Background Linezolid is the first oxazolidinone available for clinical use. Linezolid is indicated in the treatment of nosocomial pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA) or Streptococcus pneumoniae; and complicated skin and skin structure infections without concomitant osteomyelitis, caused by MRSA, Streptococcus pyogenes, or Streptococcus agalactiae; Vancomycin-resistant Enterococcus faecium infections; uncomplicated skin infections caused by Staphylococcus aureus (methicillin-susceptible only) or Streptococcus pyogenes. To reduce the development of drug-resistant bacteria and maintain their effectiveness, linezolid should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial treatment.
Purpose To evaluate the appropriateness of linezolid prescribing in our hospital.
Material and methods Retrospective study of patients treated with linezolid from January 2013 to April 2014 who continued with linezolid at discharge. Demographic and clinical data included age, sex, previous treatment, indication for linezolid, duration, side effects, antibiogram and clinical outcome.
Results 69 patients were treated with linezolid (median age 67.4 years, 47/69 male). Median days with treatment was 20.41. The indication was the most prevalent infection of the skin and soft tissues (36/69 patients). In 42% of cases, indications did not conform to those adopted by the regulatory agency. Linezolid treatment was used as directed (38/69) mainly against coagulase-negative Staphylococcus. Clinical cure was obtained in 57/69 of cases, and microbiological cure in 36/69. Treatment-related adverse reactions were reported In 2 patients. Thrombocytopenia, classified as conditional by the modified Karch-Lasagna algorithm, forced the discontinuation of linezolid and change to amoxicillin/clavulanate. A pruritic urticarial rash resolved with hydroxyzine. 3 patients died during the infectious episode.
Conclusion The effectiveness and safety of linezolid is similar to that described in the assays. Off-label use and the large number of empirical treatments mean that treatment strategies should be developed.
References and/or acknowledgements No conflict of interest.
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