Linezolid Dosing: One Size May Not Fit All

Risk for linezolid-mediated thrombocytopenia might be mitigated by adjusting renal dosing and therapeutic drug monitoring.

The oxazolidinone antibiotic linezolid has served as a convenient and efficacious therapy against methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and mycobacterial infections. However, treatment-limiting myelosuppression (particularly thrombocytopenia) is frequently encountered when the agent is administered for more than 14 days. It has also become increasingly recognized that variations in renal function may account for linezolid pharmacokinetic differences among patients, raising the possibility that myelosuppression risks may be reduced by adjusting renal therapy dosages.

Now, investigators have examined the risk for thrombocytopenia in 341 patients (39% with renal impairment and 61% without re…

Reviewing Author

George Sakoulas, MD

Disclosures

Consultant/Advisory BoardParatek Pharmaceuticals; Nestle Corp.; AbbVie; Shionogi

Speaker’s BureauAllergan/AbbVie; Paratek Pharmaceuticals; Nestle Corp.

RoyaltiesUpToDate

Editorial BoardsAntimicrobial Agents and Chemotherapy; Open Forum Infectious Diseases