Pharmacokinetics of protein-unbound linezolid in the blood and the mechanism of hepatobiliary excretion in the rat

Linezolid (Zyvox), an oxazolidinones antibiotic, was developed for the treatment of infectious diseases caused by gram-positive pathogens. To investigate the mechanism of hepatobiliary excretion of linezolid, a parallel study design used two groups; in the control group, rats received linezolid alone (3 or 10 mg/kg, i.v.). In the drug-treated groups, 10 min prior to linezolid administration, cyclosporin A (CsA; 10 mg/kg, i.v.), a P-glycoprotein (P-gp) inhibitor, was given in the rats. The microdialysis probes were implanted into the jugular vein toward right atrium and the bile duct of Sprague–Dawley rats for multiple biological fluid sampling. Separation was performed using a reversed phase C18 (4.6 mm × 150 mm i.d., 5 μm) with mobile phase of acetonitrile–methanol-1% 1-octanesulfonic acid in water of 30:10:60 (v/v/v) at flow rate of 1 ml/min. The UV detection for linezolid was set at a wavelength of 260 nm. Following linezolid (10 mg/kg, i.v.) administration, the concentration of linezolid in the brain was less than the limit of quantification and the area-under the concentration curve versus time curve (AUC) of blood and bile were 1780 ± 50 and 2850 ± 276 (min μg/ml), respectively. The bile-to-blood distribution ratio was 1.6 ± 0.2 (n = 6), which was defined as AUCbile/AUCblood. The results demonstrated that the transportation of linezolid into bile might be mediated by active transport. However, after treatment with CsA, the linezolid AUC in bile was 3060 ± 411 (min μg/ml) which did not indicate a significant difference with linezolid alone. These results suggest that the hepatobiliary excretion of linezolid might not be regulated by P-gp transportation.