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Oxazolidinone — MRSA / VRE / Drug-Resistant TB (adjunct)

Linezolid

Brand names: Zyvox

Linezolid is an oxazolidinone antibacterial used for resistant Gram-positive infections, including MRSA and vancomycin-resistant enterococci.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

Dosage, Route, and Frequency of Administration Infection Pediatric Patients (Birth through 11 years of age) Adults and Adolescents (12 years and older) Duration (Days) Nosocomial pneumonia Community-acquired pneumonia, including concurrent bacteremia 10 mg/kg intravenous or oral every 8 hours 600 mg intravenous or oral every 12 hours 10 to 14 Complicated skin and skin structure infections Vancomycin-resistant Enterococcus faecium infections, including concurrent bacteremia 10 mg/kg intravenous or oral every 8 hours 600 mg intravenous or oral every 12 hours 14 to 28 Uncomplicated skin and skin structure infections less than 5 yrs: 10 mg/kg oral every 8 hours 5 to 11 yrs: 10 mg/kg oral every …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2025-01-30. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It inhibits bacterial protein synthesis by binding the bacterial ribosome and preventing formation of the initiation complex.

Prescribing in practice

  • It is a weak monoamine oxidase inhibitor, so it can cause serotonin syndrome with SSRIs and other serotonergic drugs and interacts with tyramine-rich foods.
  • Reversible myelosuppression, especially thrombocytopenia, can occur with prolonged courses, so monitor the full blood count.
  • It has excellent oral bioavailability, allowing a switch from intravenous to oral therapy without loss of exposure.

Monitoring

Monitor the full blood count, particularly with treatment beyond about two weeks; review for peripheral and optic neuropathy if therapy is prolonged.

Counselling the patient

  • Avoid tyramine-rich foods such as mature cheese, and tell the team about any antidepressants before starting.
  • Report new visual changes, or numbness or tingling in the hands or feet, especially during longer courses.

Evidence & guidelines

An established option for resistant Gram-positive infection where oral therapy is valuable; use should follow local antimicrobial guidance.

Reference: MHRA Drug Safety Update 2014 (Linezolid Myelosuppression); WHO MDR-TB Treatment Guidelines 2022; IDSA MRSA Guidelines; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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