Linezolid for the treatment of community-acquired pneumonia in hospitalized children

Sheldon L. Kaplan, Lori Patterson, Kathryn M. Edwards, Parvin H. Azimi, John S. Bradley, Jeffrey L. Blumer, Tina Q. Tan, Frank G. Lobeck, Donald C. Anderson

Research output: Contribution to journalArticle

90 Scopus citations

Abstract

Objective. To determine the safety, tolerance, pharmacokinetics and efficacy of linezolid, a new oxazolidinone antibiotic in the treatment of community-acquired pneumonia in hospitalized children. Design. A Phase II, open label multicenter study of intravenous linezolid followed by oral linezolid suspension, both at a dose of 10 mg/kg every 12 h. Efficacy was assessed at 7 to 14 days after the last dose of linezolid. Patients. Children 12 months to 17 years old with community-acquired pneumonia admitted to the hospital of 14 participating centers. Results. From July 21, 1998, through May 14, 1999, 79 children were enrolled and 78 received linezolid. Sixty-six children completed treatment and follow-up and were evaluable for clinical outcome. The median age of the evaluable patients was 3 years (range, I to 12 years); 47 were 2 to 6 years old. Pathogens were isolated from blood or pleural fluid cultures in 8 children: Streptococcus pneumoniae, 6 (2 penicillinresistant); Group A Streptococcus, 1; methicillin-resistant Staphylococcus aureus, 1. Chest tubes were placed in 9 patients. The mean total duration of intravenous and oral administration was 12.2 ± 6.2 days (range, 6 to 41 days). The mean peak and trough plasma concentrations of linezolid were 9.5 ± 4.8 and 0.8 ± 1.2 μg/ml, respectively. At the follow-up visit 7 to 14 days after the last dose of linezolid, 61 patients (92.4%) were considered cured including all the patients with proven pneumococcal pneumonia, one failed (methicillin-resistant Staphylococcus aureus) and 4 were considered indeterminate. The most common adverse effects in the intent to treat group were diarrhea (10.3%), neutropenia (6.4%) and elevation in alanine aminotransferase (6.4%). Conclusions. Linezolid was well-tolerated and could be considered an alternative to vancomycin for treating serious infections caused by antibiotic-resistant Gram-positive cocci in children pending results of additional studies.

Original languageEnglish (US)
Pages (from-to)488-494
Number of pages7
JournalPediatric Infectious Disease Journal
Volume20
Issue number5
DOIs
StatePublished - 2001

Keywords

  • Linezolid
  • Pneumonia
  • Streptoccus pneumoniae

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)

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