Revision of Linezolid from Apr 21, 2020

Dosing: Adult Antimicrobial Dosing, Non-dialysis

Indication Dose Notes
All Indications 600 mg IV/PO q12h No renal dose adjustment*
Mycobacterial Infections 600 mg IV/PO q24h No renal dose adjustment

*In clinically stable patients with CrCl <30 mL/minute and an anticipated treatment course >10 days, some experts suggest reducing dose to 300 mg IV/PO twice daily after 72 hours to reduce the risk of thrombocytopenia. Therapeutic drug monitoring may be utilized. Contact ID or ID pharmacy for assistance.

Dosing: Antimicrobial Dosing in Intermittent & Continuous Hemodialysis

Indication Dose Notes
All Indications 600 mg IV/PO q12h No dose adjustment in hemodialysis

Dialysis Notes

Intermittent HD assumes high-flux hemodialysis. CRRT assumes CVVHD with ultrafiltration rate 2L/h and residual native GFR < 10 mL/min.  For detailed view of dialysis dosing and evidence, see Dosing in Hemodialysis document.

All use in pediatric patients at UCSF requires approval from the Pediatric Antimicrobial Stewardship Program or pediatric ID physician

All use at ZSFG requires approval by ID pharmacist or ID fellow.

References: