ZYVOX should only be initiated in a hospital environment and after consultation with a relevant specialist such as a microbiologist or infectious disease specialist1.
ZYVOX (linezolid) offers effective intervention for nosocomial pneumonia (NP), community acquired pneumonia (CAP) and complicated skin and soft tissue infections (cSSTI) caused by susceptible Gram positive pathogens1
ZYVOX is active against susceptible Gram positive pathogens only and can be used in patients with certain degrees of renal insufficiency (mild to moderate impairment)*1. However, 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 in patients on renal replacement therapies (e.g. haemodialysis), please refer to the ZYVOX SPC1.
ZYVOX does not require dose adjustment in renal impairment but it should be used with special caution in patients with severe renal insufficiency1.
In clinically appropriate patients, oral ZYVOX allows for patients to be discharged to home2.
Linezolid is recommended by the 2016 ATS/IDSA guidelines for the management of HAP/VAP as a treatment for HAP and VAP where empiric coverage of MRSA is indicated or as monotherapy where HAP/VAP is confirmed to be caused by MRSA3.
Linezolid is also recommended as an empiric MRSA treatment option for adults with community acquired pneumonia by the 2019 ATS/IDSA guidelines for the treatment of adults with CAP4.
Most β-lactam antibiotics achieve less than 50% of their serum concentration in the lung, whereas linezolid equals or exceeds its serum concentration in bronchial secretions5,6. Linezolid tissue penetration is 100% in epithelial lining lung fluid7 and 104% in inflammatory blister fluid (in healthy volunteers)8.
ATS/IDSA, American Thoracic Society/Infectious Diseases Society of America; CAP, community acquired pneumonia; CrCL, creatinine clearance; HAP, hospital-acquired pneumonia; MRSA, methicillin-resistant Staphylococcus aureus; NP, nosocomial pneumonia; VAP, ventilator-associated pneumonia
- ZYVOX® Summary of Product Characteristics
- 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
- Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society. CID 2016;63(5): 61-111
- Diagnosis and Treatment of Adults with Community-acquired Pneumonia: An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med 2019;200(7):45–67
- ATS Guidelines for Management of Adults with Hospital-acquired, Ventilator-associated and Healthcare-associated Pneumonia. Am J Respir Crit Care Med 2005; 171:388-416
- Conte J E, Jr., Golden J A et al. Intrapulmonary pharmacokinetics of linezolid. Antimicrob Agents Chemother 2002;46:1475-1480
- Boselli E, Breilh D et al. Pharmacokinetics and intrapulmonary concentrations of linezolid administered to critically ill patients with ventilator-associated pneumonia. Crit Care Med 2005;33:1529-1533
- Gee T, Ellis R et al. Pharmacokinetics and tissue penetration of linezolid following multiple oral doses. Antimicrob Agents Chemother 2001;45:1843-1846