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11st Orthopedic Clinic, 1st Medical Faculty, Charles University, 150 06 Prague, Czechia. david.jahoda@post.cz
Abstract:
During 1999-2005 we treated 15 patients with linezolid for relevant infections of locomotion apparatus (7 cases with endoprosthesis infection, 5x osteomyelitis and 3x another infection). With the exception of one case the antibiotic therapy was always combined with appropriate surgical intervention. Average period of linezolid administration was 26 d; linezolid was applied from the beginning intravenously on average for 10 d, and then orally for 16 d (average). There were no undesirable effects in the file. Success rate reached 86.6%. MRSA strains were proved by standard methods: growth on Mueller-Hinton agar with increased concentration of NaCl and 2 mg/L of oxacilline, and measuring inhibitory zones around cephoxitine disk. The sensitivity to other antibiotics was specified by disk-diffusion test; that to linezolid was verified by E-test. Linezolid represents a medical reserve for the treatment of multiresistant Gram-positive infections or for emergencies, when allergy onset, high toxicity risk, intolerance, etc. do not allow to use other, in vitro effective, antibiotics.
Insights
Linezolid effectively treated locomotion apparatus infections, including osteomyelitis and endoprosthesis infections, with an 86.6% success rate. This antibiotic is a valuable reserve for challenging Gram-positive infections when other options fail.
Area of Science:
- Infectious Diseases
- Orthopedic Surgery
- Pharmacology
Background:
- Locomotion apparatus infections pose significant treatment challenges.
- Multiresistant Gram-positive bacteria, including MRSA, are a growing concern.
- Limited treatment options exist for patients with allergies or intolerance to standard antibiotics.
Purpose of the Study:
- To evaluate the efficacy and safety of linezolid in treating infections of the locomotion apparatus.
- To assess linezolid's role as a reserve antibiotic for complex Gram-positive infections.
Main Methods:
- Retrospective analysis of 15 patients treated with linezolid between 1999-2005.
- Combined antibiotic therapy with surgical intervention in most cases.
- Microbiological methods included Mueller-Hinton agar, oxacillin, cephoxitin disk diffusion, and E-test for linezolid sensitivity.
Main Results:
- A success rate of 86.6% was achieved in treating diverse locomotion apparatus infections.
- Average linezolid treatment duration was 26 days (10 IV, 16 oral).
- No undesirable side effects were reported during linezolid administration.
Conclusions:
- Linezolid demonstrates high efficacy and safety for treating challenging Gram-positive infections of the musculoskeletal system.
- It serves as a crucial medical reserve antibiotic for patients with limited treatment alternatives.
- Linezolid is a valuable option in emergencies or when other effective antibiotics are contraindicated.
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