What is the recommended treatment and dosage for Zyvox (linezolid) in adults with bacterial infections?

From the Guidelines

Zyvox (linezolid) is typically prescribed at 600 mg orally or intravenously every 12 hours for most adult bacterial infections. The standard treatment duration is 10-14 days, though this may vary depending on the specific infection type. For vancomycin-resistant Enterococcus faecium (VRE) infections, pneumonia, or complicated skin infections, the 600 mg twice daily dosage is maintained, while uncomplicated skin infections may be treated with 400 mg orally every 12 hours. Patients with renal impairment generally don't require dose adjustments, but those with hepatic insufficiency may need monitoring. During treatment, complete blood counts should be monitored weekly due to potential bone marrow suppression, especially if therapy extends beyond 14 days. Patients should avoid tyramine-rich foods and serotonergic medications due to potential interactions. Linezolid works by inhibiting bacterial protein synthesis through binding to the 50S ribosomal subunit, making it effective against resistant gram-positive organisms including MRSA and VRE.

Key Considerations

• The dosage and treatment duration may vary depending on the specific infection type and patient factors, such as renal or hepatic impairment 1.
• Linezolid is effective against MRSA and VRE, making it a valuable option for treating resistant gram-positive infections 1.
• Patients should be monitored for potential side effects, including bone marrow suppression and interactions with other medications 1.
• The use of linezolid in pediatric patients requires careful consideration of the dosage and potential side effects 1.

Treatment Guidelines

• For MRSA infections, linezolid may be used as an alternative to vancomycin or other antibiotics, depending on the specific infection type and patient factors 1.
• For VRE infections, linezolid is a recommended treatment option, particularly for complicated infections or those that are resistant to other antibiotics 1.
• The treatment duration and dosage may vary depending on the specific infection type and patient response to treatment 1.

From the FDA Drug Label

The recommended dosage for Linezolid formulations for the treatment of infections is described in Table 1.

Table 1

(consecutive days)

(Birth through 11 Years of Age)

(12 Years and Older)

acquired pneumonia, including concurrent bacteremia

Complicated skin and skin structure infections

Vancomycin-resistant Enterococcusfaecium infections, including concurrent bacteremia

10 mg/kg intravenously or oral‡ every 8 hours

600 mg intravenously or oral‡ every 12 hours

14 to 28

Uncomplicated skin and skin structure infections

less than 5 yrs: 10 mg/kg oral‡ every 8 hours

5 to 11 yrs: 10 mg/kg oral‡ every 12 hours

Adults: 400 mg oral‡ every 12 hours

Adolescents: 600 mg oral‡ every 12 hours

10 to 14

The recommended treatment and dosage for Zyvox (linezolid) in adults with bacterial infections are as follows:

• Complicated skin and skin structure infections: 600 mg intravenously or orally every 12 hours for 10 to 14 days.
• Vancomycin-resistant Enterococcus faecium infections: 600 mg intravenously or orally every 12 hours for 14 to 28 days.
• Uncomplicated skin and skin structure infections: 400 mg orally every 12 hours for 10 to 14 days. No dose adjustment is necessary when switching from intravenous to oral administration 2.

From the Research

Recommended Treatment and Dosage for Zyvox (Linezolid)

The recommended treatment and dosage for Zyvox (linezolid) in adults with bacterial infections vary depending on the type and severity of the infection.

• The standard dosage for adults is 600 mg every 12 hours, administered orally or intravenously 3, 4, 5.
• For uncomplicated skin and skin structure infections, the treatment duration is typically 10 to 14 days 4, 5.
• For more severe infections, such as pneumonia or bacteremia, the treatment duration may be longer, typically 14 to 28 days 4, 5.

Administration and Pharmacokinetics

• Linezolid is well absorbed in the intestinal system, with oral administration resulting in serum levels comparable to those following intravenous injection of the same dose 3.
• The drug is excreted primarily intact, with two inactive metabolites, PNU-142586 and PNU-142300, accounting for a smaller portion of the excreted material 6.
• Linezolid circulates in plasma mainly as the parent drug, with a mean recovery of radioactivity in excreta of 93.8% after a single oral dose 6.

Efficacy and Safety

• Linezolid has been shown to be effective against a range of Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) 3, 4, 5.
• The drug has been found to be well tolerated, with a similar rate of adverse events to vancomycin in clinical trials 5, 7.
• However, linezolid has been associated with a greater frequency of certain adverse events, such as nausea, vomiting, and diarrhea, particularly with prolonged administration 4.