Linzolid is indicated for the treatment of:
Linzolid is ineffective against Gram-negative pathogens. Its safety and efficacy beyond 28 days of continuous use have not been established in clinical trials.
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Linezolid is a synthetic antimicrobial agent classified as an oxazolidinone. It exhibits potent activity primarily against aerobic Gram-positive bacteria, some Gram-positive anaerobes, and selected Gram-negative species. Its mechanism involves selective inhibition of bacterial protein synthesis by binding to the 23S ribosomal RNA on the 50S ribosomal subunit. This action prevents the assembly of a functional 70S initiation complex, which is essential for bacterial translation.
Bacteriostatic: Against Enterococci and Staphylococci
Bactericidal: Against most strains of Streptococci
Linzolid is available as oral tablets and intravenous infusion. It can be taken with or without food. IV infusion must be administered over 30–120 minutes.
| Infection | Pediatric (0–11 yrs) | Adults & Adolescents (12+ yrs) | Duration |
|---|---|---|---|
| Nosocomial pneumonia | 10 mg/kg every 8 hr (oral/IV) | 600 mg every 12 hr (oral/IV) | 10–14 days |
| Community-acquired pneumonia, Complicated SSTI | 10 mg/kg every 8 hr (oral/IV) | 600 mg every 12 hr (oral/IV) | 14–28 days |
| Uncomplicated SSTI | <5 yrs: 10 mg/kg every 8 hr (oral) 5–11 yrs: 10 mg/kg every 12 hr (oral) | Adults: 400 mg every 12 hr (oral) Adolescents: 600 mg every 12 hr (oral) | 10–14 days |
Neonates (<7 days, <34 weeks GA): Begin with 10 mg/kg every 12 hours. If clinical response is inadequate, 10 mg/kg every 8 hours may be considered. By day 7, switch to 10 mg/kg every 8 hours.
No dose adjustment is needed when switching between IV and oral forms.
IV Administration: Inspect the infusion visually for particulates. A yellow tint may develop without affecting potency. Avoid series connections or adding substances to the solution. Discard any unused solution after a single use.
Hepatic impairment: No adjustment needed in mild-to-moderate cases. Not studied in severe hepatic dysfunction.
Pediatric CNS infections: Not recommended for empirical treatment.
With medications: Linezolid is a reversible non-selective MAO inhibitor. It may enhance the pressor response to sympathomimetics and pose a risk of serotonin syndrome when co-administered with SSRIs, TCAs, triptans, buspirone, or meperidine.
With food: Patients should avoid tyramine-rich foods (e.g., aged cheese, fermented meats).
Pregnancy: Limited data suggest no major fetal risks. Use only if needed.
Breastfeeding: Linezolid is present in breast milk. Monitor infants for gastrointestinal symptoms.
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