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Linezolid (Zyvox)

UK Medicines Information, 2001

Linezolid is the first of a new class of antimicrobial agents, the oxazolidinones, whose mechanism of action differs from that of existing agents.
It is active against a wide range of Gram-positive bacteria including MRSA, vancomycin-resistant enterococci (VRE) and penicillin-resistant pneumococci, but not against Gram-negative pathogens
It is currently licensed for nosocomial pneumonia, community acquired pneumonia and skin and soft- tissue infections.
Use of linezolid in pneumonia demands confirmation of a Gram-positive pathogen or combination with a Gram-negative agent.
Its spectrum of activity makes it particularly appropriate for treating complicated skin and soft-tissue infections, where multiresistant enterococci or staphylococci are documented or likely.
They showed that linezolid was equivalent to vancomycin in the treatment of hospitalised patients with nosocomial pneumonia and to oxacillin- dicloxacillin in the treatment of complicated skin and soft tissue infections.
In a trial published in abstract form, linezolid produced >85% clinical/microbiological cure in VRE infections
Plasma levels do not require monitoring and it has 100% oral bioavailability enabling early switch to oral therapy.
A trial showing higher first week discharge rates with oral and IV linezolid compared with vancomycin in the treatment of complicated skin and soft tissue infections, pneumonia, UTI and bacteraemia, has been published.
Differences in discharge rates during the first week of therapy were most marked for patients with skin and soft tissue infections.
Further comparative clinical data are needed to assess the potential economic benefits of linezolid