What is the role of linezolid in VRE infections and what is a major toxicity concern?

Prepare for the Antibacterials (ABX) Exam. Study with flashcards and multiple-choice questions, each question comes with hints and explanations. Get ready to ace your test!

Multiple Choice

What is the role of linezolid in VRE infections and what is a major toxicity concern?

Linezolid is an antibiotic that covers resistant Gram-positive organisms, including vancomycin-resistant Enterococcus. It works by binding the 50S ribosomal subunit and preventing the formation of the initiation complex for protein synthesis, effective in infections where other drugs may fail. For VRE infections, linezolid is a key option when vancomycin is not an option or resistance limits other choices. The major toxicity concern with linezolid is bone marrow suppression, especially thrombocytopenia, which can occur with longer courses or prolonged therapy, so regular blood count monitoring is important. There is also a notable risk of serotonergic interactions because linezolid has MAOI-like activity, which can precipitate serotonin syndrome when combined with serotonergic drugs such as SSRIs, SNRIs, TCAs, tramadol, or meperidine. While other toxicities can occur with extended use (like neuropathies), nephrotoxicity is not the primary concern. This combination of activity against VRE and the dual risks of myelosuppression and serotonergic interactions makes the described statement the best fit.

Linezolid is an antibiotic that covers resistant Gram-positive organisms, including vancomycin-resistant Enterococcus. It works by binding the 50S ribosomal subunit and preventing the formation of the initiation complex for protein synthesis, effective in infections where other drugs may fail. For VRE infections, linezolid is a key option when vancomycin is not an option or resistance limits other choices. The major toxicity concern with linezolid is bone marrow suppression, especially thrombocytopenia, which can occur with longer courses or prolonged therapy, so regular blood count monitoring is important. There is also a notable risk of serotonergic interactions because linezolid has MAOI-like activity, which can precipitate serotonin syndrome when combined with serotonergic drugs such as SSRIs, SNRIs, TCAs, tramadol, or meperidine. While other toxicities can occur with extended use (like neuropathies), nephrotoxicity is not the primary concern. This combination of activity against VRE and the dual risks of myelosuppression and serotonergic interactions makes the described statement the best fit.

More practice questions