Tedizolid

How it works

It binds the 50S ribosomal subunit and inhibits formation of the functional initiation complex, thereby preventing bacterial protein synthesis.

Prescribing in practice

• It is a weak, reversible monoamine oxidase inhibitor, so review concurrent serotonergic and adrenergic drugs for the potential risk of serotonin syndrome and hypertensive effects.
• Safety and efficacy in neutropenic patients have not been established, so consider alternatives where neutropenia is a concern.
• It is active against Gram-positive bacteria only and should not be relied upon for Gram-negative or mixed infections.

Monitoring

Monitor the full blood count, particularly with courses extending beyond the licensed duration, and observe clinical response.

Counselling the patient

• Tell your team if you take antidepressants or other serotonergic medicines.
• It can be taken with or without food and may be given by mouth or by infusion.
• Report new visual symptoms or unusual tiredness.

Evidence & guidelines

Licensing was supported by the ESTABLISH phase 3 trials demonstrating non-inferiority to linezolid in acute bacterial skin and skin-structure infections.