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Clinical efficacy and tolerability of linezolid in pediatric patients: a systematic review

Elena Chiappini1, Camilla Conti, Luisa Galli

  • 1Department of Pediatrics, University of Florence, Florence, Italy.

Clinical Therapeutics
|February 23, 2010
PubMed

Insights

Linezolid demonstrates high clinical cure rates in pediatric patients for skin, bacteremia, and pneumonia infections, comparable to vancomycin or cefadroxil. Further research is needed to confirm long-term efficacy and tolerability in children.

Area of Science:

  • Pediatric Infectious Diseases
  • Pharmacology
  • Clinical Trials

Background:

  • Linezolid is approved for severe gram-positive bacterial infections in adults.
  • Limited data exists on linezolid's use in pediatric populations.

Purpose of the Study:

  • To review evidence on linezolid's efficacy and tolerability in infants and children.
  • To summarize clinical data for pediatric linezolid use.

Main Methods:

  • Conducted a literature search of major databases (Cochrane, EMBASE, MEDLINE) up to July 2009.
  • Included pharmacokinetic studies, case reports, and randomized clinical trials (RCTs) in children.
  • Excluded non-pertinent articles and evaluated bibliographies of relevant studies.

Main Results:

  • Analyzed 47 publications involving 447 children for pharmacokinetics and 1480 children for efficacy in RCTs.
  • Found age-dependent plasma pharmacokinetics of linezolid in pediatric patients.
  • Reported high clinical cure rates (75.0%-93.2%) for skin infections, bacteremia, or pneumonia, with no significant difference compared to vancomycin or cefadroxil.
  • Identified diarrhea, nausea/vomiting, and thrombocytopenia as common adverse events; 3 cases of neuropathy reported.

Conclusions:

  • Linezolid shows high clinical cure rates in pediatric skin infections, bacteremia, and pneumonia, similar to comparator antibiotics.
  • Further RCTs are needed for other infections (e.g., osteomyelitis, endocarditis) and long-term outcomes.
  • Ongoing monitoring for adverse events and potential resistance is crucial in pediatric patients.
Abstract

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