Friday April 9, 2010


Q; Bone marrow suppression, characterized particularly by thrombocytopenia (low platelet count), may occur during linezolid treatment but it is reversible. Less frequent side effect of Linezolid are peripheral neuropathy and optic neuropathy. Are they

A) reversible or
B) irreversible?




A; Irreversible


Long-term use of linezolid has also been associated with peripheral neuropathy and optic neuropathy, which is most common after several months of treatment and may be irreversible. Although the mechanism of injury is still poorly understood, mitochondrial toxicity has been proposed as a cause, linezolid is toxic to mitochondria, probably because of the similarity between mitochondrial and bacterial ribosomes.

A more extensive monitoring protocol for early detection of toxicity in seriously ill patients receiving linezolid has been developed and proposed by a team of researchers in Melbourne, Australia. The protocol includes twice-weekly blood tests and liver function tests; measurement of serum lactate levels, for early detection of lactic acidosis; a review of all medications taken by the patient, interrupting the use of those that may interact with linezolid; and periodic eye and neurological exams in patients set to receive linezolid for longer than four weeks.