Spectrum: Local Antimicrobial Stewardship, for Prisma Health Children’s Hospital-Midlands

Linezolid

Restricted
Restricted

C. diff Risk

Low

Oral Bioavailability

NA

Approximate Cost

IV/PO$$$$$

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

Dosing

Pediatric

Neonatal

Renal

No dosage adjustment necessary in renal insufficiency, however inactive metabolites may accumulate in renal insufficiency

Hepatic

No dosage adjustment recommended in hepatic insufficiency. Use in severe hepatic impairment has not been adequately evaluated

General Information

Common Usage

Common Usage

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

Covers MRSA and VRE

Drug Monitoring

Drug Monitoring

CBC at least once/week.

Visual testing for therapy >3mo or if symptoms develop on therapy

Adverse Effects

Adverse Effects

  • Myelosuppression (usually with >2weeks therapy) - reversible

  • Peripheral/optic neuropathy with prolonged courses

  • Rash

  • Elevated liver enzymes

  • Lactic acidosis

Major Interactions

Major Interactions

SSRI and other serotonergics/MAOIs - increased risk of serotonin syndrome

Rifampin decreases linezolid levels

Pharmacology

Pharmacology

Antimicrobial class: Oxazolidinone

Average serum half life:

  • Preterm neonates <1 week: 5.6 hours

  • Full-term neonates < 1 week : 3 hours

  • Full-term neonates ≥1 week to ≤ 28 days: 1.5 hours

  • Infants > 28 days to < 3 months: 1.8 hours

  • Infants and Children 3 months to 11 years: 2.9 hours

  • Adolescents: 4.1 hours

  • Adults: 4.9 hours

Route of Elimination:

  • Urine (~30% of total dose as parent drug, ~50 of total dose as inactive metabolites), two metabolites may accumulate in patients with severe renal impairment

  • Feces (9% of total dose as metabolites)