial in trials for gram-positive bacteria, possibly for managing VRE. See Vancomycin-resistant enterococcus.
References in periodicals archive ?
In that study, among the patients who received more than 10 days of drug therapy, one-third of patients in linezolid group experienced a platelet reduction of at least 30 percent by the end of therapy, with no such myelosuppression detected in 800 mg MRX-I group.
Blood cultures grew Candida albicans and vancomycin-resistant enterococcus, for which he was treated with amphotericin B 300 mg intravenous daily, linezolid 600 mg intravenous twice daily, micafungin 100 mg intravenous daily, and piperacillin/tazobactam 2.
Acquisition of a natural resistance gene renders a clinical strain of methicillin-resistant Staphylococcus aureus resistant to the synthetic antibiotic linezolid.
Linezolid brought in sales revenue of USD 150 million in the same year it entered market and its sales in the global market during the period of 2013- 2014 reached up to USD 1350 million.
The patients were randomly assigned either to immediately begin 600 milligrams of linezolid once daily as part of their existing treatment regimen or to start the drug after a two-month delay.
Clinical success rates were higher [in obese patients] with linezolid.
Linezolid 600 mg twice daily for 10 days was prescribed, and his previous medication was discontinued.
Appropriate additions for GN bacilli (GNB) are amikacin or ciprofloxacin and for GP cocci (GPC) vancomycin, teicoplanin or linezolid.
This policy could in time provide us with the legal tools to deal more effectively with issues like the lack of access to linezolid.
Staphylococcus aureus usually responds pretty well to strong antibiotics, including vancomycin and linezolid.