Linezolid treatment of nosocomial bacterial infection with multiresistant Gram-positive pathogens in preterm infants: a systematic review

Linezolid is an antibiotic of the oxazolidinone class that has bacteriostatic and bactericidal activity against a broad range of Gram-positive bacteria, including multiresistant pathogens. Owing to increasing resistance of Gram-positive pathogens to traditional antibiotics such as vancomycin, the oxazolidinones were introduced into therapy. The aim of this review was to summarise actual data on the pharmacokinetics, safety and clinical use of linezolid in preterm infants. The Medline and EMBASE databases were searched using the term ‘linezolid’ combined with ‘newborn’, ‘neonate’, ‘preterm’ and ‘premature’ for papers published between January 1987 and June 2009. Studies reporting on a population including preterm infants and other age groups as well as case reports on preterm infants only were acceptable for analysis. Five studies and eight case reports were identified evaluating linezolid in preterm infants. A dosage regimen of 10 mg/kg body weight given either orally or intravenously every 8 h in infants aged ≥1 week and the same dose given every 12 h in infants <1 week was shown to be safe and effective with a mean treatment duration of 10–28 days. In summary, linezolid was shown to be a safe and effective alternative to vancomycin in the treatment of infections with multiresistant Gram-positive pathogens in preterm infants.