What are the advantages and disadvantages of linezolid therapy for treating vancomycin-resistant E faecium IE?
The advantages of linezolid therapy include high bio-availability of the oral formulation, approval for pediatric patients, and a lack of many therapeutic alternatives. The disadvantages are toxicity (mild to severe neutropenia and thrombocytopenia that is reversible); peripheral and optic neuritis, which is more often seen with longer durations of therapy and may not be reversible; multidrug interactions, especially serotonin uptake inhibitors; and emergence of resistance during treatment. The previous high cost should decrease with generic availability soon. Cardiac valve replacement surgery may be necessary in patients who do not respond to linezolid therapy.