Serotonin Syndrome as a Consequence of Antimicrobial Use

Oxazolidinone antimicrobials such as tedizolid and linezolid are often used as therapy for methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci infections. Their inhibition of monoamine oxidase raises concerns about serotonin syndrome (altered mentation, rigidity, and myoclonus caused by build-up of high levels of serotonin) when they are coadministered with agents such as selective serotonin reuptake inhibitors. Given that up to 20% of American adults take antidepressant medications, we need a better understanding of this drug interaction.

Fang et al. performed a retrospective study of 479 hospitalized patients (median age, 61) who were concomitantly receiving tedizolid and serotonergic agents. The primary endpoi…