Oxazolidinones

Oxazolidinones is a topic covered in the Washington Manual of Medical Therapeutics.

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General Principles

  • Oxazolidinones block assembly of bacterial ribosomes and inhibit protein synthesis.
  • Linezolid (600 mg IV/PO q12h) IV and oral formulations produce equivalent serum concentrations. It has potent activity against gram-positive bacteria, including drug-resistant enterococci, staphylococci, and streptococci, but not against Enterobacteriaceae.
  • Linezolid is useful for serious infections with VRE, as an alternative to vancomycin for treatment of MRSA infections, in patients with intolerance to vancomycin therapy, and as oral therapy of MRSA infections when IV access is unavailable. Linezolid should generally be avoided for catheter-related bloodstream or catheter site infections. Resistance can develop to this antibiotic, and it is imperative that organism susceptibility is verified.

Tedizolid ( mg PO/IV q24h) is an oxazolidinone antibiotic which inhibits bacterial protein synthesis. It is FDA approved for treating acute bacterial skin and skin structure infections. Tedizolid has activity against staphylococci (including MRSA), streptococci, and enterococci (including some strains resistant to linezolid).

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