LINEZOLID

An oxazolidinone antibacterial, is active against Gram-positive bacteria including meticillin resistant Staphylococcus aureus (MRSA), and glycopeptide resistant enterococci.

Resistance to linezolid can develop with prolonged treatment or if the dose is less than that recommended.

Linezolid is not active against common Gram-negative organisms; it must be given in combination with other antibacterials for mixed infections that also involve Gram-negative organisms.

Dosage Forms

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Infusion

2 mg per 1 ml in 600mg/300ml infusion bag

Oral suspension

20 mg per 1 ml

Tablet

600mg

Uses

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  • Pneumonia
  • Complicated skin and soft-tissue infections caused by Gram-positive bacteria
  • Diabetic foot
  • Sepsis

Dose and Duration

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Moderate diabetic foot infection (specialist use only) or Severe diabetic foot infection (specialist use only) or Leg ulcer infection (specialist use only)

By mouth

Adult: 600 mg every 12hours

Pneumonia(when other antibacterials e.g. a glycopetide, such as vancomycin, cannot be used), Complicated skin and soft-tissue infections caused by Gram-positive bacteria, when other antibacterials cannot be used (initiated under specialist supervision)

By Mouth

Adult: 600 mg every 12 hours usually for 10–14 days(maximum duration of treatment 28 days)

By infusion

Adult: 600 mg every 12 hours

Contraindications

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  • Phaeochromocytoma
  • Thyrotoxicosis

Side Effects

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  • Anaemia
  • Gastrointestinal discomfort
  • Dyspnoea, stridor (high-pitched breath sound)
  • Arrhythmias
  • Seizure
  • Thrombocytopenia
  • Vision disorders

Interactions

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  • Beta₂ agonists are predicted to increase the risk of elevated blood pressure when given with linezolid
  • Macrolides (clarithromycin) increase the exposure to linezolid

Pregnancy

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  • Manufacturer advises use only if potential benefit outweighs risk — no informationavailable

Breastfeeding

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  • Manufacturer advises avoid — present in milk in animal studies.

⚠️ Caution

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  • Severe optic neuropathy may occur rarely, particularly if linezolid is used for longer than 28 days.
  • Haematopoietic disorders (including thrombocytopenia, anaemia, leucopenia, and pancytopenia) have been reported in patients receiving linezolid. It is recommended that full blood counts are monitored weekly
  • If significant myelosuppression occurs, treatment should be stopped unless it is considered essential, in which case intensive monitoring of blood counts and appropriate management should be implemented
  • Severe hepatic impairement