Abstract
Aims and Objectives
To assess the efficacy of linezolid in the treatment of orthopaedic related infection and the instance of adverse reactions.
Methods
The management of 22 patients treated with oral linezolid for orthopaedic related infections were reviewed. Patients were selected from the hospital database using clinical coding related to orthopaedic infections and all patients were managed within a single tertiary referral centre. These included infected joint arthroplasty (10 patients), infection following fracture fixation (8 patients), septic arthritis and soft tissue infection (non trauma 4 patients). All patients were treated with oral linezolid therapy, and in each case treatment was initiated with the involvement of a microbiologist, as per trust anti-microbial policy. A diagnosis of infection was confirmed on basis of both subjective and objective markers.
Results
77% of patients resolution of infection at follow up (mean length of follow up 28 months) with mean C reactive protein showing a significant (p<0.05) reduction from 123 mg/l to 13.2 mg/l. This included 87.5% resolution in the infection following fracture fixation, 80% in the infected arthroplasty and 75% in the non trauma related infection groups. Adverse reactions were observed in 3 patients.
Conclusion
This study demonstrates linezolid offers an excellent alternative treatment option, along with appropriate surgical management, for the management of orthopaedic related infections, with few adverse side effects. Traditionally, this cohort of patients has required lengthy in hospital admission for intra venous antibiotics. Our study demonstrates that use of linezolid may facilitate early hospital discharge in patients with orthopaedic related infections, since it is 100% bioavailable with oral administration, albeit with regular monitoring of blood parameters.
