Targeted or empiric therapy for gram positive infections including skin and soft tissue, pneumonia, and intra-abdominal infections
Covers MRSA and VRE
Usually reserved for multi-drug resistant gram positive infections where no alternative exists.
Very limited information on the use of linezolid during human pregnancy exists.
Because of the near absence of human pregnancy experience, other antibiotics with human data are preferred.
If no other alternatives are available and linezolid must be used, the maternal benefit appears to outweigh the unknown fetal risk.
No clinical data is published on the outcomes of infants exposed to linezolid via breastmilk.
Limited data on linezolid sampling in breastmilk indicate linezolid transfers into milk with a relative infant dose (RID) reported up to 15%.
This would still result in significantly less linezolid exposure than what is given as therapeutic doses directly to infants.
Monitor the infant for possible effects on the gastrointestinal tract, such as diarrhea, vomiting, and candidiasis (e.g., thrush, diaper rash).
CBC at least once/week
Visual testing for therapy > 3 months or if symptoms develop on therapy
Leukopenia, thrombocytopenia (usually with > 2 weeks therapy) - reversible
Peripheral/optic neuropathy with prolonged courses
Elevated liver enzymes
Linezolid is a weak, reversible, non-selective monoamine oxidase inhibitor (MAOI).
Multiple drug interactions are possible. Consult pharmacy.
SSRI and other serotonergics/MAOIs - increased risk of serotonin syndrome (this includes opioids)
Rifampin decreases linezolid levels
Use cautiously and monitor blood pressure when administering together with any sympathomimetic amine (dopamine, dobutamine, epinephrine, isoproterenol, norepinephrine, phenylephrine)
Antimicrobial class: Oxazolidinone