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Early experience with linezolid for infections in orthopaedics.
Injury 2006; 37(9):818-26I

Abstract

In infections following orthopaedic surgery, isolated staphylococci are reported to be methicillin resistant (MRSA) in up to 50% of cases. Linezolid, the first in a new class of antibiotics, has excellent efficacy against gram positive organisms that are resistant to other therapies and is 100% orally bioavailable. We report early results of its use for the treatment of resistant infections in orthopaedic practice. Infections were characterised according to the UK Nosocomial Infections National Surveillance Service classification of surgical infections as superficial, deep or organ/space. Osteomyelitis, joint sepsis and deep infection involving orthopaedic implants were included into the final category. Outcome was recorded as clinical, microbiological and blood parameter cure or fail. Over the 12-month study period, 54 patients received linezolid therapy, 41% of these had significant co-morbidity that might affect their ability to fight infection. Sixty-seven percent of infections were in association with implanted metal work. The majority of patients were treated with vancomycin for a short period before linezolid was used as oral 'switch' therapy for longer-term administration, allowing early discharge in all cases. MRSA was isolated in 87% of the patients treated. The mean length of linezolid therapy was 39 days (2-151). Clinical success was achieved in 90% of patients overall. Though there were no life-threatening complications, adverse event rates were significantly higher than those recorded in the literature, with 19% of patients needing to cease therapy. Linezolid offers an alternative to traditional treatments for resistant infections and can facilitate early discharge. Patients need to be monitored closely, particularly where long-term therapy is planned.

Authors+Show Affiliations

Academic Department of Orthopaedic Trauma Surgery, Leeds University, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16620816

Citation

Harwood, P J., et al. "Early Experience With Linezolid for Infections in Orthopaedics." Injury, vol. 37, no. 9, 2006, pp. 818-26.
Harwood PJ, Talbot C, Dimoutsos M, et al. Early experience with linezolid for infections in orthopaedics. Injury. 2006;37(9):818-26.
Harwood, P. J., Talbot, C., Dimoutsos, M., Sunderland, G., Shaw, D., Wilcox, M. H., & Giannoudis, P. V. (2006). Early experience with linezolid for infections in orthopaedics. Injury, 37(9), pp. 818-26.
Harwood PJ, et al. Early Experience With Linezolid for Infections in Orthopaedics. Injury. 2006;37(9):818-26. PubMed PMID: 16620816.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early experience with linezolid for infections in orthopaedics. AU - Harwood,P J, AU - Talbot,C, AU - Dimoutsos,M, AU - Sunderland,G, AU - Shaw,D, AU - Wilcox,M H, AU - Giannoudis,P V, Y1 - 2006/04/18/ PY - 2005/06/24/received PY - 2006/02/02/revised PY - 2006/02/06/accepted PY - 2006/4/20/pubmed PY - 2007/6/26/medline PY - 2006/4/20/entrez SP - 818 EP - 26 JF - Injury JO - Injury VL - 37 IS - 9 N2 - In infections following orthopaedic surgery, isolated staphylococci are reported to be methicillin resistant (MRSA) in up to 50% of cases. Linezolid, the first in a new class of antibiotics, has excellent efficacy against gram positive organisms that are resistant to other therapies and is 100% orally bioavailable. We report early results of its use for the treatment of resistant infections in orthopaedic practice. Infections were characterised according to the UK Nosocomial Infections National Surveillance Service classification of surgical infections as superficial, deep or organ/space. Osteomyelitis, joint sepsis and deep infection involving orthopaedic implants were included into the final category. Outcome was recorded as clinical, microbiological and blood parameter cure or fail. Over the 12-month study period, 54 patients received linezolid therapy, 41% of these had significant co-morbidity that might affect their ability to fight infection. Sixty-seven percent of infections were in association with implanted metal work. The majority of patients were treated with vancomycin for a short period before linezolid was used as oral 'switch' therapy for longer-term administration, allowing early discharge in all cases. MRSA was isolated in 87% of the patients treated. The mean length of linezolid therapy was 39 days (2-151). Clinical success was achieved in 90% of patients overall. Though there were no life-threatening complications, adverse event rates were significantly higher than those recorded in the literature, with 19% of patients needing to cease therapy. Linezolid offers an alternative to traditional treatments for resistant infections and can facilitate early discharge. Patients need to be monitored closely, particularly where long-term therapy is planned. SN - 0020-1383 UR - https://www.unboundmedicine.com/medline/citation/16620816/Early_experience_with_linezolid_for_infections_in_orthopaedics_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0020-1383(06)00072-6 DB - PRIME DP - Unbound Medicine ER -