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Zyvox
linezolid
Adult Dosing .
Dosage forms: TAB: 600 mg; SUSP: 100 mg per 5 mL; INJ: various
infections, VREF
- [600 mg PO/IV q12h x14-28 days]
- Info: VREF = vancomycin-resistant Enterococcus faecium; limit tyramine food content <100 mg/meal
pneumonia
- [community-acquired]
- Dose: 600 mg PO/IV q12h x7 days; Info: for inpatient tx w/ MRSA; refer to IDSA guidelines; limit tyramine food content <100 mg/meal
- [hospital-acquired or ventilator-assoc.]
- Dose: 600 mg IV q12h x7 days; Info: due to Strep. pneumoniae (incl. MDRSP) or Staph. aureus (incl. MRSA); may extend duration based on clinical response; refer to IDSA guidelines; limit tyramine food content <100 mg/meal
skin/skin structure infections, bacterial
- [complicated]
- Dose: 600 mg PO/IV q12h x10-14 days; Info: incl. MRSA, and diabetic foot infections w/o osteomyelitis; limit tyramine food content <100 mg/meal
- [uncomplicated]
- Dose: 400 mg PO q12h x10-14 days; Info: limit tyramine food content <100 mg/meal
endocarditis (off-label)
- [600 mg IV/PO q12h for at least 6wk]
- Info: for multi-drug resistant enterococcal infection; refer to AHA guidelines; limit tyramine food content <100 mg/meal
tuberculosis, pulmonary (off-label)
- [extensively drug resistant]
- Dose: 600 mg PO qd for up to 26wk; Alt: 1200 mg PO qd for up to 26wk; Info: admin. by directly observed tx; give w/ pretomanid and bedaquiline; see pretomanid pkg insert for toxicity-related dose adjustments, missed dose, and D/C recommendations; may cont. beyond 26wk; limit tyramine food content <100 mg/meal
- [multi-drug resistant]
- Dose: 600 mg PO qd for up to 26wk; Alt: 1200 mg PO qd for up to 26wk; Info: for pts w/ tx-intolerant or nonresponsive infection; admin. by directly observed tx; give w/ pretomanid and bedaquiline; see pretomanid pkg insert for toxicity-related dose adjustments, missed dose, and D/C recommendations; may cont. beyond 26wk; limit tyramine food content <100 mg/meal
anthrax, systemic (off-label)
- [600 mg IV q12h for at least 2wk]
- Info: part of multi-drug regimen; switch to PO abx for post-exposure prophylaxis if inhalational exposure; limit tyramine food content <100 mg/meal
renal dosing
- [no adjustment]
- renal impairment: no adjustment
- HD: no adjustment, on dialysis days admin. after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: no adjustment; supplement not defined
hepatic dosing
- [see below]
- Child-Pugh Class A or B: no adjustment; Child-Pugh Class C: not defined
Peds Dosing .
- Dosage forms: TAB: 600 mg; SUSP: 100 mg per 5 mL; INJ: various
infections, VREF
- [<34 wk gestation, <7 days old]
- Dose: 20 mg/kg/day PO/IV divided q12h x14-28 days; Info: incr. dose to 30 mg/kg/day PO/IV divided q8h by 7 days old or earlier if suboptimal response; VREF = vancomycin-resistant Enterococcus faecium
- [<34 wk gestation, 7 days old and older]
- Dose: 30 mg/kg/day PO/IV divided q8h x14-28 days; Info: VREF = vancomycin-resistant Enterococcus faecium
- [<12 yo]
- Dose: 30 mg/kg/day PO/IV divided q8h x14-28 days; Info: limit tyramine food content <100 mg/meal; VREF = vancomycin-resistant Enterococcus faecium
- [12 yo and older]
- Dose: 600 mg PO/IV q12h x14-28 days; Info: limit tyramine food content <100 mg/meal; VREF = vancomycin-resistant Enterococcus faecium
pneumonia, community-acquired or nosocomial
- [<34 wk gestation, <7 days old]
- Dose: 20 mg/kg/day PO/IV divided q12h x10-14 days; Info: incr. dose to 30 mg/kg/day PO/IV divided q8h by 7 days old or earlier if suboptimal response; due to Strep. pneumoniae or Staph. aureus, incl. MRSA
- [<34 wk gestation, 7 days old and older]
- Dose: 30 mg/kg/day PO/IV divided q8h x10-14 days; Info: due to Strep. pneumoniae or Staph. aureus, incl. MRSA
- [<12 yo]
- Dose: 30 mg/kg/day PO/IV divided q8h x10-14 days; Info: due to Strep. pneumoniae or Staph. aureus, incl. MRSA; limit tyramine food content <100 mg/meal
- [12 yo and older]
- Dose: 600 mg PO/IV q12h x10-14 days; Info: due to Strep. pneumoniae or Staph. aureus, incl. MRSA; limit tyramine food content <100 mg/meal
skin/skin structure infections, complicated bacterial
- [<34 wk gestation, <7 days old]
- Dose: 20 mg/kg/day PO/IV divided q12h x10-14 days; Info: incr. dose to 30 mg/kg/day PO/IV divided q8h by 7 days old or earlier if suboptimal response
- [<34 wk gestation, 7 days old and older]
- Dose: 30 mg/kg/day PO/IV divided q8h x10-14 days
- [<12 yo]
- Dose: 30 mg/kg/day PO/IV divided q8h x10-14 days; Info: limit tyramine food content <100 mg/meal
- [12 yo and older]
- Dose: 600 mg PO/IV q12h x10-14 days; Info: limit tyramine food content <100 mg/meal
skin/skin structure infections, uncomplicated bacterial
- [<34 wk gestation, <7 days old]
- Dose: 20 mg/kg/day PO/IV divided q12h x10-14 days; Info: incr. dose to 30 mg/kg/day PO/IV divided q8h by 7 days old or earlier if suboptimal response
- [<34 wk gestation, 7 days old and older]
- Dose: 30 mg/kg/day PO/IV divided q8h x10-14 days
- [<5 yo]
- Dose: 30 mg/kg/day PO/IV divided q8h x10-14 days; Info: limit tyramine food content <100 mg/meal
- [5-11 yo]
- Dose: 20 mg/kg/day PO/IV divided q12h x10-14 days; Info: limit tyramine food content <100 mg/meal
- [12 yo and older]
- Dose: 600 mg PO q12h x10-14 days; Info: limit tyramine food content <100 mg/meal
anthrax, systemic (off-label)
- [IV route, neonates >32 wk gestation]
- Dose: 20 mg/kg/day IV divided q12h for at least 2wk; Info: part of multi-drug regimen; switch to PO abx x60 days total if inhalational exposure
- [IV route, 1 mo-11 yo]
- Dose: 30 mg/kg/day IV divided q8h for at least 2wk; Max: 600 mg/dose; Info: part of multi-drug regimen; switch to PO abx x60 days total if inhalational exposure
- [IV route, 12 yo and older]
- Dose: 30 mg/kg/day IV divided q12h for at least 2wk; Max: 600 mg/dose; Info: part of multi-drug regimen; switch to PO abx x60 days total if inhalational exposure
- [PO route, neonates >32 wk gestation]
- Dose: 20 mg/kg/day PO divided q12h; Info: not 1st-line agent; part of multi-drug regimen; give after IV tx complete; give x60 days total if inhalational exposure
- [PO route, 1 mo-11 yo]
- Dose: 30 mg/kg/day PO divided q8h; Max: 600 mg/dose; Info: not 1st-line agent; part of multi-drug regimen; give after IV tx complete; give x60 days total if inhalational exposure
- [PO route, 12 yo and older]
- Dose: 30 mg/kg/day PO divided q12h; Max: 600 mg/dose; Info: not 1st-line agent; part of multi-drug regimen; give after IV tx complete; give x60 days total if inhalational exposure
bacterial arthritis, acute (off-label)
- [<12 yo]
- Dose: 30 mg/kg/day IV/PO divided q8h; Info: duration varies by organism, infection severity
- [12 yo and older]
- Dose: 20 mg/kg/day IV/PO divided q12h; Info: duration varies by organism, infection severity
renal dosing
- [see below]
- renal impairment: no adjustment
- HD: 20 mg/kg/day divided q12h, on dialysis days admin. after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: 20 mg/kg/day divided q12h; supplement not defined
hepatic dosing
- [see below]
- Child-Pugh Class A or B: no adjustment; Child-Pugh Class C: not defined