HWN Suggests

Linezolid and Other Oxazolidinones

Oxazolidinones fill an important void in infectious disease chemotherapy. Within the past few years gram-positive organisms have emerged that are resistant to nearly every available antimicrobial agent. The oxazolidinones include such organisms within their spectrum of activity. Oxazolidinones have many favorable attributes with activity against multidrug-resistant bacteria, 100% bioavailability, a long serum half life allowing twice-daily dosing, a low incidence of the emergence of primary resistance and no cross-resistance to existing compounds.

read full article

Featured

 Should Linezolid Replace Clindamycin for Necrotizing Soft Tissue Infections?

The study suggests that linezolid may be an effective and safe alternative to clindamycin for treating necrotizing skin infections. Linezolid has the benefit of good Staphylococcus aureus coverage and the ability to suppress toxin production, making it a potential choice for empiric use.

Articles of Interest

Linezolid

Linezolid (trade name Zyvox) is a synthetic antibiotic that was developed by the Upjohn Co. in the late 1990s. It was approved by the US Food and Drug Administration in 2000 and is now one of the top-selling antibiotics in the world. Linezolid is used to treat methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and other Gram-positive pathogenic bacteria.

Efficacy and safety of linezolid compared with other treatments for skin and soft tissue infections: a meta-analysis

Skin and soft tissue infections (SSTIs) represent one of the most common reasons for referral of emergency department (ED) and the most common cause of infection in the hospital. A recent strong growth trends in the incidence are mainly due to the expansion of the aging population with comorbidities and the emergence of community-acquired methicillin-resistant Staphylococcus aureus.

Linezolid (Zyvox): A New Antibiotic for Resistant Gram-Positive Organisms

For vancomycin-resistant E. faecium infections, including concurrent bacterium, the recommended dose is 600 mg IV or orally every 12 hours for 14-28 consecutive days. For nosocomial pneumonia, community-acquired pneumonia (including concurrent bacteremia), or complicated skin and skin structure infections the dose is 600 mg IV or orally every 12 hours for 10-14 consecutive days. For uncomplicated skin and skin structure infections, the dose is 400 mg orally for 10-14 consecutive days.

Linezolid Is the First of a New Class of Antibiotics

The author concludes that linezolid is useful against almost all of the important gram-positive organisms. It is effective in skin, respiratory, and systemic infections caused by susceptible organisms, but it should not be considered a first-or second-line therapy for community-acquired respiratory infections. Compared with vancomycin, linezolid may result in shorter hospital stays for patients with known or suspected methicillin-resistant staphylococcal infections.

Linezolid versus vancomycin for skin and soft tissue infections

Linezolid seems to be more effective than vancomycin for treating people with SSTIs, including SSTIs caused by MRSA.

Linezolid, the first oxazolidinone antibacterial agent

A member of the oxazolidinone class of antibiotics, linezolid is highly effective for the treatment of serious Gram-positive infections and has activity that compares favorably with vancomycin for most clinically relevant pathogens.

Linezolid: a review of its properties, function, and use in critical care

Linezolid can be considered as the first member of the class of oxazolidinone antibiotics. Oxazolidinones were first introduced in 1978 for their effectiveness in the control of plant diseases. Six years later, their antibacterial characteristics, with significantly improved antibacterial properties relative to their progenitor compounds, were documented.1 These oxazolidinone compounds are referred to as the first real lead compounds in the oxazolidinone family.

Linezolid: Its Role in the Treatment of Gram-Positive, Drug-Resistant Bacterial Infections

Linezolid disrupts bacterial growth by inhibiting the initiation process of protein synthesis—a mechanism of action that is unique to this class of drugs. It is well absorbed with high bioavailability that allows conversion to oral therapy as soon as the patient is clinically stable. It has been approved for certain gram-positive infections including certain drug-resistant enterococcus, staphylococcus, and pneumococcus strains. It is generally well tolerated, with myelosuppression being the most serious adverse effect.

Linezolid: safety and efficacy in special populations

Although toxicity, particularly haematological and neurological, has been an issue, linezolid has proved to be an effective alternative to glycopeptides in the treatment of Gram-positive infections.

Resources

Zyvox

Linezolid should not be initiated as a first line therapy for community-acquired pneumonia or uncomplicated skin infection, but may be considered if resistant strains are suspected or proven or in presence of drug allergy.