Linezolid in the treatment of methicillin-resistant staphylococcal post-neurosurgical meningitis: a series of 17 cases

Scand J Infect Dis. 2011 Oct;43(10):757-64. doi: 10.3109/00365548.2011.585177. Epub 2011 Jun 15.

Abstract

Background: Linezolid is a bacteriostatic antibiotic with good cerebrospinal fluid penetration. The aim of this study was to evaluate the efficacy of linezolid in methicillin-resistant staphylococcal (methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus (MRCoNS)) meningitis.

Methods: We extracted data and outcomes for all adult patients (age > 18 y) with culture-proven MRSA or MRCoNS meningitis treated with linezolid between January 2006 and September 2010 in our hospital. Demographic, clinical, and laboratory data and predisposing factors, as well as information on response to treatment and outcome were obtained by regular visits.

Results: A total of 17 cases (9 MRCoNS, 7 MRSA, and 1 MRCoNS and MRSA mixed) fulfilled the inclusion criteria. All patients had hospital-acquired meningitis and had undergone neurosurgery. Cumulative microbiological success on day 5 was 88%. There was 1 staphylococcal meningitis-related death. There were no severe adverse events.

Conclusions: Our experience with linezolid suggests that it can be an alternative for the treatment of MRCoNS- and MRSA-related meningitis.

MeSH terms

  • Acetamides / adverse effects
  • Acetamides / therapeutic use*
  • Adult
  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / therapeutic use*
  • Cross Infection / drug therapy*
  • Cross Infection / microbiology
  • Female
  • Humans
  • Linezolid
  • Male
  • Meningitis, Bacterial / drug therapy*
  • Meningitis, Bacterial / microbiology
  • Methicillin-Resistant Staphylococcus aureus / drug effects*
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification
  • Neurosurgical Procedures
  • Oxazolidinones / adverse effects
  • Oxazolidinones / therapeutic use*
  • Postoperative Complications / drug therapy
  • Postoperative Complications / microbiology
  • Prosthesis-Related Infections / drug therapy
  • Prosthesis-Related Infections / microbiology
  • Retrospective Studies
  • Staphylococcal Infections / drug therapy*
  • Staphylococcal Infections / microbiology

Substances

  • Acetamides
  • Anti-Bacterial Agents
  • Oxazolidinones
  • Linezolid