Linezolid

Multiple antibiotic resistance is increasing worldwide in Gram-positive bac teria, especially in hospitals. Problem organisms include multiply resistan t strains of pneumococci, Staphylococcus aureus and enterococci; for many o f these the glycopeptide vancomycin has become the treatment of last resort . This situation has been made worse by the emergence of vancomycin-resista nt enterococci and vancomycin-intermediate S. aureus. Fortunately, several compounds active against resistant Gram-positive bacteria are in active dev elopment. One of these is linezolid, the first of the oxazolidinones, a new class of antibacterial, Linezolid is a synthetic agent which is active aga inst all the clinically important Gram-positive bacteria, including multipl y resistant strains. It has good pharmacokinetics, with equal bioavailabili ty by both oral and intravenous routes and no need for dose adjustment in p atients with renal impairment. The drug has a good safety profile and clini cal trials have given excellent results in a variety of skin and soft tissu e, respiratory and bloodstream infections. Linezolid is a promising drug, w hich, together with prudent antibiotic use and the prevention and control o f hospital infection, will help in the battle against multiply antibiotic r esistant Gram-positive bacteria.