Linezolid in enterococcal urinary tract infection: a multicentre study

Eur J Clin Microbiol Infect Dis. 2024 Nov;43(11):2107-2115. doi: 10.1007/s10096-024-04923-7. Epub 2024 Aug 21.

Abstract

Purpose: Few data have been published on the efficacy of linezolid in enterococcal urinary tract infection (e-UTI). The aims of this study were to describe the characteristics of patients with enterococci UTI treated with linezolid, and to evaluate the efficacy and the tolerance of linezolid treatment.

Methods: An observational multicentre retrospective study was conducted in 5 hospitals in France. Patients were included if they met the following criteria: ≥18 years, clinical and microbiological criteria for enterococcal UTI and linezolid treatment > 48 h. Primary outcome was clinical failure.

Results: Eighty-one patients were included between January 2015 and December 2021. The median age was 73.0 [64; 83] years and 47 (58%) were men. The median Charlson comorbidity index was 3.00 [2; 6]. E. faecium was reported in 65 (80%) cases and E. faecalis in 26 cases (32%). Polymicrobial infections occurred in 41 (51%) cases. No enterococci was resistant to vancomycin. Before linezolid prescription an empiric antimicrobial treatment was started in 48 (59%) cases and was effective against enterococci in 19/48 (39.5%) patients for a median of 3.5 days [2.0; 4.0]. The median duration of linezolid antibiotic treatment was 13 days [10; 14]. Three adverse events were reported, none were serious but one led to discontinuation of treatment. Treatment failure was reported in 2 cases (2.5%).

Conclusion: This study provides evidence for efficacy and safety of linezolid in enterococcal UTI.

Keywords: Enterococcus faecalis; Enterococcus faecium; Enterococcus; Linezolid; Urinary tract infection.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents* / therapeutic use
  • Enterococcus / drug effects
  • Enterococcus faecalis / drug effects
  • Enterococcus faecium / drug effects
  • Female
  • France
  • Gram-Positive Bacterial Infections* / drug therapy
  • Gram-Positive Bacterial Infections* / microbiology
  • Humans
  • Linezolid* / therapeutic use
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome
  • Urinary Tract Infections* / drug therapy
  • Urinary Tract Infections* / microbiology

Substances

  • Linezolid
  • Anti-Bacterial Agents