Linezolid Treatment of Skeletal Methicillin-Resistant Staphylococcus aureus Infection

Isenberg, J.; Prokop, A.; Seifert, Harald; Jubel, A.

doi:10.1007/s00068-004-1334-8

Cited by 2 publications

(3 citation statements)

References 25 publications

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“…Průměrná doba podávání byla 27 dní. Linezolid byl zpočátku aplikován intravenózně v průměru 11,4 dne (9)(10)(11)(12)(13)(14). Dále pak nemocní brali antibiotika perorálně 15,9 dne (14-18).…”

Section: Výsledkyunclassified

“…Adrenergní látky (nepřímá sympatomimetika, vazopresory a dopaminergní léky) mohou při současné léčbě linezolidem přinést Také Mogenet uvádí úspěšně léčený případ MRSE infekce kloubní náhrady za pomoci perorální formy linezolidu (22). Většina recentní literatury však společně s námi preferuje kombinaci chirurgického řešení s podáváním antibiotik (12,26,28,32).…”

Section: Diskuseunclassified

“…Délka podávání linezolidu udávaná v literatuře je rozdílná a v závislosti na typu infekce kolísá mezi 5 dny a 3 měsíci (27), spíše však mezi 4-8 týdny (12,26,32). Obecně udávaná délka terapie tak překračuje firemně udávaných 28 dní.…”

Section: Diskuseunclassified

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Linezolid in the Treatment of Antibiotic-Resistant Gram-Positive Infections of the Musculoskeletal System

Jahoda¹,

Nyč²,

Pokorný³

et al. 2006

Acta Chir. orthop. Traum. Cech.

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PURPOSE OF THE STUDYThe growing incidence of resistant microorganisms has been responsible for complications associated with treatment of osteomyelitis, infections following joint arthroplasty, as well as septic arthritis. Their therapy often requires a long-term administration of antibiotics to which the bacterial strain is sensitive. Oxazolidinons present a novel group of antibiotics recently adopted in clinical medicine. However, the only member of this group so far approved for clinical use is linezolid. It is effective for Gram-positive bacteria including antibiotic-resistant strains, such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), resistant coagulase-negative staphylococci and penicillin-resistant pneumococci. Linezolid is well absorbed in the intestinal system. Oral administration results in serum levels comparable with those following intravenous injection of the same dose. MATERIAL, METHODS AND RESULTSIn the 1 st Orthopedic Department of the 1 st Faculty of Medicine at Charles University, linezolid was used for treating infections of the musculoskeletal system caused by MRSA and methicillin-resistant Staphylococcus epidermidis (MRSE). Fourteen patients, eight women and six men, were treated in the period from 1999 to 2005.The average age at the time of therapy was 65 years (range, 24-80). The treatment involved infection of 10 joints following arthroplasty (six total hip and four total knee replacements), one osteomyelitis, one septic arthritis, one abscess in the gluteal region and one infected amputation stump. With the exception of one patient, antibiotic therapy was always combined with an appropriate surgical intervention. The average antibiotic course was 27 days, with intravenous administration of linezolid at the beginning (average, 11.4 days; range, 9-14) and oral administration later (average, 15.9 days; range, 14-18). Antibiotic therapy was well tolerated by the patients, and no adverse side-effects were recorded.The success rate of therapy was 93 %. The only failure was in the patient in whom the infection of total knee replacement was treated with mere antibiotics, without any surgical intervention. DISCUSSIONLinezolid is a treatment option for joint infections following arthroplasty that are caused by resistant bacterial strains, such as MRSA, MRSE or VRE. The therapeutic efficiency varies in relation to whether the patients have undergone conservative or surgical treatment and, in the latter case, on the surgical technique used. On the basis of our results we suggest that a radical surgery is necessary, but in agreement with other recent reports we prefer a surgical approach combined with antibiotic therapy. The costs of linezolid treatment are high, but the possibility of its oral administration, with maintenance of the required tissue levels, markedly reduces hospital stay costs and increases patients' comfort during treatment. In our group, the patients received linezolid doses orally for up to 16 days, which means a hospital stay shor...

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Linezolid in the Treatment of Antibiotic-Resistant Gram-Positive Infections of the Musculoskeletal System

Jahoda¹,

Nyč²,

Pokorný³

et al. 2006

Acta Chir. orthop. Traum. Cech.

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Treatment of orthopedic infections caused by resistant staphylococci

et al. 2007

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During 1999-2005 we treated 15 patients with linezolid for relevant infections of locomotion apparatus (7 cases with endoprosthesis infection, 5x osteomyelitis and 3x another infection). With the exception of one case the antibiotic therapy was always combined with appropriate surgical intervention. Average period of linezolid administration was 26 d; linezolid was applied from the beginning intravenously on average for 10 d, and then orally for 16 d (average). There were no undesirable effects in the file. Success rate reached 86.6%. MRSA strains were proved by standard methods: growth on Mueller-Hinton agar with increased concentration of NaCl and 2 mg/L of oxacilline, and measuring inhibitory zones around cephoxitine disk. The sensitivity to other antibiotics was specified by disk-diffusion test; that to linezolid was verified by E-test. Linezolid represents a medical reserve for the treatment of multiresistant Gram-positive infections or for emergencies, when allergy onset, high toxicity risk, intolerance, etc. do not allow to use other, in vitro effective, antibiotics.

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Linezolid Treatment of Skeletal Methicillin-Resistant Staphylococcus aureus Infection

Cited by 2 publications

References 25 publications

Linezolid in the Treatment of Antibiotic-Resistant Gram-Positive Infections of the Musculoskeletal System

Linezolid in the Treatment of Antibiotic-Resistant Gram-Positive Infections of the Musculoskeletal System

Treatment of orthopedic infections caused by resistant staphylococci

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