infectious diseases
Linezolid and Tedizolid
Linezolid
Linezolidis an oxazolidinone antibiotic that has activity against the following: Streptococcal Infections None Enterococcal Infections , including Staphylococcal Infections , including methicillin-resistant Tuberculosis (TB) , including Overview of Anaerobic Bacteria , such as Linezolidis contraindicated in patients with a prior allergic reaction to it. Linezolidis contraindicated in patients who are taking monamine oxidase inhibitors (MAOIs). has the potential for causing Serotonin Syndrome (a hyperserotonergic state characterized by mental status changes, neurologic abnormalities, and autonomic instability) when it is used in patients with either of the following: Endocrinologically active Overview of Carcinoid Tumors None Use of drugs with serotonergic activity Such drugs include selective serotonin reuptake inhibitors, MAOIs (eg,phenelzine,isocarboxazid), tricyclic antidepressants, serotonin 1B,1D receptor agonists (triptans),meperidine,bupropion, andbuspirone. Patients who are taking such drugs and urgently needlinezolidmay be treated if the benefit is thought to outweigh the risk and if they Promptly stop the proserotonergic drug Are carefully monitored for manifestations of serotonin syndrome for 2 weeks after stopping the drug (forfluoxetine, 5 weeks) or for 24 hours after the lastlinezoliddose Linezolidhas not been studied in patients with carcinoid syndrome; it should be used only if patients are closely monitored for symptoms and signs of serotonin syndrome. Linezolidshould not be given to the following patients unless they are monitored for potential increases in blood pressure: Those taking any of the following: sympathomimetic drugs (eg,pseudoephedrine), vasopressors (eg,epinephrine,norepinephrine), or dopaminergic drugs (eg,dopamine,dobutamine) Those with uncontrolled hypertension Those with thyrotoxicosis Those with a pheochromocytoma Animal reproduction studies withlinezolidshow some risk, and no adequate, well-controlled studies have been done in pregnant women.Linezolidshould be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Whetherlinezolidis excreted in breast milk or is safe to use during breastfeeding is unknown. Adverse effects oflinezolidinclude Reversible myelosuppression Irreversible peripheral neuropathy Reversible optic neuropathy Serotonin Syndrome None Reversible myelosuppression, including thrombocytopenia, leukopenia, and anemia, occurs in about 3% of patients, usually when therapy is used>2 weeks. Consequently, complete blood count is monitored weekly, especially when therapy lasts>2 weeks. Peripheral and optic neuropathy may occur with prolonged use, and patients taking long-termlinezolidtherapy should be closely monitored for these disorders. 