Continuous Infusion of Linezolid Versus Intermittent Dosing in the Treatment of Nosocomial Pneumonia

Efficacy and Safety of Continuous Infusion of Linezolid Compared With Intermittent Dosing in Critically Ill Pneumonic Patients

The investigator's goal in this study is to determine the clinical efficacy and safety of continuous infusion in comparison with standard intermittent infusion.

Prospective randomized controlled clinical trial on critically ill Pneumonic patients, included two groups, over one year period. The first group will be administered intravenous (IV) linezolid 600mg twice daily. The second group will be prescribed linezolid (IV) 600 mg loading dose followed by 1200 mg by continuous infusion. Both groups will be co-administered intravenous (IV) Meropenem 1g every 8 hours empirically.

Inclusion Criteria:

• Patients admitted to ICUs diagnosed as HAP or VAP
• Chest X-ray/ computed tomography showing new or progressive infiltrate.
• New onset of purulent sputum or change in sputum character.
• Body temperature greater than 38 ℃ or less than 35.5℃.
• White blood cell counts greater than 10000 /mm3 or less than 4000 /mm3.
• Significant quantitative pathogen cultures from respiratory secretions.

Exclusion Criteria:

• Age <18 years, Pregnancy, Lactation
• Previous known allergic reaction to linezolid
• Creatinine Clearance (CrCl) <10 mL/min, calculated according to the Cockcroft-Gault formula
• Thrombocytopenia (platelet count less than 80,000/mm3)
• Severe hepatic failure (Child-Pugh C)
• Concomitant treatment with other drugs that can potentially interfere with Linezolid (i.e., macrolides, serotonin modulators, omeprazole)
• Acute DIC score > 4 points or hematological disorder
• Concurrent drug-associated Thrombocytopenia