Linezolid for the treatment of postneurosurgical infection caused by methicillin-resistant Staphylococcus

BACKGROUND: Postneurosurgical infection (PNSI) is a major problem. Linezolid is a bacteriostatic oxazolidinone antibiotic with a highly activity against Gram-positive cocci resistant to methicillin and a good cerebrospinal fluid penetration. The purpose of this study is to evaluate the efficacy of linezolid in the treatment of PNSI caused by methicillin-resistant Staphylococcus (MRS). METHODS: We conducted an observational study for all patients over 14 years old and diagnosed with MRS PNSI. Demographic, clinical, and laboratory information were collected prospectively. RESULTS: A total of 10 patients with PNSI (6 meningitis, 2 ventriculitis, and 2 subdural empyema) received linezolid. MRS isolated was Staphylococcus aureus in seven cases and Staphylococcus epidermidis in three cases. All isolated microorganisms were susceptible to vancomycin (minimum inhibitory concentration (MIC) = 2 mg/L) and linezolid (MIC = 1). The rate of microbiologic efficacy was 100% for patients with meningitis or ventriculitis. In the case of subdural empyema, focal infection had improved between 14 and 18 days. No adverse effects occurred during this study. CONCLUSION: Our results suggest that linezolid as an alternative to vancomycin for the treatment of PNSI caused by MRS with a high rate of efficacy.