OBJECTIVE The objective of this study was to assess the long-term safety of linezolid in patients with chronic infections requiring treatment for ≥6 weeks. Enhanced monitoring for optic neuropathy was included to characterize the early development of this side effect and to identify ophthalmologic tests that might be valuable in early detection of this event. METHODS This was a multicenter, o...

Linezolid has demonstrated excellent activity against drugresistant Gram-positive bacteria infections, such as staphylococci, streptococci, and enterococci.1 However, linezolid is associatedwithawide rangeof adverse effects suchasnausea, diarrhea, vomiting, headache, and serotonin-like syndrome.2 Hematologic side effects, such as thrombocytopenia and anemia, can also occur after linezolid treat...

27 Linezolid has emerged as an important therapeutic option for the treatment of 28 Staphylococcus aureus in patients with cystic fibrosis. We report the rapid emergence, 29 upon treatment with linezolid, of linezolid-resistant S. aureus clinical isolates through the 30 accumulation of 23S rRNA resistance-associated mutations, together with acquisition of 31 an altered mutator phenotype. 32 33 ...

Treatments for Clostridium difficile infection remain limited, despite the introduction of fidaxomicin, and development of new agents is necessary. We determined the in vitro susceptibilities of 199 prevalent or emerging Clostridium difficile PCR ribotypes to MCB3681, a novel investigational quinolonyl-oxazolidinone, and 8 comparators (metronidazole, vancomycin, fidaxomicin, moxifloxacin, cipro...

RWJ-416457, a novel oxazolidinone, had modal MICs of 0.5 to 1 microg/ml for linezolid-susceptible staphylococci and enterococci, versus linezolid MICs for these organisms of 1 or 2 microg/ml. RWJ-416457 MICs for mutants with 23S rRNA mutations were 2 to 32 microg/ml, versus linezolid MICs of 8 to 64 microg/ml; actual values reflected the proportion of gene copies mutated.

Resistance to linezolid among Enterococcus faecium and Enterococcus faecalis isolates has been reported in patients who receive a prolonged course of the drug. We report two cases of linezolid-resistant Enterococcus faecalis that occurred in patients who previously received linezolid for infections with vancomycin-resistant Enterococcus faecium. Both isolates had the G2576U mutation in the 23S ...

We present a case of suspected linezolid toxicity in a 34-year-old man with sickle cell disease and line-related vancomycin-resistant enterococcal bacteremia and tricuspid valve endocarditis. The patient developed sudden-onset hypoglycemia, lactic acidosis, and acute pancreatitis 11 days after initiation of linezolid. All adverse effects quickly resolved with drug cessation. The pathophysiology...

Linezolid is an oxazolidinone antibiotic with weak monoamine oxidase (MAO) type A and MAO type B inhibitory effects. Linezolid has been associated with serotonin toxicity when used concomitantly with multiple medications that are known to increase serotonin concentrations. We report the case of a 65-year-old woman with signs and symptoms of serotonin toxicity following administration of linezol...

Three invasive Streptococcus pneumoniae strains nonsusceptible to linezolid were isolated in the United States between 2001 and 2012 from the CDC's Active Bacterial Core surveillance. Linezolid binds ribosomal proteins where structural changes within its target site may confer resistance. Our study identified mutations and deletions near the linezolid binding pocket of two of these strains with...

Complications of long-term linezolid administration include anemia and thrombocytopenia. A recent report has suggested that pyridoxine may prevent myelosuppression. Pyridoxine was administered to 24 patients with bone infections who were being treated with linezolid. Thrombocytopenia occurred in 11 patients (45.8%), and anemia occurred in 6 (25%). We concluded that treatment wtih pyridoxine is ...