CLSI Susceptibility / Reference Standard: CLSI Susceptible MIC: <= 2 mcg/mL (Enterococcus) / <= 4 mcg/mL (Staphylococcus) | Standard Adult Dosing: 600 mg PO/IV every 12 hours (100% Oral Bioavailability)
Linezolid (ATC Code J01XX08) is the prototype synthetic oxazolidinone antimicrobial agent engineered to treat multidrug-resistant Gram-positive pathogens, including Methicillin-Resistant Staphylococcus aureus (MRSA), Vancomycin-Resistant Enterococcus faecium (VRE), and drug-resistant Mycobacterium tuberculosis.
Mechanism of Action & 100% Oral Bioavailability
Linezolid binds to domain V of the 23S ribosomal RNA on the bacterial 50S subunit, preventing formation of the functional 70S initiation complex (fMet-tRNA, mRNA, 30S and 50S subunits). Because oral absorption reaches 100% bioavailability, patients can transition seamlessly from 600 mg IV every 12 hours to 600 mg oral tablets without dose adjustment.
Hematologic & Neurological Monitoring
- Reversible Myelosuppression (Thrombocytopenia): Mitochondrial protein synthesis homology can induce time-dependent thrombocytopenia and anemia when treatment exceeds 10–14 days; weekly Complete Blood Counts (CBC) are required.
- Monoamine Oxidase (MAO) Inhibition: Linezolid is a reversible, non-selective MAO-A/MAO-B inhibitor; co-administration with SSRIs, SNRIs, tricyclic antidepressants, or tyramine-rich foods requires vigilant monitoring for serotonin syndrome and pressor responses.
Related Clinical Practice & Patient Interpretation Guidelines:
• Nirogi Lanka Clinical Pharmacology & Critical Care Reference
• NPI Directory: Acute Care Hospital Facilities
• Nirogi Lanka Clinical Pharmacology & Critical Care Reference
• NPI Directory: Acute Care Hospital Facilities