Linezolid for treatment of subdural empyema due to Streptococcus: case reports.

Abstract

BACKGROUND:

Recurring subdural empyema despite adequate surgical drainage and antibiotic treatment is still a life-threatening disease. This is mainly due to poor diffusion of the antibiotic into the subdural space.

CASE DESCRIPTION:

We report 2 cases of recurring subdural empyema due to Streptococcus, after repeat surgery and high-dose antibiotic treatment including beta-lactamines and vancomycin. Both patients showed marked clinical and radiologic improvement after introduction of linezolid. There was no drug-related adverse effect despite 36 and 90 days of treatment.

CONCLUSION:

Off-label use of linezolid for treatment of subdural empyema due to gram-positive bacteria should be considered after failure of conventional antibiotic treatment.

• Authors: Laurent Lefebvre, Philippe Metellus, Henry Dufour, Nicolas Bruder
• Journal: Surgical neurology (Surg Neurol) Vol. 71 Issue 1 Pg. 89-91; discussion 91 (Jan 2009) ISSN: 0090-3019 [Print] United States
• PMID: 18262639 (Publication Type: Case Reports, Journal Article)

Chemical References

• Acetamides
• Anti-Bacterial Agents
• Oxazolidinones
• Vancomycin
• Linezolid

Topics

• Acetamides (adverse effects, therapeutic use)
• Adolescent
• Anti-Bacterial Agents (adverse effects, therapeutic use)
• Brain Neoplasms (complications)
• Drainage
• Empyema, Subdural (drug therapy, microbiology, surgery)
• Facial Injuries (complications)
• Female
• Humans
• Linezolid
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Mydriasis (etiology)
• Neurosurgical Procedures
• Oxazolidinones (adverse effects, therapeutic use)
• Paresis (etiology)
• Seizures (etiology)
• Streptococcal Infections (drug therapy, microbiology)
• Subdural Space (metabolism)
• Vancomycin (therapeutic use)