Antimicrobials
Linezolid

Linezolid

Low
Excellent

Dosing

General Information

Administration

  • Intravenous over 30-120 minutes, flush line with D5W, NS or LR before and after infusion if line will be used for other medications
  • Yellow color of injection may intensify over time without affecting potency
  • PO dosing with or without food

Preparation

  • 600mg/300mL in NS
  • Prior to administration mix gently by inverting bottle; do not shake.

Compatibility

  • D5W, NS, or LR

Targeted or empiric therapy for gram positive infections including skin and soft tissue, and pneumonia.

  • Pneumonia
  • SSTI

Covers MRSA and VRE.

Tier 3 Protected Antimicrobial

  • Limited to use for the listed indications. For all other indications, the antimicrobial must be ordered by an ID physician or an ID consult placed. Prospective audit with feedback with provided by ASP/Pharmacy and utilization/compliance reported quarterly.

AHS Use Criteria:

  • Invasive VRE infection
  • Allergy/intolerance to all alternatives
  • Documented MRSA infection with vancomycin MIC ≥ 2
  • Vancomycin treatment failure
  • Necrotizing pneumonia
  • Transition to oral therapy for pneumonia, cellulitis and intra-abdominal
  • If initiated at admission, nasal MRSA screen to be ordered by pharmacy
  • CBC at least once/week
  • Visual testing for therapy >3 months or if symptoms develop on therapy
  • Serotonin syndrome
  • Rash
  • Elevated liver enzymes
  • Lactic acidosis
  • Myelosuppression (usually with >2weeks therapy)- reversible
  • Peripheral/optic neuropathy with prolonged courses

A lot of drug interactions, contact pharmacy with questions

SSRI and other serotonergics/MAOIs - Increased risk of serotonin syndrome.

Rifampin decreases linezolid levels.

Antimicrobial class: Oxazolidinone

Pregnancy category: C

Average serum half life: 5 hours

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Therapeutic

Bone penetration: Therapeutic

Suppresses toxin production