Monitoring linezolid blood concentrations
Standard adult doses of linezolid may result in underexposure or overexposure in specific patient populations as there is significant pharmacokinetic variabilityCattaneo 2016.
Linezolid plasma concentration monitoring is recommended in patients whoAbdul-Aziz 2020Rao 2020:
- are older than 80 years
- have abnormal kidney or liver function
- are critically ill
- have cystic fibrosis
- have a mycobacterial infection
- are young children
- may require prolonged therapy (more than 2 weeks).
Generally, the linezolid plasma concentration is measured 2 days after starting therapy; a target trough concentration range of 2 to 7 mg/L is suggestedAbdul-Aziz 2020Rao 2020. Linezolid toxicity (eg lactic acidosis, bone marrow suppression, neuropathy) has been associated with trough concentrations higher than 7 mg/L. For complicated infections, seek expert advice on calculating the area under the concentration–time curve over a 24-hour period (AUC24) to the minimum inhibitory concentration (MIC) ratio (AUC24/MIC).
See Practical information on using linezolid for information on clinical monitoring for linezolid.
For information on monitoring linezolid concentrations, see the International Association for Therapeutic Drug Monitoring and Clinical Toxicology position paper.