Linezolid

C difficile risk
Low
Oral Bioavailability
Excellent
Cost
IV - $30/day PO - $3/day

Dosing

Requires AMS review within 72 hours. See below for more information.

600 mg PO/IV q12h

No renal adjustment required

General Information

  • Vancomycin-resistant Enterococcus (VRE) infections when daptomycin cannot be used

  • MRSA infections in which vancomycin or daptomycin cannot be used

  • Inhibits monoamine oxidase. Risk of serotonin syndrome if given to patients taking SSRIs, serotonin norepinephrine reuptake inhibitors or MAOI – check for drug interactions

  • Predictable cytopenia after 2 weeks of therapy: monitor CBC at least once a week

  • Lactic acidosis, peripheral neuropathy, optic neuropathy after 4 weeks of therapy

  • 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

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

  • Rifampin decreases linezolid levels.

Excellent oral bioavailability (100%)

Antimicrobial class: Oxazolidinone

Pregnancy category: C

Average serum half life: 5 hours

CSF penetration: Therapeutic

Lung penetration: Therapeutic

Urine penetration: Therapeutic

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