Role of linezolid combination therapy for serious infections: review of the current evidence

Eur J Clin Microbiol Infect Dis. 2020 Jun;39(6):1043-1052. doi: 10.1007/s10096-019-03801-x. Epub 2020 Jan 2.

Abstract

As long-standing clinical problems, a series of complicated infections are more difficult to treat due to the development of antibiotic resistance, especially caused by methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus faecium (VRE), and multidrug-resistant Mycobacterium tuberculosis (M. tuberculosis). Moreover, the treatment options available to against these infections are also becoming increasingly limited. Linezolid is the first synthetic oxazolidinone antibiotic with a unique mechanism of action, and its efficacy against Gram-positive bacteria has been clearly demonstrated. However, the limitations of linezolid alone for the treatment of these complicated infections have been reported in the recent years. Combination therapy may be a good approach to enhance efficacy and prevent the development of resistance. In this review, the results of multiple linezolid combination therapies from in vitro, animal studies, and clinical cases for the treatment of MRSA, VRE, and multidrug-resistant M. tuberculosis strains will be discussed, and thus provide more relevant information for clinician in clinical practice.

Keywords: Combination; Linezolid; Methicillin-resistant Staphylococcus aureus (MRSA); Multidrug-resistant Mycobacterium tuberculosis (M. tuberculosis); Vancomycin-resistant Enterococcus faecium (VRE).

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Bacterial Agents / therapeutic use*
  • Bacteria / drug effects
  • Bacteria / isolation & purification
  • Bacterial Infections / drug therapy*
  • Bacterial Infections / microbiology
  • Drug Resistance, Bacterial / drug effects
  • Drug Therapy, Combination
  • Humans
  • Linezolid / therapeutic use*

Substances

  • Anti-Bacterial Agents
  • Linezolid