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1.
Braz. j. infect. dis ; 26(1): 101701, 2022. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1364542

ABSTRACT

Abstract Severe lactic acidosis, a mitochondrial toxicity caused by the recommended standard dosage of linezolid (LZD), may occur in patients with impaired renal function. We describe an adult male who underwent kidney transplantation with stably impaired renal function, severe dyspnea, and abdominal discomfort. He received a standard oral dose of LZD (600 mg twice daily) and azithromycin for three weeks with a reduced immunosuppressant dose due to pulmonary non-tuberculosis mycobacterial infection. He was alert and afebrile, with a blood pressure of 140/60 mmHg. Pertinent laboratory data showed: pH 7.12, PaCO2 13.6 mmHg; HCO3- 4.3 mmol/L and serum lactate 18.4 mmol/L. His trough serum LZD concentration reached toxic levels (21.4 μg/mL). With hemodialysis, his clinical symptoms improved, with a decline in serum LZD (9.8μg/mL) and lactate (3.2 mmol/L). Chronic standard dose LZD in patients with impaired renal function can lead to life-threatening lactic acidosis, especially in coexisting conditions that reduce LZD metabolism.

2.
China Pharmacy ; (12): 1520-1524, 2022.
Article in Chinese | WPRIM | ID: wpr-927202

ABSTRACT

Linezolid is a n anti-infective drug commonly used in clinic. Considering the large difference of individual condition , severe basic disease ,poor organ function and large variety and quantity of drugs ,standard dose of linezolid may not be suitable for all critically ill patients. This paper reviews the relevant researches on the application of linezolid in adult critically ill patients in recent years ,analyzes the pharmacokinetic characteristics of critically ill patients ,and summarizes the influence of common physiological and pathological changes in critically ill patients on drugs. When using linezolid ,the clinical comprehensive evaluation of this special group should be strengthened. In addition to appropriately reducing the drug dosage of patients with liver/ kidney function injury ,it is also necessary to consider appropriately increasing the drug dosage in other cases. After medication ,in order to avoid excessive or insufficient drug exposure ,clinical medication monitoring should be strengthened ,especially the important mean as therapeutic drug monitoring should be used well.

3.
Article in Chinese | WPRIM | ID: wpr-906305

ABSTRACT

Objective:To investigate the inhibitory effects and mechanism of Reyanning mixture (RYN) combined with linezolid (LNZ) against methicillin-resistant <italic>Staphylococcus aureus</italic> (MRSA) and its biofilm. Method:The minimum inhibitory concentrations (MICs) of RYN and LNZ against MRSA were determined by microdilution assay. The microplate method was used to detect the changes in viable count before and after MRSA administration at four time points (0, 6, 12, 24 h) in the process of biofilm growth. The morphological changes of MRSA after 24 h were observed by scanning electron microscope. Metabonomic technique was applied to analyze the changes in terminal metabolites of endogenous small molecules from MRSA treated by the two drugs at four time points. Result:The MICs of RYN and LNZ were 1/2 of the stock solution concentration and 4 mg·L<sup>-1</sup>, respectively. The inhibitory effect of LNZ (2 mg·L<sup>-1</sup>) against viable bacteria at 0 h was better than that of 1/16 RYN. At 6, 12, 24 h, 1/16 RYN was superior to LNZ in inhibiting MRSA. The inhibitory effects of RYN combined with LNZ were better than those of RYN or LNZ alone at the four time points. RYN combined with LNZ caused more severe damages to the morphological structure of MRSA biofilm at 24 h than RYN or LNZ alone. Cyclic adenosine monophosphate (cAMP), adenosine diphosphate (ADP)-<italic>D</italic>-ribose and 2-methylbutanoyl-coenzyme A (2M-CoA), as the metabolites related to biofilm formation, were immune to LNZ, but 2M-CoA and ADP-<italic>D</italic>-ribose were influenced by RYN at 12 h and 24 h. The combined use of RYN and LNZ interfered with the three metabolites at 24 h. <italic>L</italic>-tryptophan, phenylpyruvic acid, cytidine and sebacic acid were the pharmacometabolic markers of LNZ, and the related biological pathways were phenylalanine, tyrosine and tryptophan biosynthesis and phenylalanine metabolism. Four metabolites such as<italic> L</italic>-histidine, uric acid, and <italic>L</italic>-lysine were the pharmacometabolic markers of RYN, with phenylalanine metabolism and aminoacyl-transfer ribonucleic acid (tRNA) biosynthesis confirmed as the related biological pathways. Nine metabolites such as <italic>L</italic>-tryptophan,<italic> L</italic>-lysine, and sphingosine-1-phosphate were responsible for the efficacy of RYN combined with LNZ. The related biological pathways involved aminoacyl-tRNA biosynthesis, phenylalanine, tyrosine and tryptophan biosynthesis, novobiocin biosynthesis, and tyrosine metabolism. Conclusion:RYN combined with LNZ better exerts the inhibitory effects against MRSA at each time point of its biofilm formation, which is attributed to cAMP metabolism. The synergistic effect resulted from aminoacyl-tRNA biosynthesis and phenylalanine, tyrosine and tryptophan biosynthesis. RYN combined with LNZ can serve as a potentially effective solution to MRSA infection.

4.
China Pharmacy ; (12): 2394-2399, 2021.
Article in Chinese | WPRIM | ID: wpr-886923

ABSTRACT

OBJECTIVE:To study the effects of virus in activation treatment of plasma specimen on plasma concentration determination of voriconzole ,linezolid,vancomycin and teicoplanin. METHODS :The remaining plasma of 36 inpatients in our hospital after routine blood concentration examination of voriconazole ,linezolid,vancomycin and teicoplanin were collected as specimen(9 drug-contained plasma specimens for each drug ),and merged into three different concentration levels (low,medium, high)of mixed samples according the results of routine blood test. Then the mixed samples with different concentration levels were divided into inactivated group and non-inactivated group ,with 3 samples in each group. The inactivated plasma samples were heated at 56 ℃ for 30 min in metal bath with constant temperature. Non-inactivated group were not treated. After pretreating plasma sample of 2 groups,2-dimensional liquid chromatography was used to detect plasma concentration of the four drugs ;the difference of detection result between inactivated group and non-inactivated group were analyzed. RESULTS :Plasma samples containing voriconazole,linezolid,vancomycin and teicoplanin were still stable after heating at 56 ℃ for 30 min in metal bath with constant temperature. Compared with non-inactivated group ,relative error of plasma concentration detection result of above 4 drugs were all lower than 15% in low ,medium,high concentration mixed samples of inactivated group. CONCLUSIONS :Plasma samples can be inactivated by heating at 56 ℃ for 30 min in metal bath with constant temperature ,when the plasma concentration of voriconazole,linezolid,vancomycin and teicoplanin are determined by 2-dimensional liquid chromatography.

5.
Med. UIS ; 33(3): 59-66, sep.-dic. 2020. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1360577

ABSTRACT

Resumen El síndrome serotoninérgico es una condición potencialmente mortal causada por medicamentos que afectan el metabolismo de la serotonina o que actúan como agonistas directos del receptor de esta o una combinación de ambos. El síndrome da lugar a una variedad de manifestaciones mentales, autonómicas y neuromusculares, que pueden variar desde leves hasta potencialmente mortales. Se reporta el caso clínico de un paciente el cual desarrolló este síndrome por la coadministración y sinergismo de linezolid y fentanilo, con una gran variedad de características clínicas, desde las más sutiles, como cifras tensionales altas de difícil manejo mientras se encontraba bajo el efecto de sedoanalgesia, hasta las manifestaciones más floridas del síndrome posterior a la suspensión de esta. La asociación de estos medicamentos representa una etiología poco informada que puede favorecer la aparición del síndrome, mientras que el uso de benzodiazepinas puede enmascarar el cuadro dificultando su diagnóstico. MÉD.UIS.2020;33(3): 59-66


Abstract Serotonin syndrome is a life-threatening condition caused by medications that affect serotonin metabolism or that act as direct agonists for serotonin receptor or a combination of both. The syndrome gives rise to a variety of mental, autonomic, and neuromuscular manifestations, which can range from mild to life-threatening. We report a clinical case of a patient who developed this syndrome due to the co-administration and synergism of linezolid and fentanyl, with a wide variety of clinical characteristics, from the most subtle, such as high blood pressure levels difficult to manage while under the effect of sedoanalgesia, to the most florid manifestations of the syndrome after 48 hours of its suspension. The association of these drugs represents a poorly reported etiology that may favor the appearance of the syndrome, while the use of benzodiazepines may mask the condition, making its diagnosis difficult. MÉD.UIS.2020;33(3): 59-66

6.
Hematol., Transfus. Cell Ther. (Impr.) ; 42(3): 230-237, July-Sept. 2020. tab, graf, ilus
Article in English | LILACS | ID: biblio-1134032

ABSTRACT

ABSTRACT Background: Thrombocytopenia (TP) is the major event associated with linezolid (LZD) therapy. We investigated the incidence and risk factors for thrombocytopenia in hospitalized adults who received LZD (1200 mg/day) between 2015 and 2017. HIV-positive, death during follow-up and those with a baseline platelet count ≤100 × 103/mm3 were excluded. Method: TP was defined as a decrease in platelet count of ≥20% from the baseline level at the initiation of linezolid therapy and a final count of <100 × 103/mm3. The odds ratios (OR) for thrombocytopenia were obtained using multivariate stepwise logistic regression analysis. Main results: A total of 66 patients were included (mean age [SD] 62 [18], male gender [%], 37 [56]). LZD-associated TP was identified in 12 patients (18.2%). For TP, the adjusted OR [95% CI] of the platelet count ≤200 × 103/mm3, serum creatinine and renal impairment at baseline were 5.66 [1.15-27.9], 4.57 [1.26-16.5] and 9.41 [1.09-80.54], respectively. Male gender and dosage per weight per day (DPWD) >20 mg/kg/day were not risk factors. Conclusion: The results showed that the incidence of linezolid-induced thrombocytopenia was lower in patients with normal renal function and higher in those with platelet counts ≤200 × 103/mm3 or serum creatinine >1.5 mg/dL at the start of the treatment.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Thrombocytopenia , Creatinine , Renal Insufficiency , Linezolid/adverse effects
7.
J. Health Biol. Sci. (Online) ; 8(1): 1-6, 01/01/2020. ilus
Article in Portuguese | LILACS | ID: biblio-1102843

ABSTRACT

Objective: we investigated previous literatures for documentation of the trend in Sokoto, Nigeria and found none. We deemed it fit to determine the frequency of linezolid resistance mediated by cfr gene among MRSA isolates from Sokoto State-owned hospitals. Methods: Bacterial species identification was carried out with Microgen™ Staph-ID System kit (Microgen, Surrey, UK). Disc agar diffusion method (Modified Kirby-Bauer's) following Clinical and Laboratory Standards Institute (CLSI 2018) guidelines was used in antimicrobial susceptibility testing. The results were interpreted and managed using WHONET 5.6 software (WHO, Switzerland). Oxacillin resistant screening agar base (ORSAB) culture was used to determine phenotypic methicillin resistance. Polymerase chain reaction (PCR) was carried out to determine the presence of cfr-gene. Results: A total of 81 S. aureus isolates were phenotypically identified. Of this number, 46.91% (38/81) were MRSA; Healthcare workers (39.5%), Outpatient (28.9%), In patient (21%), Security men and Cleaners (5.3% each). Importantly linezolid resistance rate among the MRSA isolates was 44.7%. Analysis of antimicrobial susceptibility profile also showed a multiple antibiotics resistance burden of MDR (5.9%), possible XDR (47.1%), XDR (41.1%) and PDR (5.9%) amongst LR-MRSA. About 52.9% (9/17) of LR-MRSA harbored the cfr gene. Conclusions: This is the first report to document cfr gene in LR-MRSA strains in Sokoto. The cfr gene was found among the studied LR-MRSA strains and if cfr-mediated linezolid resistance is not properly checked, its phenotypic expression may result in an outbreak of multiple antibiotic resistant strains.


Objetivo: avaliar a incidência de resistência linezolida cfr-mediada entre os isolados de MRSA dos hospitais do Estado de Sokoto. Métodos: A identificação das espécies bacterianas foi realizada com Microgen™ Staph-ID System kit (Microgen, Surrey, UK). Método de difusão em ágar de disco (Kirby-Bauer modificado) seguindo as diretrizes do Clinical and Laboratory Standards Institute (CLSI 2018). O resultado foi interpretado e gerido com WHONET 5.6 (OMS, Suíça) software. A cultura ORSAB (Oxacillin resistant screening agar) foi utilizada para determinar a resistência fenotípica à meticilina. A PCR foi realizada para determinar a presença de cfr-gene. Resultados: um total de 81 isolados de S. aureus foi identificada fenotipicamente. Desse número, 46,91% (38/81) eram de MRSA; Profissionais de saúde (39,5%), Ambulatoriais (28,9%), Em paciente (21%), Homens de segurança e Limpadores (5,3% cada). A taxa de resistência linezolida entre os isolados de MRSA foi de 44,7%. A análise do perfil de sensibilidade antimicrobiana também mostrou uma carga de resistência a antibióticos múltiplos de MDR (5,9%), possível XDR (47,1%), XDR (41,1%) e PDR (5,9%) entre LR-MRSA. Um total de, 52,9% (9/17) da LR-MRSA abrigava o gene cfr. Conclusões: Este é o primeiro relatório a documentar o cfr-gen nas estirpes LR-MRSA em Sokoto. O gene cfr está presente entre as cepas estudadas de LR-MRSA, e se a resistência cfr-mediated linezolida não for adequadamente verificada, sua expressão fenotípica pode resultar em um surto de múltiplas cepas resistentes a antibióticos.


Subject(s)
Chloramphenicol Resistance , Drug Resistance, Microbial , Linezolid
8.
Article in English | WPRIM | ID: wpr-762454

ABSTRACT

As various linezolid resistance mechanisms have been identified in methicillin-resistant Staphylococcus aureus (MRSA), we investigated the molecular characteristics of MRSA with elevated linezolid minimum inhibitory concentrations (MICs), using the VITEK 2 system (bioMérieux, Marcy-l'Étoile, France). Twenty-seven MRSA isolates from 14 patients exhibiting linezolid MICs ≥8 µg/mL were examined by broth microdilution (BMD) test as well as by sequencing for mutations in the 23S rRNA gene or ribosomal proteins (L3, L4, and L22) and the presence of the optrA, cfr, and cfr(B) genes. Of the 27 isolates, four (14.8%) from one patient were confirmed as linezolid resistant by BMD and harbored a 23S rRNA T2500A mutation. The remaining 23 were confirmed as linezolid susceptible, indicating that the linezolid-resistant results were major errors generated by VITEK 2. The most commonly detected mutation (19/27, 70.4%), L3 Gly152Asp, was detected in only linezolid-susceptible isolates. No isolates contained optrA, cfr, or cfr(B) or any L4 or L22 protein alterations. Our results show that the 23S rRNA T2500A mutation was mainly associated with linezolid resistance, while the L3 Gly152Asp mutation was not related to linezolid resistance. A confirmatory test is recommended for VITEK 2 linezolid-resistant results owing to the high probability of false resistant results.


Subject(s)
Genes, rRNA , Humans , Korea , Linezolid , Methicillin Resistance , Methicillin-Resistant Staphylococcus aureus , Microbial Sensitivity Tests , Ribosomal Proteins , RNA, Ribosomal, 23S
9.
Article in English | WPRIM | ID: wpr-811097

ABSTRACT

This study investigated resistance mechanisms and epidemiology of emerging linezolid-nonsusceptible Enterococcus faecalis (LNSEF) in a tertiary care hospital. LNSEF isolated from clinical samples were collected from November 2017 to June 2019. The isolates were investigated for linezolid resistance and the associated molecular mechanisms, including mutations of 23S rRNA domain V and acquisition of the cfr or optrA resistance gene. We used pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing for the molecular typing of the isolates. Among 4,318 E. faecalis isolates, 10 (0.23%) were linezolid-nonsusceptible. All LNSEF isolates were optrA-positive and cfr-negative. Of these isolates, five were sequence type (ST) 476, two ST585, one ST16, one ST16-like, and one ST480. Six LNSEF isolates obtained in the first year clustered to three types in the PFGE analysis: two ST476 isolates of type A, two ST585 isolates of type B, and two ST16 or ST16-like isolates of type C. Seven cases were of community-onset and three were hospital acquired, but total of eight were healthcare-associated including five community-onset. None of the patients had a history of linezolid treatment, and in one patient, we detected linezolid-susceptible E. faecalis one month before LNSEF detection. In conclusion, heterogenous clones of optrA-positive LNSEF emerged in the hospital mainly via community-onset.

10.
China Pharmacy ; (12): 2781-2785, 2020.
Article in Chinese | WPRIM | ID: wpr-829982

ABSTRACT

OBJECTIVE:To systematically evaluate the efficacy and safety of linezolid (LZD)combined with routine anti- tuberculosis drugs in the treatment of tuberculous meningitis (TBM),so as to provide evidence-based reference for clinical medi- cation. METHODS :Retireved from PubMed ,Cochrane Library ,Embase,CNKI and Wanfang database ,randomized controlled trials(RCT)of LZD combined with routine anti-tuberculosis drugs (trial group )versus routine anti-tuberculosis drugs (control group)were collected from the inception to Jan. 2020. After literature screening and data extraction , the quality of the included literature were evaluated with bias risk assessment tool recommended by Cochrane system evaluator handbook 5.2. Meta-analysis was conducted by using Rev Man 5.3 software,and sensitivity analysis and publication bias analysis were performed. RESULTS : Totally 9 RCTs involving 602 patients were included. Meta-analysis showed that total response rate [OR =4.05,95%CI(2.26,7.26), P<0.000 01], changes of protein content of cerebrospinal fluid [MD =0.48,95%CI(0.20,0.77),P=0.000 8],changes of white blood cells count of cerebrospinal fluid [MD =44.43,95%CI(20.06,68.81),P=0.000 4],changes of cerebrospinal fluid glucose/ synchronous blood glucose [MD =0.09,95%CI(0.05,0.14),P<0.000 1] of trial group were significantly higher than those of control group. There was no statistical significance in the changes of chloride content of cerebrospinal fluid [MD =8.08,95%CI(-0.64, 16.80),P=0.07] and the incidence of ADR [OR =1.34,95%CI(0.57,3.11),P=0.50] between 2 groups. The results of sensitivity analysis showed that there were significant differences comparison with before exclusion when the change of protein content in cerebrospinal fluid and the change of glucose/synchronous blood glucose in cerebrospinal fluid were taken as indexes ,and there was no significant difference comparison with before exclusion when the changes of white blood cell count and chloride content in cerebrospinal fluid were taken as indexes. The results of publication bias analysis showed that there was a certain publication bias in this study. CONCLUSIONS :LZD combined with conventional anti-tuber culosis drugs is effective and safe for TBM. Because the inconsistent results of sensitivity analysis and publication bias exists in publication bias analysis ,the conclusions need to be further confirmed by more large sample and multi-center studies.

11.
Article in Chinese | WPRIM | ID: wpr-855776

ABSTRACT

AIM: The population pharmacokinetic model (PKK) of linezolid was constructed with the retrospective data of linezolid therapeutic drug monitoring from the 3 hospitals of ENZE medical center, which could be used to predict individualized pharmacokinetic parameters with Bayesian feedback method based on single point trough concentration and support scientific experimental method for rational drug use of linezolid in the future. METHODS: A total of 115 monitoring serum concentration data of 72 patients from Mar. 2016. to Dec. 2018 were included in this study. Stepwise regression method was used to screen the concomitant variable (age, weight, blood routine examination, biochemical index and drug combination etc.) for Vd and K by kinetica software. The internal and external validation were analyzed with maximum likihood method and Bayesian feedback. RESULTS: As the final model Vd=25.864-0.034×Fur(mg) shown, combination use of furosemide has a significant effect on Vd of linezolid. The level of age, Scr and the burn status of the patients have a significant effect on K of linezolid and the final model was K=0.324-0.0003×Scr-0.003×age +0.04×burn. Finally, the population mean value of Vd and K were 29.719 L(5.32, 52.36), 0.160 h-1 (0.05, 0.23) and 25.322 L (2.50, 52.51), 0.193 h-1 (0.06, 0.32) in basic model and final model. The mean absolute prediction error rate of external validation was 0.620 (0.001, 4.153) in basic model and 0.588 (0.014, 3.942) in final model. CONCLUSION: The final PPK model from the present study could well response the heterogeneous PPK characteristic of the patients from ENZE medical center, which could support scientific experiment method for improving the linezolid therapeutic effect and reducing adverse reaction rate.

12.
Indian J Ophthalmol ; 2019 Nov; 67(11): 1894-1896
Article | IMSEAR | ID: sea-197627

ABSTRACT

We report two cases of recalcitrant endophthalmitis, a delayed postoperative fungal endophthalmitis following cataract surgery and an atypical mycobacterial endogenous endophthalmitis associated with infective scleritis. Due to recalcitrant nature of the endophthalmitis, one or more sittings of double freeze and thaw cryotherapy was applied over and adjacent to the infective foci in each case. This cryotherapy was used as an adjunct alongside conventional endophthalmitis management following which resolution of infection was observed in both cases.

13.
Article | IMSEAR | ID: sea-202618

ABSTRACT

Introduction: Staphylococcus species is an asymptomaticcolonizer which has exhibited increasing resistance to variousantimicrobial agents in the recent times. Although, theorganism was naturally susceptible to all the antimicrobialagents, it has acquired multi drug resistance via variousmechanisms. In view of rising prevalence antimicrobialresistance, this study was undertaken to study the prevalenceof methicillin resistance and the emergence of linezolidresistance amongst the Staphylococcal isolates obtained fromvarious clinical samples in a tertiary care hospital.Material and Methods: This study was conducted from July2017 to December 2018 in a tertiary care hospital. Clinicalspecimens were processed, and Staphylococcal isolateswere identified using standard microbiological techniques.Antimicrobial resistance pattern of all the Staphylococcalisolates was determined and interpreted as per the latest CLSIguidelines.Results: A total of 989 Staphylococcal isolates were obtainedamongst which 498 (49.44%) were found to be methicillinresistant. Highest antimicrobial resistance was observedto beta lactam antibiotics followed by azithromycin andfluoroquinolones. 26 (2.628%) strains of Staphylococcalspecies were found to be resistant to linezolid while theyretained sensitivity to Vancomycin.Conclusion: The emergence of drug resistance in variousmicroorganisms has been a cause of global concern. Risingtrend of resistance has been observed to methicillin andlinezolid especially in indoor patients of the Intensive careunits. This study highlights the high prevalence of Methicillinresistance in both Staphylococcus aureus and Coagulasenegative Staphylococcus species in a tertiary care hospital inAmritsar, India. Although, linezolid resistance is emerging at aslow pace, adequate measures must be undertaken to preservethe therapeutic armoury.

14.
Article | IMSEAR | ID: sea-211593

ABSTRACT

Background: In India, gram-positive infections (GPIs) particularly, methicillin-resistant Staphylococcus aureus (MRSA) prevalence is reported to increase exponentially. The overall mortality rate among patients with multi drug resistant GPIs in ICU setting are as high as 16%, despite the availability of various therapeutic options. Aim of the study is to determine the burden of GPIs in critical care settings and to understand the practising behaviour among the specialists in the management of MRSA infections.Methods: The survey was conducted among 264 critical care specialists who attended the Annual National Conference of Indian Society of Critical Medicine held in February 2019 at Mumbai. The delegates were administered a validated 10 question survey.Results: In the survey, 72% of the respondents agreed to the rising prevalence of MRSA and associated increased mortality rate of >16%. Empirical gram positive cover is being given to 30-40% of ICU patients, with ABSSSI being listed as a major indication followed by CAP, VAP, CLABSI and DFI. 46% of the doctors listed vancomycin as their preferred anti-MRSA agents followed by teicolplanin and linezolid. However, more than 80% of the doctors feel that nephrotoxicity in vancomycin, thrombocytopenia in linezolid and poor biofilm penetration are major limitations of these anti-MRSA agents.Conclusions: The survey highlighted the increasing trend in the prevalence and associated mortality in GPIs in critical care settings in India. Further, the limitations of existing anti-MRSA agents have invoked the need for a newer agent with a broad spectrum anti-bacterial activity along with improved safety profile and effective biofilm penetration, which can be used as a suitable alternative empiric therapy to manage GPIs.

15.
Article | IMSEAR | ID: sea-209219

ABSTRACT

Background: Diabetic foot ulcers (DFUs) remain difficult to treat with likely incriminating risk factors involving Methicillinresistant Staphylococcus aureus (MRSA). Linezolid offers complimentary consistent action against MSSA and MRSApathogens making it an ideal choice for inpatient, switch or outpatient therapy for complicated skin and skin structureinfections.Objective: The objective of the study was to compare the efficacy of injectable versus oral linezolid in the management ofpost-operative DFUs.Materials and Methods: Retrospective analyses of 100 cases receiving oral or injectable linezolid. A total of 100 subjectswere enrolled in this study. Two groups were made of 50 patients each and labeled as Group A and Group B. In Group A,tablet linezolid was given in a dose of 600 mg BD for 7 days. In Group B, injectable linezolid was given in a dose of 600 mgintravenous (IV) BD for 7 days. Clinical and bacteriological improvement was documented. In both groups tablet cefuroxime,500 mg BD was given for 7 days in conjunction with linezolid.Results: We found 90–100% improvement in wound infections and in culture reports. Results in both the groups receivingoral or IV linezolid for post-operative DFU healing were comparable when administered for 7 days. Linezolid offered hightherapeutic success rates (75–100%) against the incriminated pathogens of S. aureus with little action against Acinetobacteror Pseudomonas aeruginosa.Conclusion: These results suggest that linezolid given empirically is highly effective in the treatment of DFUs. The equivocalclinical and microbiological eradication rates for oral and injectable formulations with 7 days therapy makes them less liable forresistance induction or development.

16.
Article | IMSEAR | ID: sea-196310

ABSTRACT

Pulmonary nocardiosis is an uncommon bacterial infection that may lead to severe disease in immunocompromised patients. The disease is rare in immunocompetent patients. Reported cases are few, and the literature is limited because disease recognition is difficult. We present a case report of two patients of pulmonary nocardiosis, who had different clinicoradiological presentations and also responded differently to treatment. Given the rising incidence of cancer, organ transplantation, and use of parenteral steroids, Nocardia is likely to attain a higher place among the causes of pulmonary infections.

17.
Chinese Journal of Burns ; (6): 614-616, 2019.
Article in Chinese | WPRIM | ID: wpr-810823

ABSTRACT

On October 3rd, 2017, one male patient, aged 27 years, was admitted to our hospital 6 hours after hydrothermal scald of torso, buttocks, and limbs. The total area of burn was about 60% total body surface area, and the depth was from deep partial-thickness burn to full-thickness burn. Immediately after admission, the patient was given symptomatic support treatments, such as anti-shock, fluid replacement, and anti-infection, etc. After being treated by debridement and xenogenic (porcine) skin grafting for 2 times, the wounds were healed well. On the 12th day of admission, linezolid was used to prevent infection according to the results of microbial culture and drug sensitivity test, since when the level of his blood lactate continued to increase. After 8 days, linezolid was discontinued and vitamin B1 was given orally for 1 week, and the level of lactic acid gradually decreased to normal in result. This case was used mainly to analyze whether linezolid could directly cause hyperlacticemia and its important mechanism, aiming at reminding clinicians of being alert to the risk of hyperlacticemia when using linezolid. If hyperlacticemia occurs, linezolid should be discontinued immediately and vitamin B1 should be taken orally to correct the high lactic acid value, and the treatment plan should be adjusted if necessary.

18.
Article in Chinese | WPRIM | ID: wpr-802895

ABSTRACT

Objective@#To observe the effects of linezolid on the levels of inflammatory factors and T lymphocytes in patients with severe tuberculosis.@*Methods@#Sixty patients with severe tuberculosis treated in Jinhua Guangfu Hospital from April 2016 to November 2017 were selected and divided into control group(n=30) and observation group(n=30) according to different treatment options.The control group was treated with personalized anti-tuberculosis regimen.The observation group was treated with linezolid on the basis of the control group, and both two groups were treated for 9 months.The changes of interleukin-1(IL-1), tumor necrosis factor alpha(TNF-α), IL-6, IL-10 and CD3+, CD4+, CD8+ and CD4+/CD8+ were observed before and after treatment.The incidence of liver injury, thrombocytopenia, myelosuppression, nausea and vomiting, diarrhea were observed.@*Results@#Before treatment, there were no statistically significant differences in IL-1, TNF-α, IL-6, IL-10, CD3+, CD4+, CD8+, CD4+/CD8+ between the two groups(all P>0.05). At 9 months after treatment, the levels of IL-1, TNF-α, IL-6 and IL-10 in the control group were (10.94±1.31)ng/L, (3.03±0.49)ng/L, (183.43±13.24)ng/L, (134.93±34.51)ng/L, respectively, which in the observation group were (6.89±1.29)ng/L, (2.49±0.45)ng/L, (129.48±10.74)ng/L, (189.35±43.27)ng/L, respectively, the differences between the two groups were statistically significant(t=12.195, 11.214, 8.414, 11.291, all P<0.05). The CD3+, CD4+, CD8+, CD4+/CD8+ in the control group were (47.61±7.16)%, (15.49±6.64)%, (20.58±5.61)%, (0.79±0.19) , respectively, which in the observation group were (65.46±8.31)%, (30.23±7.85)%, (34.59±7.41)%, (0.87±0.24) , respectively, the differences between the two groups were statistically significant(t=10.497, 7.865, 12.128, 10.291, all P<0.05). There were no statistically significant differences in the incidence of liver function impairment, thrombocytopenia, myelosuppression, nausea and vomiting, and diarrhea between the two groups(all P>0.05).@*Conclusion@#Linezolid in the treatment of severe tuberculosis can reduce the level of inflammatory factors, improve the cellular immune level of patients, and has a lower incidence of adverse effects.

19.
Article in Chinese | WPRIM | ID: wpr-753743

ABSTRACT

Objective To observe the effects of linezolid on the levels of inflammatory factors and T lymphocytes in patients with severe tuberculosis.Methods Sixty patients with severe tuberculosis treated in Jinhua Guangfu Hospital from April 2016 to November 2017 were selected and divided into control group(n =30) and observation group(n =30) according to different treatment options.The control group was treated with personalized anti-tuberculosis regimen.The observation group was treated with linezolid on the basis of the control group,and both two groups were treated for 9 months.The changes of interleukin-1 (IL-1),tumor necrosis factor alpha (TNF-α),IL-6,IL-10 and CD3+,CD4+,CD8+ and CD4+/CD8+ were observed before and after treatment.The incidence of liver injury,thrombocytopenia,myelosuppression,nausea and vomiting,diarrhea were observed.Results Before treatment,there were no statistically significant differences in IL-1,TNF-α,IL-6,IL-10,CD4+,CD8+,CD8+,CD4+/CD8+ between the two groups(all P>0.05).At 9 months after treatment,the levels of IL-1,TNF-α,IL-6 and IL-10 in the control group were (10.94 ± 1.31) ng/L,(3.03 ± 0.49) ng/L,(183.43 ± 13.24) ng/L,(134.93 ± 34.51) ng/L,respectively,which in the observation group were (6.89 ± 1.29) ng/L,(2.49 ± 0.45) ng/L,(129.48 ± 10.74) ng/L,(189.35 ± 43.27)ng/L,respectively,the differences between the two groups were statistically significant(t =12.195,11.214,8.414,11.291,all P < 0.05).The CD3+,CD4+,CD8+,CD4+/CD8+ in the control group were (47.61 ± 7.16) %,(15.49 ± 6.64) %,(20.58 ± 5.61) %,(0.79 ± 0.19),respectively,which in the observation group were (65.46 ± 8.31) %,(30.23 ± 7.85) %,(34.59 ± 7.41) %,(0.87 ± 0.24),respectively,the differences between the two groups were statistically significant (t =10.497,7.865,12.128,10.291,all P < 0.05).There were no statistically significant differences in the incidence of liver function impairment,thrombocytopenia,myelosuppression,nausea and vomiting,and diarrhea between the two groups(all P > 0.05).Conclusion Linezolid in the treatment of severe tuberculosis can reduce the level of inflammatory factors,improve the cellular immune level of patients,and has a lower incidence of adverse effects.

20.
China Pharmacy ; (12): 980-984, 2019.
Article in Chinese | WPRIM | ID: wpr-817026

ABSTRACT

OBJECTIVE: To evaluate risk factors of linezolid-induced thrombocytopenia systematically, and to provide reference for rational drug use in clinic. METHODS: Retrieved from PubMed, Embase, Cochrane library, Web of Science, CBM, CNKI and Wanfang database, during database establishment to Oct. 2018, clinical studies about risk factors of linezolid-induced thrombocytopenia were collected, and the data of literatures met criteria were collected. After Newcastle-Ottawa scale (NOS) was applied for evaluating the quality of included literatures. Meta-analysis was conducted by using Rev Man 5.3 software. RESULTS: Sixteen clinical studies involving 2 264 patients in total were included. Results of Meta-analysis showed that daily per kg dose (DKPD) [SMD=0.62, 95%CI(0.29,0.95), P=0.000 2], low platelet count before medication [SMD=-0.90, 95%CI(-1.62, -0.18), P=0.01], low creatinine clearance rate [SMD=-0.65, 95%CI(-1.10,-0.19), P=0.005], long treatment course [SMD=0.45, 95%CI(0.18,0.71), P=0.000 9], low body weight  [SMD=-0.36, 95%CI(-0.60,-0.11),P=0.005] significantly influenced the occurrence of thrombocytopenia. CONCLUSIONS: The risk factors associated with linezolid-induced thrombocytopenia include low baseline platelet count, low creatinine clearance rate, low body weight, long medication course and high DKPD.

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