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

*Corresponding author for this work

Research output: Contribution to journalArticle

88 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)
  • Infectious Diseases

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    Kaplan, S. L., Patterson, L., Edwards, K. M., Azimi, P. H., Bradley, J. S., Blumer, J. L., Tan, T. Q., Lobeck, F. G., & Anderson, D. C. (2001). Linezolid for the treatment of community-acquired pneumonia in hospitalized children. Pediatric Infectious Disease Journal, 20(5), 488-494. https://doi.org/10.1097/00006454-200105000-00004