Successful treatment of chronic bone and joint infections with oral linezolid

Clin Orthop Relat Res. 2004 Oct:(427):67-71. doi: 10.1097/01.blo.0000144860.11193.5e.


Linezolid is an attractive alternative for the treatment of chronic bone and joint infections because it is active against common pathogens including methicillin-resistant staphylococci and vancomycin-resistant enterococci and because its oral formulation is convenient for long-term administration. To evaluate the ability of linezolid to produce long-term remission, we prospectively monitored 11 consecutive adult patients who received linezolid for osteomyelitis (n = 9) or prosthetic joint infection (n = 2). Linezolid 600 mg was administered orally twice daily for a mean of 10 weeks (range, 6 to 19 weeks). Pathogens were methicillin-resistant Staphylococcus aureus (n = 5), methicillin-resistant coagulase-negative staphylococci (n = 4), vancomycin-resistant Enterococcus faecium (n = 1), and vancomycin-sensitive Enterococcus faecalis (n = 1). After a mean followup of 27 months (range, 17 to 41 months), all 11 patients had remission by clinical, laboratory, and radiographic criteria. During week 8 of linezolid treatment, one patient developed a gram-negative superinfection, which resolved with appropriate therapy. During week 6 of linezolid treatment, one patient developed mild thrombocytopenia and another patient developed mild anemia. Both episodes of myelosuppression were reversible within 10 days after completing the planned 6-week courses of linezolid. We recommend weekly complete blood counts to detect hematologic abnormalities. We conclude that oral linezolid seems to be a useful and convenient alternative for the treatment of bone and joint infections.

Publication types

  • Clinical Trial

MeSH terms

  • Acetamides / administration & dosage*
  • Administration, Oral
  • Adult
  • Aged
  • Anti-Infective Agents / administration & dosage*
  • Chronic Disease
  • Female
  • Follow-Up Studies
  • Humans
  • Linezolid
  • Male
  • Middle Aged
  • Osteomyelitis / drug therapy*
  • Osteomyelitis / microbiology*
  • Oxazolidinones / administration & dosage*
  • Prospective Studies
  • Prosthesis-Related Infections / drug therapy*
  • Remission Induction


  • Acetamides
  • Anti-Infective Agents
  • Oxazolidinones
  • Linezolid