Linezolid is an appealing option for VRE UTIs due to an oral formulation, twice daily dosing, no dosage adjustments for renal or hepatic
Background: Vancomycin-resistant Enterococcus can cause urinary
Urinary tract infections
Duration of empiric IV therapy should be counted towards total duration of therapy Treatment of Enterococcus Linezolid 600 mg PO Q12H OR Fosfomycin 3 g PO every 2–3 days (max 21 days) assessing for true urinary tract infection: (1) use of the term "bacteriuria" or "asymptomatic bacteriuria" rather than UTI to Medscape - Indication-specific dosing for Zyvox (linezolid), frequency-based adverse effects, comprehensive interactions, contraindications, pregnancy & lactation schedules, and cost information
Tedizolid is a newer drug in the same class with comparable spectrum of activity but with limited US Food and Drug Administration-approved indications
Of 4,683 patients with a positive vancomycin-resistant Enterococcus culture, 624 (13%) met criteria for chart review, and 92 (15%) had documentation of urinary tract infection symptoms and treatment
Treatment options for health care–associated MRSA or community-associated MRSA pneumonia include seven to 21 days of intravenous vancomycin or linezolid, or clindamycin (600 mg orally or Enterococci are a common cause of urinary tract infections (UTIs) among hospitalized patients
The MIC ranged from 32 to 1,024 μg/mL, with a median MIC of 256 μg/mL
9%
The normalization or stabilization of these parameters may be used to help determine the total duration of antibiotic therapy
Background
5% of patients were treated with linezolid and vancomycin, respectively
Potential oral agents active against MDR-Enterococcus that may be considered for acute uncomplicated UTI include nitrofurantoin, fosfomycin, and fluoroquinolones
Recent clinical studies have shown improved clinical and microbiologic outcomes associated with daptomycin over linezolid in VRE-BSI (6)
7-9
has become a leading cause of healthcare
found no difference in duration of bacteremia between linezolid and daptomycin treatments (22, 28)
Erlandson KM, Sun J, Iwen PC, Rupp ME