ZYVOX should only be initiated in a hospital environment and after consultation with a relevant specialist such as a microbiologist or infectious disease specialist1.
Treating Patients with ZYVOX (linezolid)
- ZYVOX is available in 3 formulations; IV, oral suspension and tablet1.
- Tablet and oral suspension formulations of ZYVOX are approximately 100% bioavailable, providing flexibility and enabling a seamless transition from IV to oral therapy when clinically indicated2,3.
ZYVOX is indicated for NP and CAP when known or suspected to be caused by susceptible Gram positive bacteria and in cSSTI only when microbiological testing has established that the infection is known to be caused by susceptible Gram positive bacteria1.
NP/CAP: ZYVOX is not active against infections caused by Gram negative pathogens. Specific therapy against Gram negative organisms must be initiated concomitantly if a Gram negative pathogen is documented or suspected1.
cSSTI: ZYVOX is not active against infections caused by Gram negative pathogens. Linezolid should only be used in patients with complicated skin and soft tissue infections with known or possible co-infection with Gram negative organisms if there are no alternative treatment options available. In these circumstances treatment against Gram negative organisms must be initiated concomitantly1.
Dosing recommendations are equivalent for oral and IV formulations due to an oral bioavailability of approximately 100%1:
The duration of treatment is dependent on the pathogen, the site of infection and its severity, and on the patient's clinical response. The following recommendations for duration of therapy reflect those used in the clinical trials. Shorter treatment regimens may be suitable for some types of infection but have not been evaluated in clinical trials1.
|Infection||Dosage||Intravenous Use||Duration of treatment|
|Nosocomial pneumonia||600mg twice daily
The solution for infusion should be administered over a period of 30 to 120 minutes
|10-14 consecutive days
|Community acquired pneumonia|
|Complicated skin and soft tissue infections|
The maximum treatment duration is 28 days. The safety and effectiveness of linezolid when administered for periods longer than 28 days have not been established1.
Dose adjustments in special populations1:
• No dose adjustments are required for elderly patients
• No dose adjustments are required for renal insufficiency, however, special caution is required in severe renal impairment* (read more about use in patients with renal insufficiency here)
• No dose adjustments for hepatic insufficiency (although there are limited data and it is recommended that linezolid should be used in such patients only when the anticipated benefit is considered to outweigh the theoretical risk)
CAP, community acquired pneumonia; CrCL, creatinine clearance; cSSTI, complicated skin and soft tissue infection; IV, intravenous; NP, nosocomial pneumonia
* In patients with severe renal insufficiency (CrCL <30 mL/min), linezolid should be used with special caution and only when the anticipated benefit is considered to outweigh the theoretical risk of higher exposure (up to 10 fold) to the two primary metabolites of linezolid. For information surrounding treatment for patients on renal replacement therapies (e.g. haemodialysis), please refer to the ZYVOX SPC1.
- ZYVOX® Summary of Product Characteristics
- Li Z, Willke R J et al. Comparison of length of hospital stay for patients with known or suspected methicillin-resistant Staphylococcus species infections treated with linezolid or vancomycin: a randomized, multicenter trial. Pharmacotherapy 2001;21:263-274
- Itani K M, Dryden M S et al. Efficacy and safety of linezolid versus vancomycin for the treatment of complicated skin and soft-tissue infections proven to be caused by methicillin-resistant Staphylococcus aureus. Am J Surg 2010;199:804-816