From the Guidelines
The dose of Linezolid for a 4-year-old, 16kg male is 10 mg/kg twice daily.
Recommended Dosing
- The recommended dosing for children <12 years of age is 10 mg/kg twice daily 1.
- This dosing is consistent across different guidelines, including those for the treatment of methicillin-resistant Staphylococcus aureus infections 1 and skin and soft tissue infections 1.
Important Considerations
- The dose should not exceed 600 mg/dose 1.
- Linezolid is generally well-tolerated, but monthly screening for peripheral neuropathy and monthly complete blood counts should be assessed while the child is receiving linezolid 1.
- It is essential to monitor for potential adverse events, such as significant anemia, leukopenia, or thrombocytopenia, and avoid using linezolid in children with these conditions 1.
- The most recent and highest quality study supporting this dosing is from the American Journal of Respiratory and Critical Care Medicine 1.
From the Research
Dosing Information for Linezolid in Pediatric Patients
- The recommended dose of linezolid for pediatric patients is 10 mg/kg every 8 hours, as stated in the study 2.
- However, a study published in 2019 3 suggests that this dosage may lead to underdosing in children, especially those with bacteria having minimum inhibitory concentrations (MICs) of ≥2 mg/liter.
- The same study 3 proposes that an elevated dosage of 15 or 20 mg/kg every 8 hours may be required to reach the pharmacokinetic target.
- Another study 4 notes that the pharmacokinetics of linezolid in pediatric patients is age-dependent, with children under 12 years of age having a faster clearance and shorter elimination half-life than adults.
- A study published in 2023 5 suggests reducing the linezolid dosing interval to 8 hours in pediatrics.
Specific Dosing for a 4-year-old, 16kg Male
- Based on the recommended dose of 10 mg/kg every 8 hours 2, the dose for a 16kg child would be 160mg every 8 hours.
- However, considering the proposal for an elevated dosage 3, the dose could be 240mg (15mg/kg) or 320mg (20mg/kg) every 8 hours.
- It is essential to consult the latest clinical guidelines and consider the specific clinical context, including the severity of the infection and the susceptibility of the causative pathogen, when determining the optimal dose for a pediatric patient 5, 3, 4, 6.