Linezolid

Class: Oxazolidinone antibiotic

Mechanism of Action: Inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit, preventing formation of the initiation complex.

Indications

• Nosocomial pneumonia (including MRSA)
• Community-acquired pneumonia
• Complicated and uncomplicated skin and soft tissue infections
• Vancomycin-resistant Enterococcus (VRE) infections

Dosage

• Adults: 600 mg every 12 hours (oral or IV)
• Children (birth–11 years): 10 mg/kg every 8 hours (Max: 600 mg/dose)

Maximum Dose

600 mg per dose

Side Effects

• Bone marrow suppression (thrombocytopenia, anemia, leukopenia)
• Lactic acidosis
• Peripheral and optic neuropathy (especially with prolonged use)
• Diarrhea, nausea, vomiting
• Headache

Contraindications

• Known hypersensitivity to linezolid or excipients
• Concurrent or recent use of MAO inhibitors (risk of serotonin syndrome)

Compatible Fluids

• 5% Dextrose
• 0.9% Sodium Chloride
• Lactated Ringer’s solution

Route of Administration

• Oral (tablets, suspension)
• Intravenous infusion

Type of Administration

IV infusion over 30–120 minutes; oral bioavailability ≈ 100% (oral dose = IV dose).

Special Precautions

• Monitor complete blood counts weekly (risk of bone marrow suppression)
• Use with caution in patients with hypertension or receiving serotonergic agents
• Avoid prolonged use (>28 days) due to neuropathy risk