Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The increase in serious gram-positive infections has increased the need for treatment of gram-positive infections in patients with hematologic malignancies. Common gram-positive pathogens exhibit a variety of resistance mechanisms, and this has supported the need for new antibiotics with unique modes of action and no endogenous resistance mechanism(s) directed against them. Linezolid (Zyvox), the first member of the oxazolidinone class of antibiotics to be tested clinically, is such an antibiotic. Linezolid has been shown to be effective against key gram-positive pathogens in vitro, without evidence of resistance development or cross-resistance to other antibiotics. Its efficacy and safety in the treatment of non-immunocompromised patients with hospital- and community-acquired pneumonia and skin and soft-tissue infections have been found to be comparable to commonly used present-day antibiotics. It has also been shown to be effective against vancomycin-resistant enterococci and methicillin-resistant Staphylococcus aureus. Linezolid has a wide gram-positive spectrum of activity and is amenable to oral or parenteral administration These attributes make it potentially useful for continuing outpatient therapy that was initiated for inpatients.
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PMID:Linezolid--a new option for treating gram-positive infections. 1098 21

Linezolid (Zyvox--Pharmacia)--the first oxazolidinone antibacterial--is marketed in the UK for treating hospital- and community-acquired pneumonia, skin and soft tissue infections. The manufacturer claims that switching from i.v. to oral administration of linezolid needs no dose adjustment and "will lead to early patient discharge and reduced hospital length of stay" for patients needing treatment for infections caused by Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA). Here, we assess the place of linezolid.
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PMID:Linezolid for gram-positive infections. 1147 17

Linezolid (Zyvox), the first available oxazolidinone antibacterial agent, has good activity against Gram-positive pathogens, including multidrug-resistant organisms such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus faecium. Randomised multicentre trials in patients with various types of serious Gram-positive infections showed that clinical cure rates with linezolid were similar to those with vancomycin or teicoplanin. In some subgroup analyses, which must be interpreted with a degree of caution, clinical advantages were noted for linezolid (e.g. versus vancomycin in confirmed MRSA nosocomial pneumonia and MRSA-complicated skin and soft tissue infections). Although generally well tolerated, gastrointestinal adverse effects are relatively common with linezolid and it has been associated with thrombocytopenia and myelosuppression. The oral bioavailability of linezolid is approximately 100%, thus allowing sequential intravenous-to-oral administration without changing the drug or dosage regimen. Healthcare resource use data from various countries indicate that this practical advantage translates into at least a trend towards reduced length of hospital stay compared with vancomycin, which may offset its several-fold higher acquisition cost. Modelled analyses from the US, despite some limitations, indicate that, compared with vancomycin, linezolid is associated with lower total hospitalisation costs for the treatment of patients with cellulitis and has a favourable incremental cost-effectiveness ratio of approximately US30,000 dollars per QALY gained (2001 value) for patients with ventilator-associated pneumonia. Broadly similar results have also been reported in modelled analyses from other countries. In conclusion, for patients with serious Gram-positive infections, including those caused by suspected or proven multidrug-resistant pathogens such as MRSA, linezolid is an effective and generally well tolerated therapeutic option. Linezolid is currently the only antibacterial agent with good activity against MRSA that can be administered orally (as well as intravenously). It may be particularly useful as an alternative to vancomycin in patients who have impaired renal function, poor or no intravenous access, require outpatient therapy, or who have been unable to tolerate glycopeptides. Healthcare resource use studies and pharmacoeconomic analyses generally support the use of linezolid in some subgroups of patients, although results should be interpreted with due consideration of the study limitations.
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PMID:Linezolid: a pharmacoeconomic review of its use in serious Gram-positive infections. 1615 36

The seventh year of the Zyvox Annual Appraisal of Potency and Spectrum Program (2008) continues to monitor the in vitro activities of linezolid and comparator agents tested against Gram-positive pathogens in Latin America, Europe, Canada, and the Asia-Pacific region. Linezolid is an oxazolidinone approved for the treatment of vancomycin-resistant Enterococcus faecium infections, complicated skin and soft tissue infections, and nosocomial pneumonia caused by various Gram-positive species including methicillin-resistant Staphylococcus aureus (MRSA). Surveillance isolates were submitted from 64 medical centers (24 countries) for a total of 6121 strains. Each country was requested to send 200 consecutive isolates in 6 targeted pathogen categories to a central processing laboratory, except the United Kingdom, Japan, and China where more strains were processed (400, 400, and 800, respectively). Reference broth microdilution susceptibility testing methods were used to test the following organism groups: S. aureus (3240), coagulase-negative staphylococci (CoNS) (748), enterococci (864), Streptococcus pneumoniae (655), viridans group (297), and beta-hemolytic streptococci (317). Eight linezolid-resistant (LZD-R) isolates were detected in 7 countries (Italy [2], France, China, Brazil, Sweden, Germany, and United Kingdom) among the enterococci (Enterococcus faecalis [3] and E. faecium [2]) and CoNS (3 Staphylococcus epidermidis). Five LZD-R isolates contained 23S rRNA mutations (G2576T or G2447T), and 2 strains had undeterminable resistance mechanisms. One CoNS (Italy) contained the mobile cfr gene. Vancomycin-resistant enterococci rates ranged from 0.0% in several countries to 59.4% in Taiwan. All streptococci were linezolid susceptible (MIC(90), 1 microg/mL). In conclusion, the activity of linezolid remained uniform and stable across the sampled geographic regions studied when compared to the 2006 to 2007 results. Documented LZD-R remains rare (only 0.13% overall but highest for CoNS [0.41%] and enterococci [0.69%]) among the 24 countries sampled for the 6 different pathogen groups. Rates of clindamycin resistance and the frequency of MRSA varied by geographic region and between nations; therefore, like oxazolidinones, it requires continued surveillance for changing resistance patterns.
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PMID:Zyvox Annual Appraisal of Potency and Spectrum program: linezolid surveillance program results for 2008. 1991 83