Linezolid is an oxazolidinone antibiotic recently approved for treatment of infections due to antibiotic-resistant strains of Enterococcus faecium, Staphylococcus aureus, and Streptococcus pneumoniae. Because infections with these organisms, particularly vancomycin-resistant E faecium (VREF) and methicillin-resistant S aureus (MRSA), are becoming more common in critically ill neonates, linezolid is likely to play an increasingly important role in the antibiotic treatment of neonates who have antibiotic-resistant gram-positive infections.

Oxazolidinone antibiotics, including linezolid, inhibit bacterial protein translation through a unique mechanism. Linezolid binds to the 23S subunit of the bacterial 50S ribosome. In doing so, the antibiotic blocks formation of the 70S translation initiation complex. Not surprisingly, nonclinical strains that have 23S rRNA mutations have shown linezolid resistance in vitro.

Organisms against which linezolid has proven antibacterial efficacy include: E faecium (vancomycin-resistant strains only), S aureus (including methicillin-resistant strains), S agalactiae, S pneumoniae, and S pyogenes. Linezolid also shows in vitro...

You do not currently have access to this content.