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Linezolid-associated toxic optic neuropathy

J C Rucker1, S R Hamilton, D Bardenstein

  • 1Department of Neurology, Rush University Medical Center, Chicago, IL 60612, USA. janet_rucker@rush.edu

Neurology
|March 1, 2006
PubMed

Insights

Linezolid, an antibiotic for gram-positive infections, can cause optic and peripheral nerve damage with prolonged use. This neural toxicity may stem from impaired mitochondrial protein synthesis.

Area of Science:

  • Pharmacology
  • Neuroscience
  • Infectious Diseases

Background:

  • Linezolid is a crucial oxazolidinone antibiotic for treating gram-positive bacterial infections.
  • Recommended treatment duration is typically 28 days, but longer courses are frequently administered.

Observation:

  • Prolonged linezolid therapy, exceeding 28 days, is associated with neurological side effects.
  • Cases of reversible optic neuropathy and irreversible peripheral neuropathy have been reported.

Findings:

  • This report details three cases of combined optic and peripheral neuropathy induced by linezolid.
  • A review of existing literature on linezolid-induced optic neuropathy is included.
  • Mitochondrial protein synthesis impairment is a potential mechanism for linezolid's neurotoxicity.

Implications:

  • Clinicians should be vigilant for neurological symptoms in patients on extended linezolid treatment.
  • Understanding the mechanism of neurotoxicity may inform safer antibiotic prescribing practices.
  • Further research into mitochondrial dysfunction could lead to strategies mitigating linezolid-induced nerve damage.

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