The Use of Linezolid in the Treatment of Infected Total Joint Arthroplasty

Fourteen patients with a diagnosis of infected total joint arthroplasty treated by 1 or 2-stage revision and a course of oral linezolid were reviewed. Patients were assessed according to McPherson stage, inflammatory markers, nature of surgery, use of antibiotics, pathogen isolated, and outcome at follow-up. Pathogens isolated were coagulase-negative staphylococcus, multiresistant Staphylococcus aureus, Enterobacter cloacae, and mixed growth. McPherson stages were 1 IB2, 1 IA3, 1 II A2, 3IIIA2, 2 IIIB1, 3 IIIB2, 1 IIIB3, 1 IIIC2, and 1 IIIC3. All patients showed resolution of infection, with normalization of inflammatory markers after treatment. Mean length of follow-up is 32.7 months (range, 9-44 months). Comparison is drawn with previous studies highlighting the good results achievable with the use of this antibiotic. Although no substitute for adequate surgical management, it does allow oral treatment and therefore avoids the difficulties associated with long-term intravenous antibiotic therapy.