Systematic Therapeutic Drug Monitoring for Linezolid: Variability and Clinical Impact

Antimicrob Agents Chemother. 2017 Sep 22;61(10):e00687-17. doi: 10.1128/AAC.00687-17. Print 2017 Oct.

Abstract

Linezolid serum trough (Cmin) and peak (Cmax) levels were determined prospectively in 90 patients. Adequate exposure was defined as a Cmin of 2 to 8 mg/liter. Therapy was empirical (73.3%) or targeted (26.7%). Wide interindividual variability in linezolid Cmin levels was recorded (0.1 to 25.2 μg/ml). Overall, 65.5% of the patients had out-of-range, 41.1% had subtherapeutic, and 24.4% had supratherapeutic trough levels. We did not find a correlation between abnormal levels and adverse events, in-hospital mortality, or overall poor outcome.

Keywords: drugs for Gram-positive bacteria; linezolid; therapeutic drug monitoring.

MeSH terms

  • Aged
  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / blood*
  • Anti-Bacterial Agents / therapeutic use*
  • Drug Monitoring*
  • Female
  • Hospital Mortality
  • Humans
  • Linezolid / adverse effects
  • Linezolid / blood*
  • Linezolid / therapeutic use*
  • Male
  • Middle Aged
  • Prospective Studies
  • Staphylococcal Infections / drug therapy*
  • Staphylococcal Infections / mortality
  • Staphylococcus aureus / drug effects
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Linezolid