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Bacteriological relevance of linezolid vs vancomycin in postoperative empirical treatment of osteoarticular infections: A retrospective single-center study

International Journal of Antimicrobial Agents May 25, 2018

Takoudju E, et al. - The bacteriological relevance of linezolid for orthopaedic postoperative probabilistic antibiotic therapy was investigated in an observational cohort of patients empirically treated by a combination of linezolid with piperacillin/tazobactam during the immediate postoperative stage for an osteoarticular infections (OAI) between July 1st 2015 and July 1st 2016, in a French reference center. In the treatment of osteoarticular infections, linezolid was advantageous in terms of high bioavailability, the lack of need for pharmacological monitoring, and an excellent osteoarticular diffusion. With short treatments like those used for postoperative empirical treatments, myelotoxicity concerns of linezolid seemed not consistent. In this cohort, susceptibility to linezolid (MICs ≤ 4 mg/L [9]) of all the S. aureus and S. epidermidis strains was noted, except in one patient previously treated by linezolid who was infected with a linezolid-resistant S. epidermidis strain (MIC > 256 mg/L). They recommended documentation of the notion of previous treatments by oxazolidinones before initiation of such a probabilistic postoperative treatment, to detect this at-risk situation of linezolid-resistance.
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