Clinical experience with linezolid: A case series of 53 patients

Linezolid, the first oxazolidinone antibiotic, was approved by the United States Food and Drug Administration in April 2000 for treating gram-positive infections. We reviewed inpatient linezolid use for the first 12 months after its approval at a large teaching hospital, to evaluate indications, outcomes, and adverse events. Linezolid was prescribed 53 times for 52 inpatients from April 2000 through March 2001. The most common microbiologic indications for linezolid were vancomycin-resistant Enterococcus faecium and methicillin-resistant Staphylococcus aureus. The most common sites of infection were blood, bone, and ascitic fluid. Among those receiving linezolid for more than 48 hours (42), clearance of the primary infection site of 32 (76%) was documented; seven did not have cultures repeated; and three died before documentation of clearance. Of patients treated for more than 48 hours (42), 10 (23.8%) developed thrombocytopenia; seven had pre-existing thrombocytopenia. Although most patients had moderate to severe illness, most patients had good clinical and microbiologic responses, and treatment-limiting adverse events were limited.