Linezolid

C difficile risk
Low
Oral Bioavailability
Excellent

Dosing

600 mg PO/IV q12h

Infuse over 30 to 60 minutes

Age 0-7 DaysAge >7 Days10 mg/kg/dose IV/PO Q12H10 mg/kg/dose IV/PO Q8H

10 mg/kg/dose IV/PO Q8H

10 mg/kg/dose IV/PO Q8H

IV, PO

IV: 2 mg/mL PO: 20 mg/mL

Supplied by manufacturer

24H Room Temperature

General Information

  • Targeted or empiric therapy for gram positive infections including skin and soft tissue, pneumonia, and intra-abdominal infections

  • Covers MRSA and VRE

  • Usually reserved for multi-drug resistant gram positive infections where no alternative exists.

Pregnancy:

  • Very limited information on the use of linezolid during human pregnancy exists.

  • Because of the near absence of human pregnancy experience, other antibiotics with human data are preferred.

  • If no other alternatives are available and linezolid must be used, the maternal benefit appears to outweigh the unknown fetal risk.

Breastfeeding:

  • No clinical data is published on the outcomes of infants exposed to linezolid via breastmilk.

  • Limited data on linezolid sampling in breastmilk indicate linezolid transfers into milk with a relative infant dose (RID) reported up to 15%.

  • This would still result in significantly less linezolid exposure than what is given as therapeutic doses directly to infants.

  • Monitor the infant for possible effects on the gastrointestinal tract, such as diarrhea, vomiting, and candidiasis (e.g., thrush, diaper rash).

  • CBC at least once/week

  • Visual testing for therapy > 3 months or if symptoms develop on therapy

  • Leukopenia, thrombocytopenia (usually with > 2 weeks therapy) - reversible

  • Peripheral/optic neuropathy with prolonged courses

  • Serotonin syndrome

  • Rash

  • Elevated liver enzymes

  • Lactic acidosis

  • Gastrointestinal intolerance

Linezolid is a weak, reversible, non-selective monoamine oxidase inhibitor (MAOI). Multiple drug interactions are possible. Consult pharmacy.

SSRI and other serotonergics/MAOIs - increased risk of serotonin syndrome (this includes opioids)

Rifampin decreases linezolid levels

Use cautiously and monitor blood pressure when administering together with any sympathomimetic amine (dopamine, dobutamine, epinephrine, isoproterenol, norepinephrine, phenylephrine)

Antimicrobial class: Oxazolidinone

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