Linezolid Bladder Irrigation as Adjunctive Treatment for a Vancomycin-Resistant Enterococcus faecium Catheter-Associated Urinary Tract Infection

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Abstract

Objective: To describe the first reported successful use of adjunctive linezolid bladder irrigation. Case Summary: An 89-year-old woman with 10% TBSA burns developed septic shock and anuric acute kidney insufficiency. She acquired a urinary tract infection caused by vancomycin-resistant Enterococcus faecium (VREfm). Based on clinical status, a linezolid bladder irrigation was initiated in addition to high-dose intravenous linezolid and demonstrated microbiological cure with 7 days of treatment. Discussion: Linezolid is primarily hepatically cleared and has no labeled indication for urinary tract infections. Anuria adds an additional complication of potentially reduced urinary drug concentrations. Bladder irrigation offers the benefit of achieving high local drug concentrations, but there are no data regarding such a route for linezolid. This case report is the first demonstrating the use, stability, safety, and efficacy of linezolid as a continuous bladder irrigation. Conclusions: Linezolid use as a bladder irrigation may be a feasible route of administration in anuric, critically ill patients with VREfm and few antimicrobial options. Further studies are warranted.

Original languageEnglish (US)
Pages (from-to)250-253
Number of pages4
JournalAnnals of Pharmacotherapy
Volume49
Issue number2
DOIs
StatePublished - Jan 1 2015

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Linezolid
Catheter-Related Infections
Enterococcus faecium
Urinary Tract Infections
Urinary Bladder
Therapeutics
Anuria
Septic Shock
Vancomycin-Resistant Enterococci
Burns
Acute Kidney Injury
Critical Illness
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)

Cite this

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title = "Linezolid Bladder Irrigation as Adjunctive Treatment for a Vancomycin-Resistant Enterococcus faecium Catheter-Associated Urinary Tract Infection",
abstract = "Objective: To describe the first reported successful use of adjunctive linezolid bladder irrigation. Case Summary: An 89-year-old woman with 10{\%} TBSA burns developed septic shock and anuric acute kidney insufficiency. She acquired a urinary tract infection caused by vancomycin-resistant Enterococcus faecium (VREfm). Based on clinical status, a linezolid bladder irrigation was initiated in addition to high-dose intravenous linezolid and demonstrated microbiological cure with 7 days of treatment. Discussion: Linezolid is primarily hepatically cleared and has no labeled indication for urinary tract infections. Anuria adds an additional complication of potentially reduced urinary drug concentrations. Bladder irrigation offers the benefit of achieving high local drug concentrations, but there are no data regarding such a route for linezolid. This case report is the first demonstrating the use, stability, safety, and efficacy of linezolid as a continuous bladder irrigation. Conclusions: Linezolid use as a bladder irrigation may be a feasible route of administration in anuric, critically ill patients with VREfm and few antimicrobial options. Further studies are warranted.",
author = "Hill, {David M.} and Wood, {G Christopher} and William Hickerson",
year = "2015",
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language = "English (US)",
volume = "49",
pages = "250--253",
journal = "Annals of Pharmacotherapy",
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T1 - Linezolid Bladder Irrigation as Adjunctive Treatment for a Vancomycin-Resistant Enterococcus faecium Catheter-Associated Urinary Tract Infection

AU - Hill, David M.

AU - Wood, G Christopher

AU - Hickerson, William

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Objective: To describe the first reported successful use of adjunctive linezolid bladder irrigation. Case Summary: An 89-year-old woman with 10% TBSA burns developed septic shock and anuric acute kidney insufficiency. She acquired a urinary tract infection caused by vancomycin-resistant Enterococcus faecium (VREfm). Based on clinical status, a linezolid bladder irrigation was initiated in addition to high-dose intravenous linezolid and demonstrated microbiological cure with 7 days of treatment. Discussion: Linezolid is primarily hepatically cleared and has no labeled indication for urinary tract infections. Anuria adds an additional complication of potentially reduced urinary drug concentrations. Bladder irrigation offers the benefit of achieving high local drug concentrations, but there are no data regarding such a route for linezolid. This case report is the first demonstrating the use, stability, safety, and efficacy of linezolid as a continuous bladder irrigation. Conclusions: Linezolid use as a bladder irrigation may be a feasible route of administration in anuric, critically ill patients with VREfm and few antimicrobial options. Further studies are warranted.

AB - Objective: To describe the first reported successful use of adjunctive linezolid bladder irrigation. Case Summary: An 89-year-old woman with 10% TBSA burns developed septic shock and anuric acute kidney insufficiency. She acquired a urinary tract infection caused by vancomycin-resistant Enterococcus faecium (VREfm). Based on clinical status, a linezolid bladder irrigation was initiated in addition to high-dose intravenous linezolid and demonstrated microbiological cure with 7 days of treatment. Discussion: Linezolid is primarily hepatically cleared and has no labeled indication for urinary tract infections. Anuria adds an additional complication of potentially reduced urinary drug concentrations. Bladder irrigation offers the benefit of achieving high local drug concentrations, but there are no data regarding such a route for linezolid. This case report is the first demonstrating the use, stability, safety, and efficacy of linezolid as a continuous bladder irrigation. Conclusions: Linezolid use as a bladder irrigation may be a feasible route of administration in anuric, critically ill patients with VREfm and few antimicrobial options. Further studies are warranted.

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