The incidence of Linezolid induced lactic acidosis in post GIT-operative patients.

Abstract

Linezolid is antibiotic belonging to oxazolidinones group. It acts by protein synthesis inhibition and has clinical utility in the treatment of infections caused by resistant aerobic Gram-positive bacteria (as methicillin- resistant S. aureus (MRSA), Vancomycin Resistant Enterococci (VRE), and mycobacterial infections). LZD inhibits bacterial protein synthesis by binding to residues within the 23S ribosomal RNA of the 50S large subunit of bacterial ribosomes. Linezolid induced lactic acidosis is currently a documented adverse event associated with Linezolid treatment. The underlying mechanism may be related to mitochondrial dysfunction. LZD binds to mammalian ribosomes, leading to decrease in the activity of respiratory chain complexes containing mitochondrial DNA-encoded subunits and a decrease in the amount of protein of these complexes due to obvious similarities between bacterial ribosomes and mammalian cytoplasmic ribosomes. The current study was conducted to evaluate the incidence of linezolid induced lactic acidosis in post GIT-operative patients. The study was carried on 150 patients admitted to ICU after gastro intestinal tract surgery. Patients were divided into two groups: those who used LZD and those who used vancomycin with 75 patients in each group. Patients with other risk factors for lactic acidosis were excluded from the study. The results of arterial blood gases at day 0 before administration of drug, and daily after drug administration were recorded from patients’ charts. Daily hemodynamic measurements (blood pressure, pulse rate and temperature), fluid balance, urine output and CVP were also recorded daily.