Linezolid gets into everywhere, including the pleural space! #clinmicro #IDSky #AMR @bsacandjac.bsky.social academic.oup.com/jac/advance-... - ThreadSky

gpollara.bsky.social • 70 days ago

Linezolid gets into everywhere, including the pleural space!
#clinmicro #IDSky #AMR @bsacandjac.bsky.social

https://academic.oup.com/jac/advance-article-abstract/doi/10.1093/jac/dkae444/7932790?redirectedFrom=fulltext&utm_source=advanceaccess&utm_campaign=jac&utm_medium=email

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tbrnaughttb.bsky.social•70 days ago

one of my faves <3

zacrobid.bsky.social•70 days ago

It’s fantastic. Still too many docs putting patients into SSRI withdrawal for a minuscule risk of serotonin toxicity!

catherineberry.bsky.social•70 days ago

Don't get me started. We use smaller doses in TB and have done for a long time and I still see SSRI as a contraindication.

mikejohansenmd.medsky.social•70 days ago

Do we know the actual risk; I view the problem more with board exams than anything else. It's like the thing that would be asked about linezolid on a board exam.

zacrobid.bsky.social•70 days ago

Great point. We have created this word association. I say linezolid, you immediately say serotonin syndrome.

eliowa.bsky.social•69 days ago

Some data showing it’s at most rare https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2799688

redneeraj.bsky.social•69 days ago

📌

drfreeze.bsky.social•69 days ago

This is a FFICM question…

sebpoule.bsky.social•70 days ago

*docs or pharmacists

zacrobid.bsky.social•70 days ago

Very true.

jgpharmd.bsky.social•70 days ago

^motivated by fear of lawyers

zacrobid.bsky.social•70 days ago

True. That’s why I’m going back to get my JD. Get CAP treatment for 10 days and got CDiff? Call 1-800-POO-SAVE. Maybe that will change practice 😎

rdrpharmacist.bsky.social•70 days ago

It would be awesome if we taught anything beyond “instant death and career-ending lawsuit” about these things.

jgpharmd.bsky.social•69 days ago

Balancing risk and benefit is not taught well, at least in pharmacy schools. I imagine it is better is medical schools since physicians often see the direct benefits and harms from actions they perform, where pharmacists are usually a step removed and focused on a safety-check role.

sebpoule.bsky.social•70 days ago

💯

alanplotzker.bsky.social•70 days ago

And CSF. I’ve still never heard a great explanation for why we don’t use it in meningitis

gpollara.bsky.social•70 days ago

We certainly use it judiciously in confirmed CNS infections.

jgpharmd.bsky.social•70 days ago

Indeed - can confirm with n=1 of pts that we had linezolid concentrations drawn from pleural fluid.

anniejoseph.bsky.social•70 days ago

📌

dobbyjog.medsky.social•70 days ago

What about in yer pee? 🤭

gpollara.bsky.social•70 days ago

Gets into renal parenchyma. Off top of head tho, not sure re urine excretion. Feel like I should know though!!!

(exhausted after weekend on call - team #UTISky help please)

cmcurtis.bsky.social•70 days ago

Yes it does. It gets everywhere.

gpollara.bsky.social•70 days ago

Excellent, thank you!

For what it covers, and while the bone marrow holds up, it's a great drug! 💪

joshosowicki.bsky.social•69 days ago

We’ve used TDM to support very early oral switch and long marrow-friendly courses in kids with bad infections (e.g. MRSA brain abscess).

phillipaburns.bsky.social•70 days ago

I do wonder if the favourable outcomes we see in PWID infection is mainly because linezolid is just so much better for complex SA infection. Now, where is that study?!?

ssvar.bsky.social•69 days ago

📌

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