Update on the safety of linezolid

Linezolid is still the only representative of the oxazolidinones antibiotic class. Because of its novel mechanism of action and excellent tissue penetration, it is used in a variety of approved and off-label clinical conditions.

To review the literature (including latest publications) about the adverse events of linezolid and its overall safety.

The range of adverse events of linezolid is growing; new ones, such as nephro-toxicity and Bell's palsy, have been reported. Toxicity of linezolid is mostly related with the prolonged duration of treatment and the presence of predisposing factors. Physicians must be alerted when using linezolid for indications and duration different from the approved ones, and must be aware of the possible adverse events. In case of toxicity, the main option is the discontinuation of the drug; although, not all adverse events are fully reversible. Linezolid represents an important advance in therapeutics and is still considered safe enough, but anticipated benefits must always be counterbalanced by the possible toxicity.