Use of linezolid in pediatrics: a critical review☆

Summary 

Background

Linezolid, an oxazolidinone antibacterial agent, is available for intravenous/oral administration, with activity against Gram-positive bacteria including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and penicillin-resistant Streptococcus pneumoniae (PRSP). These pathogens are important causes of hospital- and community-associated infections in children.

Methods

PubMed was searched for all English language articles on patients younger than 18 years of age treated with linezolid, and an analysis of these articles was performed.

Results

From the 133 articles retrieved, a total of 30 were studied (18 case reports, nine case series, and three clinical trials) based on the inclusion criteria preset for this review. In these articles, a total of 597 children received linezolid. MRSA was the most common pathogen, followed by VRE, PRSP, other bacteria and less common mycobacterial species. Linezolid was reported to be safe and effective for the treatment of pneumonia and endocarditis, as well as skin and soft tissue, central nervous system and osteoarticular infections.

Conclusions

Linezolid is promising as a safe and efficacious agent for the treatment of infections due to mainly resistant Gram-positive organisms in children who are unable to tolerate conventional agents or after treatment failure.

Keywords: Linezolid, Children, Indications, Gram-positive bacteria, Resistance